Autopercepção de saúde bucal por idosos atendidos pelo sistema público de um município de Minas Gerais / Self-perception of oral health by the elderly assisted by the public system of a municipality in Minas Gerais

Objective:To analyze the self-perception of oral health by the elderly assisted by the public system of a municipality in Minas Gerais. Methods: descriptive, cross-sectional study with a quantitative approach, carried out with 100 elderly people during dental care in a public clinic and in a reference center. The data were treated using simple descriptive statistical analysis. Results: it was observed that the changes not noticeable by the elderly were: dry mouth sensation, decreased taste, decreased salivary flow and increased gingival problems. These consider it impossible to avoid tooth loss, however they reported that care for the remaining teeth and periodic consultation with the dentist are necessary. The reasons for seeking the professional were: toothache, gum pain, need for dental treatment and mouth injury. Conclusion: the elderly showed a satisfactory perception of their oral health. You are aware of oral changes resulting from aging, as well as care

Objetivo: analisar a autopercepção de idosos atendidos em uma clínica odontológica pública e em um centro de referência de um município de Minas Gerais sobre sua saúde bucal. Métodos: trata-se de um estudo descritivo, transversal, com abordagem quantitativa, realizada com 100 idosos durante atendimento odontológico em uma clínica pública e em um centro de referência. Utilizou-se um questionário semiestruturado, adaptado e validado. O tratamento dos dados se deu por meio de análise estatística descritiva simples. Resultados: observou-se prevalência de idosos do sexo feminino, casado, branco, renda de 1-2 salários, ensino médio completo e de outros municípios. As alterações não perceptíveis pelos idosos são: sensação de boca seca, diminuição do paladar, diminuição no fluxo salivar e aumento dos problemas gengivais. Os idosos consideram ser impossível evitar a perda dentária, todavia relataram que cuidados com os dentes remanescentes e consulta periódica ao cirurgião-dentista são necessários. Os motivos da procura ao dentista foram: dor de dente, dor na gengiva, necessidade de tratamento dentário e lesão na boca. Conclusão: a maior parte dos idosos apresenta uma percepção satisfatória quanto a sua condição atual de saúde bucal. Tem ciência das alterações bucais advindas do processo de envelhecimento, bem como das medidas de cuidados

Objetivo: Analizar la autopercepción de salud bucal por ancianos asistidos por el sistema público de una ciudad de Minas Gerais. Métodos: estudio descriptivo, transversal, con enfoque cuantitativo, realizado con 100 ancianos durante la atención odontológica en una clínica pública y en un centro de referencia. Los datos fueron tratados mediante análisis estadístico descriptivo simple. Resultados: se observó que los cambios que los ancianos no notaron fueron: sensación de boca seca, disminución del sabor, disminución del flujo salival y aumento de los problemas gingivales. Estos consideran imposible evitar la pérdida de dientes, pero informaron que es necesario cuidar los dientes restantes y consultar periódicamente con el dentista. Las razones para buscar al profesional fueron: dolor de muelas, dolor de encías, necesidad de tratamiento dental y lesiones en la boca. Conclusión: los ancianos mostraron una percepción satisfactoria de su salud bucal. Tiene consciencia de los cambios orales resultantes del envejecimiento, así como de la atención

Características de Autocuidado em Saúde Oral, Hábitos e Acesso a Serviço Odontológico por Idosos Rurais e Urbanos / Characteristics of oral health self-care, habits and access to dental service by rural and urban elderly / Características del autocuidado en salud bucal, hábitos y acceso al servicio odontológico por ancianos rurales y urbanos

O artigo buscou investigar as diferenças no estado de saúde oral entre idosos rurais e urbanos, incluindo características de autocuidado, hábitos e acesso a serviços odontológicos, através daPesquisa Nacional de Saúde de2013.Foram encontrados perfis diferentes depacientes,de acordo com a zonageográfica.Idosos urbanosmostraram melhores indicadores de saúde oral, agendamento com maior uso de tecnologiase menor busca de tratamentospor patologia oral que os idosos rurais.

