Gerodontology[JOURNAL]
Sun
200 papers
Comparing approaches to determining poor oral health among older adults in a national survey.
Horncastle AJ, Gauld TD, Smith MB … +1 more , Thomson WM
Gerodontology · 2024 Dec · PMID 38009567 · Full text
OBJECTIVES: To compare the clinical validity of the three approaches in residential care facility residents. BACKGROUND: In NZ residential care facilities, the interRAI assessment tool is used by trained registered nurse...
OBJECTIVES: To compare the clinical validity of the three approaches in residential care facility residents. BACKGROUND: In NZ residential care facilities, the interRAI assessment tool is used by trained registered nurses for assessing oral status when new residents are admitted, but its validity has been questioned. Although Locker's global oral health item has been used to measure oral health in surveys and health services research, it is not routinely used in care facilities, yet its clinical validity has been demonstrated in population-based samples. Self-perceived oral health need may also be useful. MATERIALS AND METHODS: Using a secondary analysis of clinical and self-reported data from a national survey of nursing home residents (the 2012 New Zealand Older People's Oral Health Survey, or OPOHS), we compared the validity of Locker's item, the interRAI tool and self-reported treatment need for identifying three key clinical indicators of poor oral health among dentate older adults; those were coronal caries (3+ teeth affected), root caries (1+ teeth affected) and xerostomia. Analyses were conducted using STATA, and survey weighting was used to obtain estimates for a source population of 25-843 individuals. RESULTS: The prevalence of 3+ teeth with coronal caries was 28.7% (23.9, 34.0), the prevalence of 1+ teeth with root caries was 33.7% (28.7, 39.0), the prevalence of xerostomia was 23.1% (18.4, 28.3). Marked gradients in prevalence risk ratio were seen across different categories of Locker's global oral health item and the interRAI assessment tooth for coronal caries and xerostomia. Locker's global oral health item gave a better fitting model and was more discriminative in detecting coronal caries than the interRAI assessment tool (Lockers AIC = 0.76, interRAI AIC = 0.81). None of the approaches was particularly discriminative for root surface caries experience. CONCLUSION: Self-reported approaches are discriminative for poor oral health. Standardised assessment tools used in residential care facilities should consider including a self-assessment component such as Locker's global oral health item.
Toothbrushing-induced vestibular ulcerations with severe gingival defects.
Liu B, Cao J, Lu W … +1 more , Yao H
Gerodontology · 2023 Dec · PMID 37971287 · Publisher ↗
BACKGROUND: Daily toothbrushing is a routine approach for helping to keep the oral cavity healthy. However, using a toothbrush as an ordinary oral hygiene habit can also lead to adverse events. CASE PRESENTATION: A 75-ye...
BACKGROUND: Daily toothbrushing is a routine approach for helping to keep the oral cavity healthy. However, using a toothbrush as an ordinary oral hygiene habit can also lead to adverse events. CASE PRESENTATION: A 75-year-old man was referred by a periodontist for vestibular ulcerations with gingival defects. The patient reported no significant medical or social history, which might be associated with his symptoms. On examination, wide labio-buccal gingival defects, white attached gingiva and linear vestibular ulcerations were observed. With the help of the periodontist, a diagnosis of inappropriate toothbrushing-induced traumatic ulcerations was reasoned via an approach of aetiological elimination. The patient was put on a trial course of topical dexamethasone powder with lincomycin. The resolution of vestibular ulcerations was apparent after two weeks. He reported no similar oral ulcerations during the following nine years. CONCLUSION: To our knowledge, this is the first case reported in the literature of vestibular ulcerations with severe gingival defects caused by inappropriate toothbrushing. The establishment of a correct diagnosis needs a close collaboration between periodontists and oral medicine specialists. Instruction on correct toothbrushing, especially for older people can be beneficial.
Oral mucosa and cutaneous manifestations of psoriasis in an older patient: A case report.
Bertolini GR, Teixeira LR, Chahud F … +4 more , Elias D, da Silva Souza C, Lourenço AG, Motta ACF
Gerodontology · 2023 Dec · PMID 37971285 · Publisher ↗
BACKGROUND: Psoriasis is a common cutaneous disease; however, information about psoriasis-related oral mucosal lesions is scarce in the literature. CASE DESCRIPTION: We report a case of a 73-year-old male patient with cu...
BACKGROUND: Psoriasis is a common cutaneous disease; however, information about psoriasis-related oral mucosal lesions is scarce in the literature. CASE DESCRIPTION: We report a case of a 73-year-old male patient with cutaneous and oral palatal alterations. An incisional biopsy of these lesions revealed psoriasis. CONCLUSION: The current case highlights the importance of a systematic examination of the oral cavity in psoriasis patients for the appropriate diagnosis and management on the control of these lesions.
