Assessment of Knowledge and Attitudes to Preserve Oral Health among Older People Aged 60+ in FYROM

Download Article

1 / F. Tozja2

1PZU “ProdentIdadija”, Skopje
2Institute of Public Health, Faculty of Medicine, Skopje, FYROM


Introduction. In the last decade, the impact of oral health on overall health status in the elderly has attracted considerable attention. Elderly people are often not aware that oral diseases and tooth loss can be prevented. Oral health behaviour involves acquisition of individual habits for preservation and maintenance of oral health, such as regular brushing and brushing teeth, using fluoride-rich toothpastes and dental floss, reducing sugar in the diet and habit of regular visits to the dentist. The aim of this research was to assess knowledge and attitude toward maintenance and preservation of oral health in people over 60 years in FYROM.

Methods. This is a cross-sectional study of the population, older than 60 years in FYROM, who use dental services and treatment in public health institution, at the Faculty of Dentistry in Skopje (Clinic of Mouth and Periodontal Diseases) and in the Health Centre in Skopje. As an instrument of this research, a questionnaire which included issues related to oral health behaviour was used for the targeted population. 193 patients answered the questions in this questionnaire.

Results. The age of respondents was significantly associated with the frequency of brushing their teeth and interdental spaces, as well as the habits of frequent dental care visits to the dentist. The gender of the patients had a highly significant effect on the use of fluoride toothpastes and the time that had passed since their last visit to the dentist (p<0.01). Education level in elderly patients significantly affected the knowledge of the individual oral health care.

Conclusion. Respondents with higher education brushed their teeth and interdental spaces more frequently and had regular dental check-ups. Furthermore, they almost always used fluoride toothpaste when brushing their teeth. The increased concern for their own health correlated to a higher level of knowledge, awareness and attitudes about oral health care, and follow recommendations by a dentist. In FYROM, oral health behaviour of patients above 60 years is far behind the levelof care that is achieved in higher developed countries.