We have investigated the differences related to oral health status between urban and rural elderly, including oral health self-care, habits and access to dental service characteristics. Data was obtained from Brazilian National Health Survey (2013). According to geographic area we have found different profiles. Urbans demonstrated better indicators of oral health status, more use of technology to appoint a dentistry consultation and less looking for treatment because oral pathology than rural elderly.

El artículo buscó investigar las diferencias en el estado de salud bucal entre ancianos rurales y urbanos, incluyendo características de autocuidado, hábitos y acceso a servicios dentales, a través de la Encuesta Nacional de Salud de 2013. Se encontraron diferentes perfiles de pacientes, segúnel área geográfica.Los ancianos urbanos mostraron mejores indicadores de salud bucal, programación con mayor uso de tecnologías y menor búsqueda de tratamientos para patología oral que los ancianos rurales.

Predoctoral Teaching of Geriatric Dentistry in U.S. Dental Schools.

The aim of this study was to assess the current teaching of geriatric dentistry in U.S. dental schools and compare the findings to previous reports. Academic deans at all 67 U.S. dental schools were contacted in November 2015 via email, asking them to complete a questionnaire about the teaching of geriatric dentistry or gerodontology at their institution. Questionnaires were received from 56 of the 67 schools (84% response rate). The results showed that geriatric dentistry was taught in all responding schools; for 92.8% of the respondents, the instruction was compulsory. Among the responding schools, 62.5% were teaching it as an independent course, 25% as an organized series of lectures, and 8.9% as occasional lectures in parts of other courses. In addition, 57.1% had some form of compulsory clinical education in geriatric dentistry. Public schools, as opposed to private schools, were marginally associated with an increased interest in expanding geriatric dentistry teaching (p=0.078). No differences were found between any teaching variables and school location. This study found that the form of education in geriatric dentistry in U.S. dental schools differed in many ways, but the teaching of geriatric dentistry had increased among all respondents and had been increasing for over 30 years. Future research is needed to determine the impact of this teaching on services to the geriatric community.

Barriers to dental services for older adults.

OBJECTIVE: To explore barriers to older adults' accessing dental care. METHODS: We performed oral exams on 184 community-dwelling older adults; those who needed dental care were contacted 6-12 weeks later to determine if they were able to access treatment. Those who could not access care were interviewed regarding barriers. RESULTS: Of those examined, 89% needed dental treatment. After 6 weeks, 52% had received treatment, 48% had not. Those unable to access treatment had fewer teeth, were more likely to be referred regarding dentures, and were less likely to have a dentist. Reasons cited for not accessing care among the 35 participants we interviewed included a lack of finances, transportation, or assistance in navigating dental service. CONCLUSIONS: Older adults have a high burden of oral disease and access barriers remain.

Geriatrics education in U.S. dental schools: where do we stand, and what improvements should be made?

The number of adults above sixty-five years of age in the United States will expand considerably over the next thirty years. However, many dentists believe that their dental education did not adequately prepare them to treat an older adult population. Consequently, it is important to review dental curricula to determine where these gaps in education may occur and what can be done to address them in order to improve access to care. In this study, information was gathered from the websites of sixty-two U.S. dental schools in order to understand the types of geriatric courses offered. This review revealed that while most schools (89 percent) provide their predoctoral students with some education in geriatrics, only fourteen (22.6 percent) offer clinical training specifically for older adult care. In addition, forty-three schools (69 percent) include a geriatric component in either their General Practice Residency or Advanced Education in General Dentistry programs or have a certificate program in geriatric dentistry. Only about 23 percent of the schools offer a continuing education course in geriatrics at any one time. Previous studies have shown that clinical training is the most effective method of increasing students' confidence in treating older patients. Consequently, dental schools should work to incorporate clinical experience into geriatric education to prevent widening an existing gap in older adult oral health care.

Modelling workforce skill-mix: how can dental professionals meet the needs and demands of older people in England?