Oral health of older Koreans by region and family status in 2020-2021.
Kim EJ, Kim DH, Yu RG … +4 more , Lee YJ, Lee YJ, Im DG, Lee HJ
Gerodontology · 2024 Dec · PMID 37965782 · Publisher ↗
OBJECTIVE: To describe the oral health of older people by region and family status using data from the National Health and Nutrition Survey. BACKGROUND: As the ageing of Korean society intensifies, health inequalities ba...
OBJECTIVE: To describe the oral health of older people by region and family status using data from the National Health and Nutrition Survey. BACKGROUND: As the ageing of Korean society intensifies, health inequalities based on region and family status are also deepening. METHODS: Data from the 8th National Health and Nutrition Survey (2020-2021) conducted by the Korea Centers for Disease Control and Prevention were used, and a total of 3437 older people aged 65 or older were selected as study participants. Chewing discomfort and oral health behaviours were assessed by region and family status using multivariable logistic regression analysis with the complex sample survey design. RESULTS: We found an association between living alone and greater chewing discomfort. Residing in rural areas was also associated with a higher prevalence of this. In urban areas, chewing discomfort was 1.27 times higher among older people living alone than in those not living alone, while in rural areas, the discomfort was 1.52 times higher among the older people who lived alone. CONCLUSIONS: Region and family status were associated with greater chewing discomfort in older people. In Korean society, where the number of single-person older people households is increasing, along with the ageing population, attention to resolving the disparities in oral health in older people is needed.
Associations between activities of daily living, leisure activities and subjective well-being in Chinese older adults.
Yang W, Tian G, Cui Y … +6 more , Li R, Zhou T, Shi Y, Shuai J, Ma Y, Yan Y
Gerodontology · 2024 Sep · PMID 37948355 · Publisher ↗
OBJECTIVES: The study aimed to explore the internal pathway of the association between activities of daily living and subjective well-being among Chinese older adults using a large and representative sample. BACKGROUND:...
OBJECTIVES: The study aimed to explore the internal pathway of the association between activities of daily living and subjective well-being among Chinese older adults using a large and representative sample. BACKGROUND: There is still a lack of systematic investigation into the association between activities of daily living and subjective well-being among Chinese older adults. MATERIALS AND METHODS: The study included 10 578 participants from the Chinese Longitudinal Healthy Longevity Survey. We applied multiple linear regression analysis and Spearman correlation analysis to examine the association between activities of daily living and subjective well-being and PROCESS macro to determine the mediating effect of leisure activities on the relationship between them. RESULTS: The mean total score of subjective well-being was 30.5 ± 4.4. The prevalence of basic activities of daily living and instrumental activities of daily living limitations was 18.0% and 60.8%, respectively. Correlation analysis showed that activities of daily living score were negatively correlated with subjective well-being. Leisure activities were positively correlated with subjective well-being. The effect of instrumental activities of daily living on subjective well-being was partially mediated by leisure activities and leisure activities completely mediated the association between basic activities of daily living and subjective well-being. CONCLUSIONS: The effect of instrumental activities of daily living on subjective well-being was partially mediated by leisure activities and leisure activities completely mediated the association between basic activities of daily living and subjective well-being.
Access to dental services in an elder population of African descent in Brazil.
da Silva-Sobrinho AR, Lima NLB, Ramos LFS … +3 more , Jerônimo SF, da Costa Araújo FA, Sette-de-Souza PH
Gerodontology · 2024 Mar · PMID 37948317 · Publisher ↗
OBJECTIVES: We investigated access to dental services and associated factors in a community of Quilombola older people. BACKGROUND: Quilombola populations are groups of individuals descended from black Africans subjected...
OBJECTIVES: We investigated access to dental services and associated factors in a community of Quilombola older people. BACKGROUND: Quilombola populations are groups of individuals descended from black Africans subjected to slavery during part of Brazilian history. As marginalised and neglected individuals, they have high rates of negative indicators and require further attention to the social determinants that affect their health reality. MATERIALS AND METHODS: A cross-sectional quantitative study was conducted in the Quilombola community of Castainho, in the Northeast region of Brazil. In this community, 34 older people aged between 65 and 74 resided. We collected self-report data on sociodemographic and economic characteristics, along with oral examinations by the researchers. The primary dependent variable was regular access to dental services. Statistical analysis used Fisher's exact test (P = .05). RESULTS: Among the 32 participants in the final sample, 18.8% (n = 6) reported accessing dental services in the previous 6 months. Self-declared individuals of mixed race, with positive self-assessment of oral health, and those who did not self-perceive the need for treatment had lower rates of regular access to dental services (P < .05). CONCLUSION: Use of dental services by older Quilombola people is low, and there are differences by ethnicity and individual perception of oral health.
