Background

In September 2016, Japan’s graying population reached a level where 27.3% (34.61 million) of the total population was 65 years or older, as announced by the Statistics Bureau of the Ministry of Internal Affairs and Communications. Of the older adults, over 6 million people or approximately 20% require long-term care. These elderly people have difficulty attending clinics, which easily results in worsening of intraoral conditions. Meanwhile, the prevalence of dental implants is rising; the Survey of Dental Diseases for fiscal year 2011 reported that 3% of older adults have implants. However, the 4253 survey respondents included only 1510 older adults, and older people who were institutionalized in long-term care homes were excluded from the research. Therefore, the results of the survey have not yet revealed a comprehensive picture of the status of dental implants in the elderly population receiving long-term care.

Treatment with implants in itself has been successfully performed even in older adults and people with disabilities as long as the patients are appropriately managed. It is likely that older adults who are receiving long-term care and unable to travel to the dentist’s office have difficulty continuing to perform oral self-care and receive professional oral care due to the complexity of the form of prosthesis and the problem of the implant placement. Accordingly, in a study of three case reports, Visser et al. indicated the importance of considering the following aspects: “Is the patient supported by a well-functioning oral (self) care assisting network?” and “Is it possible for the patient to regular see an oral health care professional and is oral health care easily accessible in cases of an emergency?”. In addition, for the fixed implant prosthetic devices which have been selected for the patient who is getting old, the original prosthetic devices have to be removed and may be changed to removable prosthetic devices or submerged implants when self-care becomes difficult or when having trouble with the prosthetic device. However, if the manufacturers or type of the implants in patients are not sure, it might be difficult to change the design of the prosthesis.

Therefore, a survey was carried out to investigate the rate of having received implant treatment in receiving long-term care or home-visit dental care patients and the actual status of oral self-care, as well as the actual status of post-operative care by the dentist who placed the implants, in homebound or institutionalized older adults who are receiving home-visit dental care due to the inability to visit a dental clinic on their own. Additionally, usage status and recognition of the implant card (it refers to the card which described the record of implant placed in the patient, such as the implant manufacturer, implant type, length, diameter), which contains information on the implanted implant and may contribute to continuing post-operative implant care, were surveyed.