BACKGROUND: There is an urgent need to consider the skill-mix of the dental team to meet the oral health needs and demands of the population in general, and older people in particular. As people live longer and retain their teeth there will be a progressive change in both the volume and type of dental care required, and the demand for care. Operational research modelling provides the opportunity to examine and test future scenarios for National Health Service (NHS) care. AIM: The aim of this research was to explore the required skill-mix of the dental team to meet future need and demand of older people in England to 2028 utilising operational research methods and to examine a range of future scenarios. METHOD: A three-stage computer model was developed to consider demand for dental care, workforce supply and skill-mix. First, the demand model combined population demography and a marker of oral health with attendance and treatment rates based on NHS activity data. Monte Carlo simulation was used to give an indication of the uncertainty surrounding this projected demand. Second, projections on workforce supply and other assumptions relating to clinical hours, NHS commitment and workforce whole time equivalents (WTEs) were analysed to produce a range of estimates for the current and future workforce. Third, staff skill-mix competencies were examined and the data fed into an optimisation model. Linear programming was used to give the optimal workforce makeup and predictions for workforce requirements. Five future scenarios were run from 'no skill-mix' through to 'maximum skill-mix' in the dental team, and the outputs compared. RESULTS: The results indicate that by 2028 there will be an increase in demand for care among older people of over 80% to almost 8.8 million hours; however, Monte Carlo simulation suggests considerable uncertainty surrounding the demand model outputs with demand deviating from the average in terms of treatment hours by as much as 22%. Modelling a healthcare system with 'no skill-mix' resulted in the lowest volume of clinical staff equivalents (dentists: 8,668) providing care for older people, whereas maximum skill-mix involved more staff (clinical staff = 10,337, of whom 2,623 were dentists, 4,180 hygienist/therapists and 3,534 clinical dental technicians) if all care is provided at the relevant level of competence. CONCLUSION: The model suggests that with widening skill-mix, dental care professionals can play a major role in building dental care capacity for older people in future. The implications for health policy, professional bodies and dental teamworking are discussed.

Geriatric dentistry: a new specialty in Brazil.

OBJECTIVE: To present the current status of geriatric dentistry in Brazil. BACKGROUND: In 2001, the Brazilian Dental Council established a new specialty: geriatric dentistry. This decision was based on the increase in both the elderly population and the demand for dental treatment of this cohort. MATERIALS AND METHODS: Data were obtained through online searches of the Brazilian Dental Council and the Brazilian Institute of Geography and Statistics. RESULTS: Brazil has 170 dental schools offering around 14 000 undergraduate vacancies every year. At the postgraduate level, there are 19 recognised dental specialties, one of which is geriatric dentistry, comprising 18 certificate programmes, with the potential to produce 216 new specialists every 18 months. The dentist/habitant ratio was 1:870, higher than that recommended by the Word Health Organization. The Brazilian population consists of around 14.5 million elderly people (8.6%). There were 124 specialists in geriatric dentistry distributed irregularly throughout the country. The specialist/elderly population rate was 1:117 249. At the undergraduate level, this new specialty is not included in the curricula of most dental schools in Brazil. CONCLUSIONS: Geriatric dentistry should be included in the undergraduate curricula of dental schools in Brazil. Postgraduate degree courses should be developed to produce more clinical academics and researchers in this field.

[Prosthetic treatment needs among the elder in Germany]. / Potrzeby leczniczo-protetyczne u seniorów w Niemczech.