Factors influencing xerostomia and oral health-related quality of life in polymedicated patients.
Ramírez L, Sánchez I, González-Serrano J … +5 more , Muñoz M, Martínez-Acitores ML, Garrido E, Hernández G, López-Pintor RM
Gerodontology · 2024 Sep · PMID 37944110 · Publisher ↗
OBJECTIVES: To evaluate whether the severity of xerostomia in older polymedicated patients impacts oral health-related quality of life (OHRQoL). BACKGROUND: Medication-associated xerostomia is common in older people. Xer...
OBJECTIVES: To evaluate whether the severity of xerostomia in older polymedicated patients impacts oral health-related quality of life (OHRQoL). BACKGROUND: Medication-associated xerostomia is common in older people. Xerostomia may impair OHRQoL. MATERIALS AND METHODS: This cross-sectional study included older hypertensive patients from two health centres. We assessed the severity of xerostomia and OHRQoL using the Xerostomia Inventory (XI) tool, and the Oral Health Impact Profile-14 (OHIP-14) instrument, respectively. We measured unstimulated (UWS) and stimulated (SWS) salivary flows. Univariate and multiple linear regression analyses evaluated the associations of XI and OHIP-14 and different explanatory variables. RESULTS: Of the 218 patients enrolled, 51.8% had xerostomia, and 38.1% and 27.5% suffered from UWS and SWS hyposalivation, respectively. Patients with xerostomia, UWS, and SWS hyposalivation scored significantly higher on the XI. However, only those with xerostomia or UWS hyposalivation had significantly higher OHIP-14 scores. A moderate correlation was observed between XI and OHIP-14 scores. The multiple regression model showed that factors with the greatest impact on XI were the patient's complaint of xerostomia, UWS flow rate, age and sex. However, only the XI score was significantly associated with the OHIP-14 score. CONCLUSION: Xerostomia has a negative impact on OHRQoL in older polymedicated patients, but this impact is less than in other types of xerostomia. Longitudinal studies are needed to determine whether changes in the detected explanatory variables influence XI and OHIP scores in these patients.
Interdental cleaning and periodontal status among older Koreans: Findings from KNHANES VII.
Son JY, Kim EJ
Gerodontology · 2024 Jun · PMID 37927103 · Publisher ↗
OBJECTIVE: To assess the association between the usage of interdental cleaning and periodontal status among older people in Korea. BACKGROUND: In order to maintain oral health in older people, it is very important to use...
OBJECTIVE: To assess the association between the usage of interdental cleaning and periodontal status among older people in Korea. BACKGROUND: In order to maintain oral health in older people, it is very important to use interdental cleaning devices. However, there is a lack of research on periodontal status and interdental cleaning device use in older people. METHODS: This study used data collected from the 7th National Health Nutrition Survey (KNHANES VII: 2016-2018). A total of 3426 older people adults aged 65 years or older were selected from 16 489 participants. Data on sociodemographic status (sex, age, level of education, income, residential area), personal health practice (subjective health status, smoking, physical activity, hypertension, and diabetes mellitus), oral health practice (subjective oral health status, tooth brushing frequency, dental visits, and chewing problem), the number of teeth and periodontitis were collected. Periodontitis was defined as having a World Health Organisation community periodontal index (CPI) code greater than or equal to three, and severe periodontitis was defined as a CPI code 4. Participants having a CPI code of 3 or 4 were considered to have periodontal disease in this study. Logistic regression analysis investigated the association between interdental cleaning devices usage and periodontitis controlling the confounding factors. RESULTS: Those who do not use dental floss had a higher rate of periodontal disease (AOR = 1.47, 95% confidence interval [CI]: 1.05 to 2.1). However, there were no significant differences by interdental brush use. In those with 20 or more teeth, non-users of dental floss had a higher risk of periodontitis in all models. Conversely, in those with fewer than 20 teeth, no significant differences were observed. CONCLUSIONS: Older people with mostly intact dentitions have better periodontal health if they clean between their teeth.
Digital denture scanning and 3D printing for residents in care homes: A feasibility study for pre-empting denture loss.
Gillway D, Doshi M
Gerodontology · 2024 Sep · PMID 37899693 · Publisher ↗
OBJECTIVE: The aim of this study was to assess the feasibility of digitally scanning dentures and 3D printing replica dentures for care home residents. The study also investigated whether the process and replacement dent...
