Dental Treatment Needs in Older Adults Undergoing Acute Geriatric Care: A Cross-Sectional Observational Study of Clinical Need and Patient-Reported Wish for Dental Treatment

Background/Objectives: Dental care is not routinely integrated into acute geriatric complex treatment, although older inpatients often present with substantial oral disease. This study assessed dental treatment needs, their relationship with patients’ expressed wish for dental treatment, and their association with oral health-related quality of life (OHRQoL). Methods: In this cross-sectional observational study, patients undergoing acute geriatric complex treatment at a university hospital in Germany (April 2023 to September 2024) were included if able to provide valid self-reported data. Standardized bedside dental examinations were performed by calibrated dentists without radiographs. Treatment needs were categorized as restorative, periodontal, surgical, and prosthodontic. General health and geriatric data were obtained from medical records. Patients reported their wish for dental treatment and completed the General Oral Health Assessment Index (GOHAI). Results: A total of 214 hospitalized older adults (mean age 82 ± 6 years; 58.4% female) were included. Overall, 94.9% showed clinically assessed dental treatment needs; however, most were elective or functionally relevant, while medically urgent needs (e.g., extraction indications) were identified in 26.7% of dentate patients. The most frequent categories were periodontal (93.2%) and prosthodontic (67.7%) treatment need. No significant association was found between clinically assessed treatment need and patient-reported wish for dental treatment. In exploratory analyses, surgical treatment need and supportive living environments were associated with treatment wish, although model fit was limited. Prosthodontic treatment need, lower functional oral intake, and institutional living were associated with lower OHRQoL. Conclusions: Dental treatment needs are highly prevalent in older adults undergoing acute geriatric complex treatment but are not consistently reflected by patient-reported wish for treatment during hospitalization. These findings indicate a mismatch between clinical assessment and patient-reported preferences. Interpretation is limited by the cross-sectional design and the use of a single dichotomous measure of treatment wish.