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Objective The aim of this study was to compare the perceived oral health of elderly persons and the clinical reality of their oral status. Background Persons aged over 60 have considerable need for oral health care; a need that increases over time. However, this population appears to be unaware of their state of oral health, and this may be a further obstacle to professional management. We thought it useful to examine the objective and the perceived oral health of these patients. Understanding what may influence their perception can help us to improve their management. Methods The data analyzed in this work are the findings of a field survey carried out in elderly nursing home residents. Their objective oral health was evaluated by using two variables: oral profile, determined by clinical examination, and the oral health index determined using the Oral Health Assessment Tool (OHAT). Perceived oral health was evaluated using the various categories and fields of the General Oral Health Assessment Index (GOHAI). Results Our clinical study showed a discrepancy between perceived oral health and the clinical reality: although a significant association can be demonstrated between the OHAT and the GOHAI, there are considerable variations. It also appeared that the number of teeth and total edentation considerably influence perceived oral health and that findings vary according to different situations. Conclusion Numerous factors influence elderly persons' perception of their true oral health. In order to improve our elders' quality of life, the necessary measures must be taken for the follow-up and regular monitoring of their oral health. At the same time, all possible means should be used and awareness should be raised to improve the health behavior and perception of patients and their entourage.

Gérald Maille,1,2 Bérengère Saliba-Serre,1 Anne-Marie Ferrandez,1 Michel Ruquet1,2 1UMR 7268 ADÉS, Aix-Marseille Université–EFS–CNRS, Faculté de Médecine Nord, 2Faculté d’Odontologie, Aix-Marseille Université, Marseille Cedex, France Objective: We aimed to analyze, from the data in a national survey, the use of oral care and the oral health status of patients living at home or in an institution.Background: Patients aged 60 years and older have important oral health needs, but their oral management may differ according to their immediate environment. The fact of living at home or in an institution can influence the use of care and alter the patients’ perception of their oral health status.Methods: The data analyzed were taken from a survey on disability and health carried out in 2008–2009, which is representative of the population living in France. It consists of two sections, one centered on disability and health among home-dwellers and the other on patients living in an institution. In each of these two populations, we carried out descriptive analysis of three themes: use of care, forgoing of care, and oral health.Results: Although visits to physicians and specialists were frequent, visits to dentists were lower in both populations. While a minority of patients forwent care, it was dental care that was mainly forgone by both home-dwellers and institutionalized patients. The cost factor remained the principal reason, but other factors such as fear or accessibility problems were cited. Use of a dental appliance was considerably more frequent among institutionalized patients than among home-dwellers, with just over half the institutionalized population wearing a dental appliance. Perceived state of oral health remained difficult to interpret.Conclusion: To improve access to oral care for the elderly, the patients, their entourage and health providers need increased awareness and information on the importance of good oral health. Better information must be associated with regular clinical examination. Keywords: dental care, health care access, elderly, home-dwellers, community-dwellers, institution, national Disability and Health Survey, France