OBJECTIVE: The aim of this study was to assess the feasibility of digitally scanning dentures and 3D printing replica dentures for care home residents. The study also investigated whether the process and replacement denture was acceptable to the resident. BACKGROUND: Denture loss is a significant issue for people living in care homes and impacts on nutrition, quality of life and dignity. Denture loss is underreported, and care home residents have barriers to accessing dental care. The conventional process for remaking a denture can often take approximately 2 months with multiple clinical stages, often not feasible in adults with frailty and cognitive impairment. Scanning and 3D (3 dimensional) printing are increasingly used in dentistry, this rapidly evolving technology may provide an innovative solution to denture loss. MATERIALS AND METHODS: A digital workflow was established using a handheld scanner and 3D printing technology. Care home residents wearing functional acrylic dentures were recruited. Dentures were scanned within the care home, and the scan was sent to a dental laboratory for 3D printing. The dentures were fitted at a subsequent visit, and semi-structured interviews were undertaken with the resident. Using thematic analysis, the feasibility of this pathway was assessed, and the use of digital scanning technology was explored. RESULTS: Eight residents successfully had dentures scanned and replicated to a satisfactory standard. It took, on average, 10 minutes to scan a denture and 20 minutes to print the denture. All replica dentures were satisfactory to the resident. Qualitative data from semi-structured interviews showed that study participants were satisfied with denture replacements and the process. The 3 main themes that emerged were: the significance of dentures to the individual, satisfaction with the scanning process and general low self-esteem and fatigue. CONCLUSIONS: This study has established a workflow for digitally storing dentures and replicating them satisfactorily. In the context of a care home setting, a scan of a denture can be used to provide a replacement denture if lost or broken. A large-scale study could follow now that the feasibility of this pathway has been demonstrated.
Effect of oral health interventions for dependent older people-A systematic review.
Salazar J, Andersen C, Øzhayat EB
Gerodontology · 2024 Jun · PMID 37847812 · Publisher ↗
BACKGROUND: There is an increasing proportion of older people in the population worldwide, with a large group being dependent on the care of others. Dependent older people are more vulnerable to oral diseases, which can...
BACKGROUND: There is an increasing proportion of older people in the population worldwide, with a large group being dependent on the care of others. Dependent older people are more vulnerable to oral diseases, which can heavily impact their quality of life (OHRQoL) and general health. OBJECTIVE: The purpose of this systematic review was to comprehensively assess interventions to improve oral health or guarantee access and adherence to dental treatment of dependent older people. METHODS: We searched MEDLINE, EMBASE, CENTRAL and clinical trial registries. Two reviewers performed the selection, data extraction, risk of bias evaluation using the Cochrane Risk of Bias tool and assessment of certainty of the evidence. When possible, we conducted a meta-analysis to calculate effect estimates and their 95%CIs. Primary outcomes were OHRQoL, oral/dental health, and use of the oral care system. RESULTS: We included a total of 30 randomised clinical trials assessing educational and non-educational interventions for community-dwelling older people (n = 2) and those residing in long-term care facilities (n = 28). Most studies assessed oral hygiene and showed that interventions may result in a reduction in dental plaque in the short term (with low certainty of evidence), but there is limited evidence for long-term effectiveness. Only one study assessed OHRQoL, and none evaluated changes in the use of the oral health care system. CONCLUSION: Our findings do not provide strong conclusions in favour of any specific intervention, mainly due to study quality and imprecision. There is limited information about the long-term effect of interventions, and further research is needed, especially targeting community-dwelling older people. PROSPERO ID: CRD42021231721.
Orofacial and cervical myofunctional intervention programmes for older adults: A scoping review.
Borges AFM, Taveira KVM, Eduardo JYM … +1 more , Cavalcanti RVA
Gerodontology · 2024 Jun · PMID 37847803 · Publisher ↗
INTRODUCTION: Senescent stomatognathic systems undergo anatomical changes that are not always compensated by physiology due to associated factors such as poorly fitted dentures, dental changes, and clinical conditions th...
