Department of Oral Public Health Institute of Dentistry Faculty of Medicine University of Helsinki Helsinki, Finland Oral health behaviour, conditions and care among dentate elderly patients in Lithuania: preventive aspects Sonata Vyšniauskaite Academic dissertation To be presented with the permission of the Faculty of Medicine of the University of Helsinki, for public discussion in the main auditorium of the Institute of Dentistry, Mannerheimintie 172, Helsinki, on 11 December, 2009 at noon Helsinki 2009 Supervisor: Adjunct Professor Miira M Vehkalahti, DDS, PhD Department of Oral Public Health Institute of Dentistry University of Helsinki Helsinki, Finland Reviewers: Professor Matti Knuuttila, DDS, PhD Department of Periodontology and Geriatric Dentistry Institute of Dentistry University of Oulu Oulu, Finland and Professor Timo Närhi, DDS, PhD Department of Prosthetic Dentistry and Biomaterial Science Institute of Dentistry University of Turku Turku, Finland Opponent: Professor Angus WG Walls, BDS, PhD School of Dental Sciences University of Newcastle Newcastle upon Tyne, UK ISBN: 978-952-92-6312-7 (paperback) ISBN: 978-952-10-5811-0 (PDF) Yliopistopaino 2009 electronic version available at: http//:ethesis.helsinki.fi In the ancient is wisdom, and in length of days, prudence (Job 12: 12) To Valerija and Alfonsas, my grandparents, bright lights among the elderly LIST OF ORIGINAL PUBICATIONS I S Vyšniauskait÷, N Kammona and M.M Vehkalahti Number of teeth in relation to oral health behavior in dentate elderly patients in Lithuania Gerodontology 2005; 22: 44-51 II S Vyšniauskait÷ and M.M Vehkalahti First-time dental care and the most recent dental treatment in relation to utilization of dental services among dentate elderly patients in Lithuania Gerodontology 2006; 23: 149-156 III S Vyšniauskait÷ and M.M Vehkalahti Professional guidance on and self-assessed knowledge of oral self-care as reported by dentate elderly patients in Lithuania Oral Health & Preventive Dentistry 2007; 5: 193-199 IV S Vyšniauskait÷ and M.M Vehkalahti Impacts of tooth brushing frequency on periodontal findings in a group of elderly Lithuanians Oral Health & Preventive Dentistry 2009; 7: 129-136 The articles are not included in the e-thesis In addition, some unpublished data are presented ABSTRACT Vyšniauskaite S Oral health behaviour, conditions and care among dentate elderly patients in Lithuania: preventive aspects Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Helsinki, Finland, 2009 72 pp ISBN 978-952-92-6312-7 The present cross-sectional study aimed to assess oral health behaviour, dental and periodontal conditions, dental care, and their relationships among elderly dentate patients in Lithuania The target population in the study were dentate patients aged 60 and older attending public dental services in Kedainiai, Lithuania The data collection took place between the autumn of 1999 and the winter of 2001 Data were collected by means of a self-administered questionnaire for all (n=174) and a clinical examination targeting about half of the subjects (n=100) The questionnaire inquired about oral health behaviour, the life-first and also the most recent dental treatments, sources on and self-assessed knowledge of oral self-care, a self-reported number of teeth, and socio-demographic information The clinical examination included basic dental and periodontal conditions A total of 82 women and 92 men completed the questionnaire; their mean age was 69.2 and their average number of teeth was 16.2 (CI 95% 15.4-17.1) In all, 25% had 21 or more teeth and 32% indicated wearing removable dentures The oral health behaviour, the participants reported, was poor: 30% reported twice daily toothbrushing, 57% responded that they always use fluoride toothpaste, 19% indicated daily interdental cleaning, nearly all said they take sugar in their coffee and tea, and 30% indicated going for check-ups As the main source of information on oral self-care, the subjects indicated health professionals (82%), followed by social contacts (72%), broadcasted media (58%), and printed media (42%) A total of 34% assessed their knowledge of oral self-care as good, and their self-assessed knowledge correlated (r=0.52) with professional guidance they had received about oral self-care In their most recent treatment, conservative (39%) and non-conservative (34%) treatments dominated, and preventive ones were the least reported (7%) Regarding guidance in oral self-care, 54% reported having received such about toothbrushing, 32% about interdental cleaning, and 33% had been given visual information Clinical examinations revealed the presence of plaque, calculus, bleeding on probing and deepened pockets in all of the subjects; 70% of the subjects were diagnosed with pockets of 6mm and deeper, 94% with caries, and 73% with overhangs of restorations Those subjects assessing their knowledge of oral self-care as good and reporting a higher intensity of guidance in oral self-care as received, indicated practicing the recommended oral self-care more frequently Twice daily toothbrushing was associated with good selfassessed knowledge of oral self-care (OR 4.1, p