Needs for gerodontological treatment in the elderly living in Lower Silesia.

BACKGROUND: Many factors influence decisions regarding gerodontological treatment. Apart from the clinical condition of a patient, there is a complex of crucial socioeconomic factors, comorbidities, place of residence, and psychological aspects. Therefore, gerodontological treatment plans are significantly diversified. OBJECTIVES: One of the goals of our cross-sectional epidemiological study of Lower Silesia seniors aged 65-74 was to identify all their needs related to gerodontological treatment. MATERIAL AND METHODS: From the randomly selected sample group of 1,600 people, 387 inhabitants of Wroclaw and Olawa reported to take part in the study. The anamnestic study identified demographic and socioeconomic determinants, coexistence of general diseases and behavioral variables related to oral health behaviors. In the clinical study, the decayed-missing-filled (DMF) index, the community periodontal index (CPI), oral hygiene indices, clinical pathological lesions in oral mucosa, and the index of prosthetic reconstruction of missing teeth according to the World Health Organization (WHO) were determined. Criteria for the need for prosthetic treatment, dental caries treatment, periodontal disease treatment, improvement of oral hygiene, and treatment of mucosal diseases, including potentially pre-cancerous and cancerous disorders, were defined. RESULTS: As many as 95.6% of all respondents required at least 1 form of dental treatment. The most common need (75%) was prosthetic treatment of missing teeth either in the maxilla or in the mandible. Forty-nine per cent of the respondents needed treatment of caries in the clinical crown or root of at least 1 tooth. Further, these needs were related to the following factors: treatment of oral mucosal diseases (35.4%), professional periodontal treatment (35%), improvement of very bad oral hygiene (29.2%), and oncological treatment of pre-cancerous and cancerous lesions in the oral cavity (9.6%). CONCLUSIONS: The needs for gerodontological treatment found in the regional study of young Lower Silesian seniors are very high and cannot be met by services provided and funded by the state.

Reasons and risk indicators tor tooth loss in the Polish cross-sectional gerodontological study

INTRODUCTION: The number of teeth in the elderly is the most essential epidemiological data in gerodontological studies. It depends mainly on two medical causes in the form of caries and periodontitis, as well as many risk factors and indicators for tooth preservation and loss. The goals of the cross-sectional study among the residents of Wroclaw and Olawa aged 65-74 have been to assess the number of preserved teeth, severe tooth loss and edentulism in a 30-year trend and in relation to current European regional data. In addition, the most important risk indicators for tooth preservation and loss in the assessed population will be determined. MATERIAL AND METHODS: After applying the two-tier stratification method from a group of 1,200 people, 387 volunteered for the study. The examination was conducted in dental offices in Wroclaw and Olawa, it consisted from clinical and anamnestic parts. The average number of preserved teeth in the entire group was 13.07 (median 15), there were 21.2% persons with functional dentition, 21.4% with severe tooth loss and 14.2% with edentulism. The main direct reason of tooth loss was caries and its complications, which concerned 81.9% of the teeth removed, on average over 12 teeth in the examined person. RESULTS: Referring the results of the obtained study to previous observations can be seen, that in the 30-year trend for Wroclaw in people aged 65 to 74 years, the average number of teeth as well as the percentage of edentulism have improved, but they are still worse than the results of regional European studies. The main risk indicators of earlier loss of teeth by seniors in Lower Silesia are low income, past incorrect pro-health behaviours towards the oral cavity as well as current smoking and history of cardiovascular incidence.

Prevalence of oral mucosal lesions in young seniors in the Wroclaw region.

BACKGROUND: The morbidity of certain oral pathologies, for example denture-related stomatitis, burning mouth syndrome (BMS) and benign neoplasms is higher in the elderly. It is necessary to periodically assess the changes in the profile of the occurrence of these diseases and determine the dominant risk factors associated with their incidence. OBJECTIVES: The aim of the study was to evaluate the prevalence of oral mucosal pathologies (in particular, potentially malignant and cancerous disorders) in a randomly selected population of 65-74-year-old residents of Wroclaw and Olawa, Poland. MATERIAL AND METHODS: A group of 1,600 persons aged 65-74 years, living in Wroclaw (a large city) and Olawa (a small town) were randomly selected to participate in the study. 285 people from Wroclaw and 102 from Olawa were examined. In a clinical dental examination, the following parameters were assessed: the number of teeth; probing/pocket depth (PD) and clinical attachment level (CAL) for all the teeth at 4 measuring points (on this basis, periodontal diagnoses were made according to American recommendations - of the American Center for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP)); and the presence of prosthetic restorations and their quality. In the anamnestic study, variables concerning the socioeconomic status, systemic conditions (comorbidity of selected general diseases, nicotine addiction status, body mass) and selected behaviors promoting oral health were determined. RESULTS: The most common clinical changes in the oral mucosa were denture-related stomatitis (6.7%), hemangiomas (5.9%) and fibromas (4.1%). Potentially malignant disorders and cancerous lesions were diagnosed in 59 persons (15.2% of the respondents). One case of tongue cancer was diagnosed in an inhabitant of Olawa. CONCLUSIONS: More than 1/3 of the examined persons were diagnosed with certain clinical, pathological oral mucosal lesions requiring treatment, of which nearly half were potentially malignant and cancerous. Poor tooth brushing efficiency was associated with a higher incidence of pre-cancerous and cancerous lesions in the oral cavity.

[Dental perspective on Crohn's disease: literature review].

Crohn's disease (CD) is a chronic, idiophatic inflammatory process of the gastrointestinal tract and its cause remains unknown. It can affect any part of the digestive system, but preferentially involves the terminal part of the small intestine and the beginning of the large intestine. The disease course is usually long-term with episodes of remission and relapses. The clinical presentation of the disease varies and depends on the site of inflammation. Oral lesions can occur in 80% of pediatric and 90% of adult patients with CD. The most frequent are swelling of the oral mucosa with surface cobblestoning, ulcerations, candidiasis, angular cheilitis. The difficulty in diagnosis, resulting from the non-specific clinical manifestation, hamper proper diagnosis and delay the start of treatment. This paper presents etiology, epidemiology, clinical features and basic therapeutic capabilities for CD in the light of the literature. Oral manifestation of this disease was particularly emphasized.