Oral health status and related conditions among Norwegian nursing home residents – a cross-sectional study

An increasing number of older individuals are retaining their natural teeth, yet oral hygiene remains a neglected area of care, particularly among vulnerable and care-dependent older adults. Poor oral health is linked to systemic conditions and cognitive decline, affecting quality of life and healthy ageing. Understanding the burden of oral diseases and its association with systemic conditions is essential to raise awareness among non-dental healthcare providers and improve integration of oral health into national healthcare programmes. The aims of this study were to 1) assess, through clinical examination, the oral hygiene status and number of retained teeth among a sample of Norwegian nursing home residents, and 2) identify resident-level factors, including systemic conditions associated with oral hygiene status, in order to inform a more targeted oral care strategy. A cross-sectional study was conducted among 309 older adults residing in 12 nursing homes in a county in western Norway. Clinical oral examinations were performed by trained dental personnel using intraoral mirrors and a portable headlamp. Oral hygiene was assessed with the mucosal – plaque score (MPS), alongside denture type, and number of natural teeth. Sociodemographic and medical data were obtained from patient journals. Of the participants, 12% were edentulous, and 55% had a functional number of teeth (≥ 20). Nevertheless, 55% exhibited unacceptable oral hygiene. Residents with 1–9 teeth had the highest odds of good oral hygiene (OR = 9.86, p < 0.001), whereas the odds diminished and were not statistically significant among those with full or near-full dentition (i.e., ≥ 26) (OR = 1.79, p = 0.265). Cardiovascular disease (OR = 0.26, p < 0.001) was associated with lower odds of good oral hygiene, while multimorbidity (OR = 2.42, p = 0.031) was associated with higher odds. Despite increased tooth retention poor oral hygiene remains prevalent among nursing home residents, with declining odds of good oral hygiene among those with more retained teeth suggesting that greater tooth retention places additional demands on daily oral hygiene routines. Systemic conditions were significantly associated with oral hygiene status, in differing directions, however these associations are exploratory and should be interpreted with caution.