Medical status of elderly patients consulting two oral and maxillofacial surgery departments in Germany

  • Frank Halling
    Corresponding author at: Gesundheitszentrum Fulda, Oral and Maxillofacial Surgery, Fulda, Germany.
    Gesundheitszentrum Fulda, Oral and Maxillofacial Surgery, Fulda, Germany

    Department of Oral and Maxillofacial Surgery, University Hospital Marburg UKGM GmbH, Marburg, Germany
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  • Klemens Weigl
    Human-Computer Interaction Group, Technische Hochschule Ingolstadt, Ingolstadt, Germany

    Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
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      An increasing number of elderly patients requires dental care. The data concerning the medical risk profile of seniors consulting dentists are scarce. In this context, the comorbidity-polypharmacy-score (CPS) could be an effective clinical tool to quickly assess the medical status of elderly patients. The medical data from 648 patients (60 years and older) of two cohorts (Fulda group [Fg] and Marburg group [Mg]) from two maxillofacial surgical units were recorded using a standardised questionnaire and compared concerning the number of the regular medications and the CPS. No medication was needed in 57 patients and 311 took 1 to 4 medications per day. Polypharmacy (5 or more medications per day) could be observed in 280 patients. The average medication was 4.28 in the Fg and 4.57 in the Mg groups (p = 0.249). Antihypertensives and antithrombotics were the most common medications. The CPS was subdivided into three groups (minor, moderate, severe). In total, 332 patients belonged to the minor group and 80 to the severe group. The average CPS was 7.49 in the Fg and 7.99 in the Mg groups (not significant). CPS was strongly correlated with age (p < 0.001) but not with sex. The prevalence of elderly patients with polypharmacy presenting for dental care is increasing. Scores like CPS may be a useful adjunct for quantifying the burden of disease in the context of dental treatment.


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        • Chatterji S.
        • Byles J.
        • Cutler D.
        • et al.
        Health, functioning and disability in older adults – present status and future implications.
        Lancet. 2015; 385: 563-575
      1. Bundesinstitut für Bevölkerungsforschung. Proportions of age groups under 20 years, from 65 years and from 80 years (1871-2060) Available from URL: (last accessed 11 May 2022) (Page in German and English).