INTRODUCTION: Senescent stomatognathic systems undergo anatomical changes that are not always compensated by physiology due to associated factors such as poorly fitted dentures, dental changes, and clinical conditions that trigger sarcopenia. When these conditions are not properly addressed, they can lead to nutritional deficiencies. Hence, this study aimed to map orofacial and cervical myofunctional intervention programmes for older adults, evaluate the current research in this area, and formulate suggestions for further investigation. METHODS: Scoping review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. The EMBASE, LILACS, PubMed/Medline, Scopus, Web of Science, and grey literature databases were systematically searched. Studies addressing therapeutic programmes, myofunctional exercises, and their influence on the stomatognathic system of older adults were included. Studies with populations younger than 60 years, residing in long-term care facilities, homes, or hospital care, and with associated comorbidities were excluded, as well as secondary studies. RESULTS: A total of 3098 studies were retrieved. After applying the eligibility criteria, nine studies were eligible for this review. The nine studies were published in English between 2008 and 2021 in the United States, Japan, and South Korea. The participants' mean ages ranged from 64 to 81 years, with a preponderance of females. Six of the studies divided the sample into intervention and control groups. Two studies referred to programmes to promote oral function through facial expression and tongue muscle exercises, salivary gland massage, and swallowing biomechanics. Seven studies report the positive influence of myofunctional exercises on the stomatognathic system. CONCLUSION: The mapping concluded that therapeutic programmes, including educational actions, help prevent orofacial myofunctional disorders, and improve the functionality of the stomatognathic system.
Chronic periodontitis and risk of cerebro-cardiovascular diseases among older Koreans.
Jang KA, Kim YR, Joo K … +1 more , Son M
Gerodontology · 2024 Sep · PMID 37847802 · Publisher ↗
BACKGROUND AND OBJECTIVE: There is a relative lack of evidence from observational studies of older populations investigating the association between chronic periodontitis and cerebro-cardiovascular diseases. Accordingly,...
BACKGROUND AND OBJECTIVE: There is a relative lack of evidence from observational studies of older populations investigating the association between chronic periodontitis and cerebro-cardiovascular diseases. Accordingly, we investigated the risk of cerebro-cardiovascular diseases according to the severity of chronic periodontitis among older adults. METHODS: Data on older adults with chronic periodontitis were extracted from the Korea National Health Insurance Service-Senior Cohort Database using diagnosis codes and dental procedures. Participants were divided into two exposure groups. Among 46 737 participants eligible for inclusion, 21 905 (46.9%) had newly diagnosed mild chronic periodontitis, and 24 832 (53.1%) had newly diagnosed severe chronic periodontitis. To determine the risk of cerebro-cardiovascular diseases, including ischemic stroke, haemorrhagic stroke, and myocardial infarction, multivariable-adjusted Cox proportional hazards modelling was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) in this retrospective follow-up study. RESULTS: A total of 3453 (7.4%) outcomes were identified during a mean follow-up of 6.1 years. Kaplan-Meier analysis revealed that disease-free probability was lower in the severe group than in the mild group (log-rank P < .001). In the multivariable-adjusted model, the HR for cerebro-cardiovascular diseases in the severe group (relative to the mild group) was 1.16 (95% CI: 1.09-1.25). In individual outcome analysis, ischemic stroke and myocardial infarction were associated with chronic periodontitis severity, but haemorrhagic stroke was not. CONCLUSION: The severity of chronic periodontitis could be associated with the risk of cerebro-cardiovascular diseases in older adults.
Effect of oral health status and oral function on malnutrition in community-dwelling older adult dental patients: A two-year prospective cohort study.
Sawada N, Takeuchi N, Ekuni D … +1 more , Morita M
Gerodontology · 2024 Sep · PMID 37847782 · Publisher ↗
OBJECTIVES: To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment. BACKGROUND: Malnutrition is common in older adults and increases the...
OBJECTIVES: To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment. BACKGROUND: Malnutrition is common in older adults and increases the risk of frailty, sarcopenia, and mortality. However, few longitudinal studies have been performed to investigate the causal effect of oral status on malnutrition in detail, and the information reported in those longitudinal studies has been limited to dentition status and swallowing ability. MATERIALS AND METHODS: The participants in this prospective cohort study were patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2021. The number of teeth, periodontal condition, oral function (oral diadochokinesis, masticatory ability, number of bacteria in tongue coating, occlusal force, oral moisture, tongue pressure, swallowing function), nutritional status, the number of comorbidities, and mental health status were examined. These variables were analysed using structural equation modelling (SEM). RESULTS: The final analysis included 141 participants (40 males and 101 females; mean age, 73.5 ± 6.3 years; follow-up rate: 79.7%). The results of the SEM revealed that oral status (number of teeth present and swallowing function) was positively associated with nutritional status 2 years later. In addition, age was negatively associated with oral status. CONCLUSION: In community-dwelling older adult dental patients (age ≥60 years), oral function at baseline was associated with nutritional status two years later.
Outreach dental care programme for older adults using long-term care services in Hong Kong: A qualitative study.