Keywords: Oral Health Care; Oral Health Behaviour; Population, old


  1. Petersen PE, Ueda H. Oral Health in Ageing Societies. Integration of Oral Health and General Health. Report of the meeting at the WHO Centre for Health Development in Kobe, Japan, June 2005.
  2. Harford J. Population ageing and dental care. Community Dent and Oral Epidemiol, 2009; 37(2):97-103. [PubMed]
  3. United Nations, Department of Economic and Social Affairs, Population Division. World population ageing. 2007.
  4. Statistical State Office. Statistical Review: Population and social statistics. Nov. 2011 accessed on this website
  5. Coleman P. Improving oral health care for the frail elderly: A review of widespread problems and best practices. Geriatric Nursing, 2002; Vol. 23, No 4.[Crossref]
  6. Andersson K. Oral health in old age. Perceptions among elderly persons and medical professionals. Division of Geriatric Dentistry, Institution ofOdontology, KarolinskaInstitutet, Stoskholm, Sweden, 2006.
  7. Axelsson P, Albandar JM, Rams TE. Prevention and control of periodontal diseases in developing and industrialized nations. Periodontol 2000, 2002; 29:235-246. [Crossref]
  8. Kelly M, Steele J, Nuttall N, Bradnock G, Morris J, Nunn J, Pine C, Pitts N, Treasure E, White D. Adult Dental Health Survey. Oral Health in the United Kingdom 1998. Office of National Statistics. London: The Stationary Office, 2000; pp 13-400.
  9. Walker A, Cooper A (Ed). Adult dental health survey. Oral health in United Kingdom, 1998. Office of National Statistics. London: The Stationery Office, 2000.
  10. Woods N, Whelton H, Kelleher V. Factor Influencing the Need for Dental Care amongst the Elderly in the Republic of Ireland. Centre for Policy Studies, National University of Ireland, Cork, 2009, accessed on this website
  11. Petersen PE, Kwan S. Evaluation of community-based oral health promotion and oral diseases prevention – WHO recommendations for improved evidence in public practice. Community Dent Health, 2004; 21:319-329.
  12. Vysniauskaite S. Oral health behavior, conditions and care among dentate elderly patients in Lithuania: preventive aspects. 2009.
  13. World Health Organization/Federation Dentaire Internationale. Global Goals for oral health by the year 2000. Int Dent J, 1982; 32:74-77.
  14. Petersen PE, Yamamoto T. Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol, 2005; 33:81-92. [Crossref]
  15. Sapuric M. Public health aspects of oral health in elderly, over 65 years in the Republic of Macedonia – state and implications for strategic planning. Master’s Thesis. March 2011.
  16. Health Strategy of the Republic of Macedonia, accessed on the website
  17. Todd JE, Lader D. Adult Dental Health 1988. United Kingdom, 1990. London: Her Majesty’s Stationary Office, 1991.
  18. Tseveenjav B, Suominen AL, Vehkalahti MM. Oral health-related behaviours among dentate adults in Finland: findings from the Finnish Health 2000 Survey. Europ J Oral Sciences, 2012; 120(1):54-60. [Web of Science]
  19. ADA, 2007a. American Dental Association. Professionally applied topical fluoride: evidence-based clinical recommendations. J Dent Educ, 2007; pp 393-402.
  20. ADA 2000. American Dental Association. Division of Communications for the Dental Patient. ADA 2000; 131:1095.
  21. Attin T, Hornecker E. Tooth brushing and oral health: How frequently and when should tooth brushing be performed? Oral Health Prev Dent, 2005; 3:135-140. [PubMed]
  22. Berchier CE, Slot DE, Haps S, van der Wejden. The efficacy of dental floss in addition to a toothbrush on plaque and parameters of gingival inflammation: a systematic review. Int J Dent Hyg, 2008; 6:265-279. [Crossref]
  23. World Health Organization, Geneva. Oral Health Surveys – basic methods, 1st Edition, 1973.
  24. World Health Organization, Geneva. Oral Health Surveys – basic methods, 2nd Edition, 1979.
  25. World Health Organization, Geneva. Oral Health Surveys – basic methods, 3rd Edition, 1987.
  26. World Health Organization, Geneva. Oral Health Surveys – basic methods, 4th Edition, 1999.
  27. Petersen PE, Aleksejuniene J, Christensen LB, Eriksen HM, Kalo I. Oral health behaviour and attitudes of adults in Lithuania. Acta Odontol Scand, 2000; 58:243-248. [Crossref] [PubMed]
  28. Petersen PE. Sociobehavioural risk factors in dental caries-international perspectives. Community Dent Oral Epidemiol, 2005; 33:274-279. [Crossref]
  29. Petersen PE. The World Oral Health Report 2003: Continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme., accessed May 2009.
  30. Petersen PE. World Health Organization global policy for improvement of oral health. World Health Assembly 2007. Int Dent J, 2008; 58:115-121. [Webof Science]
  31. Petersen PE. Global Strategies for Promoting Oral Health – the approach of the World Health Organization, 2009.
  32. Petersen PE, Bourgeois DM, Brathhall D, Ogawa H. Oral Health Information Systems towards measuring progress in oral health promotion and disease prevention. Bulletin of the World Health Organization, 83(9). September 2005.
  33. Sheiham A, Netuveli GS. Periodontal disease in Europe. Periodontol 2000, 2002; 29:104-121.
  34. Ling Z, Petersen PE, Wang HY, Bain JY, Zhang BX. Oral health knowledge, attitudes and behaviour of adults in China. Int Dent J, 2005; 55:231-241.[Crossref]
  35. Bourgeois DM, Llodra JC (Ed). Health Surveillance in Europe. European Global Oral Health Indicators Development Project. Report Proceedings 2003. Paris: Quintessence International, 2004.
  36. Bourgeios DM. Health Surveillance in Europe. European Global Oral Health Indicators Development Project. Final Report 2003-2005.
  37. Petersen PE, Kandelman D, Arpin S, Ogawa H. Global oral health of older people. Call for public health action. Community Dent Health, 2010; 27(Suppl. 2):257-268. [PubMed]
Citation Information: Balkan Journal of Dental Medicine. Volume 19, Issue 1, Pages 26–32, ISSN (Online) 2335-0245, DOI:, July 2015