The underdetection of pain of dental etiology in persons with dementia

Background. The detection of dental pain in persons suffering from dementia has not yet been investigated. Subjects and methods. Twenty-one nursing home residents with a mean age of 88 participated in this study. Nine rotating volunteer dentists came to the nursing home to conduct dental evaluations. Two outside geriatricians performed a second assessment, and additional information concerning dental status was obtained from the minimum data set (MDS). Results. Over 60 percent of assessed participants were considered to have a pain-causing condition. Less than half of these were rated by the geriatricians as having dental-related pain. Only one participant was rated to have dental or mouth pain on the MDS. Only one of the 18 persons with either a full or partial evaluation had no dental problems. Conclusions. Dental problems are underdetected and undertreated in the nursing home. Better training for non-dentists in detection of such problems and better reimbursement for dental care are needed to improve care of residents.