Yang SX, Lo ECM, Leung KCM
Gerodontology · 2024 Mar · PMID 37792413 · Publisher ↗
OBJECTIVES: To explore the effects and improvement needs of an outreach dental care programme (ODCP) for older adults using residential care or daycare services from the perspectives of the caregivers, the dentists and a...
OBJECTIVES: To explore the effects and improvement needs of an outreach dental care programme (ODCP) for older adults using residential care or daycare services from the perspectives of the caregivers, the dentists and administrative staff involved in the implementation of the ODCP. METHODS: A qualitative study was conducted through semi-structured interviews with three stakeholders, long-term care (LTC) facility caregivers, administrative staff and dentists working for the ODCP. Combined maximum variation and snowball sampling strategies were adopted, and 22, 9 and 7 participants were interviewed from each stakeholder, respectively. The interviews were conducted via telephone, which were audio-recorded and transcribed verbatim for analysis. NVivo software was used for storing and analysing the data. Data analysis was conducted continuously during the study. RESULTS: Most participants opined that the ODCP benefited older adults by raising their oral health conditions and awareness. However, they complained of the complicated administrative procedures, unmet dental treatment needs, inefficient coordination, unclear work guidelines and shortage of dental manpower. More advanced dental treatment options, better coordination among different parties, simpler administrative processes and better incentives for dentists were proposed to further improve the programme. CONCLUSIONS: According to the stakeholders, ODCP seems beneficial to older adults using LTC services. Further improvements in the scope of dental treatments, cooperation between the outreach dental teams and caregivers, and streamlining of the administrative process are needed for the provision of effective outreach dental care to satisfy the unmet treatment needs of older adults who use LTC services. Better incentives are needed to attract and retain dentists.
Current status of geriatric dentistry education in selected dental schools in Latin America and the Caribbean.
León S, Giacaman RA, Araya-Bustos F … +13 more , Venegas S, Saavedra N, Hugo FN, De Marchi RJ, Muñoz MF, Salazar C, Castrejón-Pérez RC, Bustillos L, Fortanete A, de López AC, Aredes JE, Marín-Zuluaga D, Elias-Boneta A
Gerodontology · 2024 Sep · PMID 37792411 · Publisher ↗
OBJECTIVE: Latin American and Carribean (LAC) are currently experiencing a rapid aging of their population, coupled with a significant burden of oral diseases. Despites this, there is a scarcity of evidence regarding the...
OBJECTIVE: Latin American and Carribean (LAC) are currently experiencing a rapid aging of their population, coupled with a significant burden of oral diseases. Despites this, there is a scarcity of evidence regarding the manner in wich geriatric dentistry is being taught in dental schools across LAC. So, the objective of this study is to investigate the current status of geriatric dentistry education at undergraduate and postgraduate levels in selected LAC dental schools. METHODS: An electronic questionnaire was developed and emailed to all 539 dental schools in 19 LAC countries. The questionnaire recorded activity levels, contents and methodology of geriatric dentistry education as part of dental degree programmes. Reminders by email and telephone calls were used to encourage non-responders to complete the questionnaire. RESULTS: In total, 317 schools from 17 countries responded to the questionnaire (response rate: 58.8%). Geriatric dentistry was taught in 54.6% of the schools at the undergraduate level and in 6.9% at the postgraduate level. Thirty two percent of the schools had a programme director trained in geriatric dentistry. Geriatric dentistry was taught as an independent course in 14.5% of the schools. Dry mouth, periodontal disease, denture-related conditions and prosthodontic management, oral mucosal disease and age-related changes of the orofacial complex were the most frequently covered topics. Clinical teaching of geriatric dentistry was reported by 26.5% of the schools, with 38.0% providing clinical training in outreach facilities. CONCLUSIONS: Geriatric dentistry education remains incipient in LAC, with only one in every four dental school offering it as a standalone course. There is an urgent need to further develop geriatric dentistry education in the continent, including further research to develop a minimum geriatric dentistry curriculum.
Association between frailty and oral health services use in Brazilian older adults.
de Vasconcellos NBT, Fagundes MLB, Menegazzo GR … +3 more , do Amaral Júnior OL, Hilgert JB, do Amaral Giordani JM
Gerodontology · 2024 Mar · PMID 37750043 · Publisher ↗
OBJECTIVES: To assess the association between frailty and oral health services use in Brazilian older adults. METHODS: This cross-sectional study analysed the baseline data from the Longitudinal Study on Brazilian Ageing...