        • Palladino R.
        • Pennino F.
        • Finbarr M.
        • et al.
        Multimorbidity and health outcomes in older adults in ten European health systems, 2006–15.
        Health Aff (Millwood). 2019; 38: 613-623
        • Dhanuthai K.
        • Sappayatosok K.
        • Bijaphala P.
        • et al.
        Prevalence of medically compromised conditions in dental patients.
        Med Oral Patol Oral Cir Bucal. 2009; 14: E287-E291
        • Johnston M.C.
        • Crilly M.
        • Black C.
        • et al.
        Defining and measuring multimorbidity: a systematic review of systematic reviews.
        Eur J Public Health. 2019; 29: 182-189
        • Marengoni A.
        • Angleman S.
        • Melis R.
        • et al.
        Aging with multimorbidity: a systematic review of the literature.
        Ageing Res Rev. 2011; 10: 430-439
        • Charlesworth C.J.
        • Smit E.
        • Lee D.S.
        • et al.
        Polypharmacy among adults aged 65 years and older in the United States: 1988–2010.
        J Gerontol A Biol Sci Med Sci. 2015; 70: 989-995
        • Masnoon N.
        • Shakib S.
        • Kalich-Ellett L.
        • et al.
        What is polypharmacy? A systematic review of definitions.
        BMC Geriatr. 2017; 17: 230
        • Guthrie B.
        • Makubate B.
        • Hernandez-Santiago V.
        • et al.
        The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995–2010.
        BMC Med. 2015; 13: 74
        • Khezrian M.
        • McNeil C.J.
        • Murray A.D.
        • et al.
        An overview of prevalence, determinants and health outcomes of polypharmacy.
        Ther Adv Drug Saf. 2020; 11 (2042098620933741)
        • Watt R.G.
        • Serban S.
        Multimorbidity: a challenge and opportunity for the dental profession.
        Br Dent J. 2020; 229: 282-286
        • Evans D.C.
        • Gerlach A.T.
        • Christy J.M.
        • et al.
        Pre-injury polypharmacy as a predictor of outcomes in trauma patients.
        Int J Crit Illn Inj Sci. 2011; 1: 104-109
        • Evans D.C.
        • Cook C.H.
        • Christy J.M.
        • et al.
        Comorbidity-polypharmacy scoring facilitates outcome prediction in older trauma patients.
        J Am Geriatr Soc. 2012; 60: 1465-1470
        • Justiniano C.F.
        • Coffey R.A.
        • Evans D.C.
        • et al.
        Comorbidity-polypharmacy score predicts in-hospital complications and the need for discharge to extended care facility in older burn patients.
        J Burn Care Res. 2015; 36: 193-196
        • Stawicki S.P.
        • Kalra S.
        • Jones C.
        • et al.
        Comorbidity polypharmacy score and its clinical utility: a pragmatic practitioner's perspective.
        J Emerg Trauma Shock. 2015; 8: 224-231
        • Tolentino J.C.
        • Stoltzfus J.C.
        • Harris R.
        • et al.
        Comorbidity-polypharmacy score predicts readmissions and in-hospital mortality: a six-hospital health network experience.
        J Basic Clin Pharma. 2017; 8: 98-103
        • Al-Nawas B.
        • Grötz K.A.
        Medically compromised patients in the dental office. Demographics and progress in health care. Medically compromised patients in the dental office: demographics and progress in health care.
        Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2011; 54 (paper in German): 1066-1072
        • Donoff B.
        • McDonough J.E.
        • Riedy C.A.
        Integrating oral and general health care.
        New Engl J Med. 2014; 371: 2247-2249
        • Jacobsen P.L.
        • Chávez E.M.
        Clinical management of the dental patient taking multiple drugs.
        J Contemp Dent Pract. 2005; 6: 144-151
        • Seitz M.W.
        • Listl S.
        • Bartols A.
        • et al.
        Current knowledge on correlations between highly prevalent dental conditions and chronic diseases: an umbrella review.
        Prev Chronic Dis. 2019; 16: E132
        • Aggarwal A.
        • Panat S.R.
        • Talukder S.
        Self-reported medical problems among dental patients in Western Uttar Pradesh, India.
        J Dent Educ. 2011; 75: 1635-1640
        • Knopf H.
        • Grams D.
        Medication use of adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1).
        Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013; 56 (paper in German): 868-877
        • Aubert C.E.
        • Streit S.
        • Da Costa B.R.
        • et al.
        Polypharmacy and specific comorbidities in university primary care settings.
        Eur J Intern Med. 2016; 35: 35-42
        • Moßhammer D.
        • Haumann H.
        • Mörike K.
        • et al.
        Polypharmacy—an upward trend with unpredictable effects.
        Dtsch Arztebl Int. 2016; 113: 627-633
        • Fernández-Feijoo J.
        • Garea-Gorís R.
        • Fernández-Varela M.
        • et al.
        Prevalence of systemic diseases among patients requesting dental consultation in the public and private systems.
        Med Oral Patol Oral Cir Bucal. 2012; 17: e89-e93
        • Aggarwal P.
        • Woolford S.J.
        • Patel H.P.
        Multi-morbidity and polypharmacy in older people: challenges and opportunities for clinical practice.
        Geriatrics (Basel). 2020; 5: 85
        • Charlson M.E.
        • Pompei P.
        • Ales K.L.
        • et al.
        A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.
        J Chronic Dis. 1987; 40: 373-383
        • McGowan K.
        • Acton C.
        • Ivanovski S.
        • et al.
        Systemic comorbidities are associated with medication-related osteonecrosis of the jaws: case-control study.
        Oral Dis. 2019; 25: 1107-1115