INTRODUCTION: The life expectancy has significantly increased in the last 100 years. Therefore it has to be taken into account that many patients who come to the dentist are over 60. In this group of patients, you should pay attention to geriatric aspects of medical history and treatment plan. Nowadays as well as in the past, teeth loss correlates with the age especially thus with the branch of dentistry which is prosthetics. The aim of this study was to define: 1) the condition of the masticatory system of people over 60 who live with their families or at the nursing home; 2) the assessment of prosthetics needs of these groups; 3) differences (if occure) in these examined groups; 4) coexistence of general diseases. MATERIAL AND METHODS: The study was conducted on the group of 100 elder people in the range of age between 61-95. First group constituted 50 patients from nursing home in Hannover next 50 patients were treated in private dental practice in Lohne. The study included medical history and the dental examination. The dental examination focused on the inspection of the face symmetry, condition of TMJ, teeth, mucosa and the type of dental appliences as well as the level of oral hygiene. RESULTS: The proper condition of masticatory system was classified in 58% of patients from nursing home and 62% of patients from private practice. Only in 60% of patients from both of group the proper shape of the temporo-mandibular joint was determinated. Patients who suffered from general diseases constituted 72% of those living in nursing home and 66% those from private practice. Among these patients, the circulatory system problems were the most frequent and the diabetes occure almost equally often. 42% of patients from nursing home determinated need to weave dentures or other dental appliences in comparison to 32% from private practice. CONCLUSIONS: The condition of the masticatory system was inefficient in both groups but the dental needs of patients from nursing home were significantly higher.

[Geriatric dentistry: dental needs, problems, and expectations of residents of care homes]. / Stomatologia geriatryczna - potrzeby, problemy i oczekiwania stomatologiczne pensjonariuszy domów pomocy spolecznej.

PURPOSE: Elderly people deserve respect and the right to receive appropriate medical assistance. This work was undertaken to determine the stomatognathic status of residents of Care Homes, condition of their dental prostheses, their main dental problems, expectations and needs, with emphasis on aspects of prosthetic treatment and psychosocial status. MATERIAL AND METHODS: Altogether, 135 residents of the Care Homes were studied. It was found that the stomatognathic status of the residents was disappointing. The residents had problems with hygiene, their prosthetic appliances were in a poor condition, and they also experinced problems when using the prostheses. Prosthetic problems were noted in almost every resident of Care Homes. RESULTS: Expectations as to dental care cannot be fulfilled without changing the national health care system. A relationship between satisfaction in life and extent of prosthetic needs, condition of prosthetic appliances, and problems with their use was found. A positive life history plays an important role in past dental care. CONCLUSION: The psychosocial status of residents of Care Homes was poor.

Condiciones de salud oral en ancianos residentes en hogares geriátricos de Asunción / Oral health conditions in elderly residents of nursing homes in Asuncion

La longevidad es una conquista de la humanidad, por lo tanto, la sociedad debe estar preparada para enfrentar los nuevos desafíos en lo que se refiere al ambiente, prácticas de salud y políticas sociales de atención al anciano, creando condiciones que posibiliten un envejecimiento saludable. Las Naciones Unidas clasifica dentro de la categoría de ancianos a las personas de 60 años y más, en el Paraguay este grupo de etario constituye alrededor del 73% de la población total. El envejecimiento es un proceso multicausal en el que intervienen numerosos factores que influyen en la cavidad bucal, al igual que el resto del organismo. La pérdida de piezas dentales no es propia de la edad, sino un indicador del mal estado de salud oral del paciente. En nuestro país no se tiene reporte de la situación de salud oral de los ancianos, por lo que se realizó es estudio observacional descriptivo de corte transverso, con el objetivo de observar clínicamente las condiciones de salud oral en personas mayores de 60 años residentes en hogares geriátricos de Asunción, con el propósito de establecer las condiciones y necesidades prioritarias y proponer un plan preventivo para mejorar dichas condiciones. Fueron examinados 46 pacientes, de ambos sexos, entre 60 y 92 años, residentes en hogares de ancianos "Nuestra Señora de la Asunción", "La Piedad" y "El Buen Samaritano", el muestreo fue no probabilístico de casos consecutivos. Entre los hallazgos más importantes se destacan la prevalencia de caries y enfermedad periodontal que fueron de 100% y el promedio de 4,4 piezas dentarias sanas presentes en boca. Por lo que se sugiere la realización de otro estudio para conocer la situación real en el país, la creación de una cátedra de odontogeriatría, para la atención especializada de los ancianos institucionalizados o no, y el establecimiento de medidas educativas tendientes a posibilitar un país con ancianos saludables

Current status of predoctoral geriatric education in U.S. dental schools.