OBJECTIVES: To assess the association between frailty and oral health services use in Brazilian older adults. METHODS: This cross-sectional study analysed the baseline data from the Longitudinal Study on Brazilian Ageing (ELSI-Brazil) representative of Brazilians aged 50 or over. The outcome was oral health services used in the year prior to the interview. The main exposure variable was Frailty defined by the frailty phenotype. Age, skin colour, wealth, sex, education, type of service, health insurance, number of teeth and self-perceived oral health were included as covariates. Prevalence ratios (PR) with their respective 95% confidence intervals (CI) were estimated using Poisson regression with robust variance. RESULTS: 8405 individuals were included in this study. The prevalence of frailty was 7.5%. Regarding frailty status, the prevalence of dental service use was 47.0%, 48.5% and 4.5% for robust, pre-frail and frail individuals, respectively. Frail individuals had a 7% higher prevalence of not using dental (PR: 1.07; 95% CI: 1.01-1.13) than robust individuals. Frailty was independently associated with not using oral health services. CONCLUSION: Given the complexity of the determinants of dental service use, frailty adds another dimension to be examined in older adults. Public health strategies considering a common risk factor approach should be endorsed.
Electrolysed oxidising water as a multi-purpose biocide in dental healthcare-A scoping review.
Krishnan CS, Tompkins GR, Lyons KM … +1 more , Cannon RD
Gerodontology · 2023 Dec · PMID 37694292 · Publisher ↗
OBJECTIVES: The objective of this scoping review was to map evidence of electrolysed oxidising water (EOW) as a biocide for dental applications of relevance to older people and identify research gaps. BACKGROUND: EOW is...
OBJECTIVES: The objective of this scoping review was to map evidence of electrolysed oxidising water (EOW) as a biocide for dental applications of relevance to older people and identify research gaps. BACKGROUND: EOW is an emerging, "green," and cost-effective biocide. There are no reviews on the landscape of EOW research as either an antiseptic or disinfectant in dental healthcare or its suitability for the oral healthcare of older people. MATERIALS AND METHODS: The review follows the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Database searches (Google Scholar, PubMed, Web of Science, Ovid, Scopus and Science Direct) were undertaken using MESH terms and Boolean operators with no date restrictions, to identify full-text, original reports published in English-language peer-reviewed journals. RESULTS: The search yielded 114 papers that met the inclusion/exclusion criteria. Dental applications of EOW include its use as an endodontic irrigant (39%); mouth rinse/surgical irrigant (21%); disinfectant for dental unit water lines (19%) and dental biomaterials (17%); and for antimicrobial efficacy, effects on oral tissues and on dental material properties. Most studies (83%) evaluated a single EOW formulation (acidic, moderately acidic or neutral) that was either generated at 'point-of-use' (POU; 72%), bottled ('ready-to-use', RTU; 24%) or from unspecified (3%) sources. Six reports evaluated storage-related parameters and 25 evaluated clinical applications; 89 were in vitro studies and one investigated the cost-effectiveness of POU EOW. CONCLUSIONS: Neutral-pH, EOW is effective as an antimicrobial agent without deleterious effects on oral tissues. However, research on the impact of storage conditions, anti-Candida biofilm efficacy and mechanism of action against yeasts, long-term effects on denture materials and cost-effectiveness is required to establish the suitability of EOW as a multipurpose biocide for dental healthcare, including infection-control requirements relating to older people.
Orofacial dysfunction after stroke-A multidisciplinary approach.
Skott P, Åkesson E, Johansson K … +6 more , Dalum J, Persson E, Karlsson Å, Seiger Å, McAllister A, Sandborgh-Englund G
Gerodontology · 2024 Sep · PMID 37694276 · Publisher ↗
OBJECTIVE: This paper describes the study protocol in an ongoing clinical trial evaluating oral screen training as part of a post-stroke rehabilitation programme. Baseline data were related to four domains: dysphagia, li...
OBJECTIVE: This paper describes the study protocol in an ongoing clinical trial evaluating oral screen training as part of a post-stroke rehabilitation programme. Baseline data were related to four domains: dysphagia, lip function, masticatory performance and patient-related outcome measures (PROM). BACKGROUND: Stroke is one of the most common causes of disability-adjusted life years, and dysphagia is a common remaining problem after stroke. Rehabilitation using oral screen training has been suggested to improve swallowing, but evidence is still insufficient. MATERIALS AND METHODS: Patients diagnosed with stroke with persisting objective and/or subjective swallowing dysfunction after primary rehabilitation were assessed for eligibility. In total, 25 patients were included. Objective function was assessed by swallowing capacity test (SCT), lip force and masticatory performance, subjective function by EAT-10 and NOT-S and PROM by LiSat-11 and ESAS. RESULTS: Baseline data presented a heterogeneous pattern with no significant association between objective and subjective dysfunction. Most of the participants (20/25) showed impaired swallowing capacity in SCT, and 23/24 revealed orofacial dysfunction according to NOT-S. The most common subjective item reported was chewing and swallowing problems (19/24). CONCLUSION: The heterogenous findings in the included tests and the lack of correlations emphasise the importance of multidisciplinary approaches to identify objective and subjective orofacial post-stroke dysfunction in clinical practice to be able to offer evidence-based individualised care. The included participants were representative of stroke patients with dysphagia, which supports proceeding with the planned intervention.
