2006 Volume 5 Issue 1 Pages 52-56
Purpose: Multifactorial interventions to prevent falls are relatively less effective in the elderly with dementia. We hypothesize that the primitive posture reflex associated with dental occlusion may play an important role in preventing falls in elderly persons with dementia. To demonstrate this, we compared the incidence of falls in individuals with and without dental occlusion.
Methods: This study was conducted at a special geriatric hospital for patients with severe dementia in Hiroshima, Japan. One hundred and forty-six ambulatory institutionalized elderly subjects (42 male and 104 female; mean age, 82.2 y) were divided into three groups on the basis of oral examinations: Group A, premolar and molar occlusion was maintained by natural dentition; Group B, occlusion was maintained by partial or full denture(s); and Group C, occlusion was not maintained by either natural or prosthetic teeth. Each subject was classified into either the "High Falls" (history of two or more falls during the previous one year) or "Low Falls" (history of one or no fall during the previous one year) category. In addition, a small pilot study was conducted to investigate the prevalence of falls in edentulous individuals within one year following denture delivery.
Results: During the 1-year investigation period, 41 of the 146 subjects had recurrent falls and the dental occlusion status was found to be significantly different between the "High Falls" group and the "Low Falls" group (P<0.0001). In the "High Falls" group, 10 subjects had dentures; of these, three patients were excluded because of a comatose condition or death from old age, and the remaining 7 patients experienced fewer falls during the one-year follow-up.
Conclusion: These findings suggest that dental occlusion with either natural or prosthetic teeth may play an important role in maintaining the postural reflex and preventing falls in the elderly with dementia.