The elderly constitute the fastest growing segment of the U.S. population. Dental schools must educate dental students so that they are competent and confident in managing the treatment needs of elderly patients. Programs in geriatric dentistry have been developed in response to the changing oral health needs of growing numbers of older adults. The purpose of this online survey was to identify the current status of predoctoral geriatric dental education in U.S. dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the World Wide Web, and fifty-four US. dental schools were invited to complete the form. Data from completed questionnaires were submitted to the investigators via email. Following repeated phone calls and emails to urge school administrators to respond to the electronic questionnaire, a 100 percent response rate was achieved. All schools reported teaching at least some aspects of geriatric dentistry, and 98 percent had curricula that contain required didactic material. Sixty-seven percent of schools reported having a clinical component to geriatric dental teaching. Of these schools, the clinical content was required in 77 percent and elective in the rest. Thirty percent of schools reported a specific geriatric dentistry clinic within the school, and 11 percent had a remote clinical site. Sixty-three percent of schools have a geriatric program director or a chairman of a geriatric section. Over a third of schools indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has continued to expand over the last twenty years and has established itself in the U.S. predoctoral dental curriculum. The format of teaching the subject varies considerably among the dental schools. Although didactic teaching of geriatric dentistry has increased markedly in the last two decades, clinical experience, both intramurally and extramurally, did not keep pace.

[Oral health of community-living elderly. 1. Condition of teeth, use of professional dental care and oral hygiene habits]. / Mondgezondheid van thuiswonende ouderen. 1. Gebitstoestand, verleende professionele tandheelkundige zorg en mondhygiënisch gedrag.

With the aim to get information on oral health, professional dental care and oral hygiene habits a study was performed on persons aged 60 up to 79 years in Haarlem, the Netherlands. After an interview an oral examination was performed, using a mirror and a pocket lamp. Of all persons approached, 376 (38%) participated in the clinical part of the study. In elderly persons with natural teeth (52% of all participants) the mean numbers of present teeth (third molars excluded), FT and obvious DT were 18.1, 10.8 and 0.7 respectively. The percentage of persons with natural teeth showed a strong relationship with level of education. A comparison with results of a study performed in 1986 showed that oral health in elderly persons is improved. Of all the elderly with natural teeth 91% visited their dentist periodically at least one time a year and 76% of them brushed their teeth at least two times a day.

Utilisation of domiciliary dental services.

OBJECTIVES: To develop undergraduate dental student understanding of the attitudes of elderly people towards dentistry and of the barriers which prevent them from seeking treatment. DESIGN: Each student interviewed a) an elderly person already known to them and b) an elderly person at a Day Rehabilitation Unit using a questionnaire. Students were not trained nor standardised. SETTING: a) in the student's home locality, b) in a Rehabilitation Unit in Sheffield. SUBJECTS: 161 people were interviewed with mean ages a) 78 years and b) 85 years. MAIN OUTCOME MEASURES: Perceptions of treatment need and domiciliary treatment by these elderly people. The results are summarised but not analysed because of the inherent limitations of data derived by unsupervised students. CONCLUSIONS: This educational exercise successfully engaged the studentsí minds and, for some, generated enthusiasm. They achieved valuable insight into the topic and realised that many people who inevitably have dental problems either feel that this is acceptable or do not know that they can obtain domiciliary dental care.

Economic impact of dental service utilization by older adults.

A total of 747 general dental practitioners--in Arizona, Colorado, Connecticut, Florida, and Minnesota--responded to a questionnaire in 1988 by completing a detailed productivity report of patient services performed during a specified period. The results, based on 11,909 patient visits and 22,712 dental procedures, indicated that stereotypes of older adults as underutilizers of dental care are incorrect. This finding and others, detailed within this article, indicate that older adults make up a substantial portion of regular patients and that their utilization of dental services should increase throughout 1990.

And what of the providers of geriatric dental services?

The changing demographic characteristics of the dental profession are reviewed in an effort to stimulate consideration of the evolving relationship that exists between the providers and the geriatric population.