Evaluation of a protocol to assess a novel artificial biofilm equivalent for dentures-A prospective clinical pilot study.
Kresse-Walczak K, Meissner H, Mauer R … +2 more , Trips E, Boening K
Gerodontology · 2024 Sep · PMID 37665947 · Publisher ↗
OBJECTIVES: This pilot study aimed to carry out preliminary tests of the removability of an artificial biofilm equivalent (ABE) and to verify the reproducibility of the ABE testing protocol for a planned main study. BACK...
OBJECTIVES: This pilot study aimed to carry out preliminary tests of the removability of an artificial biofilm equivalent (ABE) and to verify the reproducibility of the ABE testing protocol for a planned main study. BACKGROUND: There is a lack of data to develop suitable artificial biofilm substitutes, which may be helpful to perform denture hygiene education and to carry out in vitro examinations of oral hygiene products. MATERIALS AND METHODS: This single-group, prospective, longitudinal, interventional pilot study was conducted in Dresden (Germany) from February until December 2020. Participants were recruited who wore fully functional upper complete dentures. Denture biofilm was grown on acrylic specimens by wearing dentures for 12 h and 36 h using intraoral appliances. Acrylic specimens were coated with ABEs of three compositions: chitosan (ChS) 0.3 g, methylcellulose (MC) 1.7 g; ChS 0.2 g, MC 1.8 g; ChS 0.1 g, MC 1.9 g (labelled 1.7MC, 1.8MC and 1.9MC, respectively). All specimens underwent standardised mechanical brushing. The percentages of remaining biofilm (POB) were measured. RESULTS: Thirty-one participants were prescreened, and eight (26%) were included. The appliances were well tolerated, and biofilm was collected. ABE was prepared and brushed as planned. Three and six brushing strokes were needed to remove 12-h and 36-h natural denture biofilm, respectively. Correspondingly, three brushing strokes were needed to remove 1.9MC ABE and six brushing strokes to remove 1.8MC and 1.7MC ABE. A reproducibility of ABE removal was indicated. CONCLUSION: The removability of ABE and the ABE testing protocol were feasible and reproducible for conducting the future main study.
Binge drinking and oral health-related quality of life in older adults: Socioeconomic position matters.
Oliveira LM, Pelissari TR, Demarco FF … +1 more , Zanatta FB
Gerodontology · 2023 Dec · PMID 37634896 · Publisher ↗
OBJECTIVE: The objective of the study was to investigate whether the association between binge drinking and oral health-related quality of life (OHRQoL) differs by socioeconomic position (SEP) in Brazilian older adults....
OBJECTIVE: The objective of the study was to investigate whether the association between binge drinking and oral health-related quality of life (OHRQoL) differs by socioeconomic position (SEP) in Brazilian older adults. BACKGROUND: The adverse health effects of alcohol consumption disproportionately affect socioeconomically disadvantaged and older individuals. Moreover, measures of binge drinking may capture different domains of the association between alcohol misuse and health that might be independent of the traditional markers of volume or frequency of consumption. Evidence of the association between alcohol use and oral health outcomes has failed to consider binge drinking and possible effect modification by SEP. METHODS: We conducted a secondary cross-sectional analysis using the baseline data from The Brazilian Longitudinal Study of Ageing (2015-2016). Effect Measure Modification analyses using multivariable Poisson regression models tested whether the association between past-month binge drinking and higher scores of the Oral Impacts on Daily Performance (OIDP) questionnaire differed in magnitude by level of household wealth and educational attainment, assessed using Relative Excess Risk due to Interaction (RERI) and simple slope test. RESULTS: The analytical sample comprised 8857 individuals. Participants who were from low-wealth households or with lower education and reported past-month binge drinking had 27% (95% CI: 1.16 to 1.39) and 28% (95% CI: 1.18 to 1.40) higher OIDP scores, respectively, than those not binge drinkers from higher SEP, and super-additive associations were detected (RERI for household wealth: 0.12; RERI for educational attainment: 0.14). CONCLUSION: Binge drinkers from low SEP have poorer OHRQoL. Public oral health initiatives aiming to combat binge drinking are likely to disproportionately benefit vulnerable groups.
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