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1.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 59(9): 935-941, 2024 Sep 09.
Artículo en Chino | MEDLINE | ID: mdl-39289982

RESUMEN

Objective: To evaluate preliminary application effects of a provincial-county-township-village four-level network framework which aims at promoting oral health of the elderly, and to conduct preliminary evaluations of the application of this model in the prevention and treatment of oral diseases among the elderly in economically accelerated areas. Methods: Based on the population survey in June 2022, the study focuses on the elderly (≥85 years old) veterans who fought in the Korean War and currently resided in Wuyi County, an old revolutionary base area in Zhejiang Province with accelerated economic development. A four-level network medical service model matrix was constructed, spanning from the provincial level to the county, township, and village. Digital oral health records were established, and in-home dental treatment was provided for elderly individuals who met the inclusion and exclusion criteria. Pre-treatment and 3-months follow-up visits were conducted, and the impact of oral health was recorded using a scale, along with a survey of denture satisfaction. Results: A total of 54 elderly individuals received the geriatric oral healthcare services. After a 3-months follow-up, the mean total score of the oral health impact profile-14 questionnaires was (3.27±3.00), which was significantly lower than the score (32.82±7.15) in pre-treatment ones (Z=-2.94, P=0.003). Scores in dimensions such as physical pain, functional limitations, psychological discomfort, psychological disorders, and physical disorders were all significantly lower than the pre-treatment scores (P<0.05). The visual analogue score for denture satisfaction was 48.64±1.21, indicating a satisfaction rate of 100% (11/11). Conclusions: These findings confirm the favorable preliminary application effects of the four-level network framework in improving the prevention and treatment of oral diseases among the elderly in economically accelerated areas.


Asunto(s)
Salud Bucal , Humanos , Anciano de 80 o más Años , Anciano , Cuidado Dental para Ancianos/economía , Dentaduras
2.
Artículo en Inglés | MEDLINE | ID: mdl-39101529

RESUMEN

BACKGROUND: Long-term care (LTC) costs create burdens on aging societies. Maintaining oral health through dental visits may result in shorter LTC periods, thereby decreasing LTC costs; however, this remains unverified. We examined whether dental visits in the past 6 months were associated with cumulative LTC insurance (LTCI) costs. METHODS: This cohort study of the Japan Gerontological Evaluation Study targeted independent adults aged≥65 years in 2010 over an 8-year follow-up. We used data from a self-reported questionnaire and LTCI records from the municipalities. The outcome was cumulative LTCI costs, and exposure was dental visits within 6 months for prevention, treatment, and prevention or treatment. A 2-part model was used to estimate the differences in the predicted cumulative LTCI costs and 95% confidence intervals (CIs) for each dental visit. RESULTS: The mean age of the 8 429 participants was 73.7 years (standard deviation [SD] = 6.0), and 46.1% were men. During the follow-up period, 17.6% started using LTCI services. The mean cumulative LTCI cost was USD 4 877.0 (SD = 19 082.1). The predicted cumulative LTCI costs were lower among those had dental visits than among those who did not. The differences in predicted cumulative LTCI cost were -USD 1 089.9 (95% CI = -1 888.5 to -291.2) for dental preventive visits, -USD 806.7 (95% CI = -1 647.4 to 34.0) for treatment visits, and -USD 980.6 (95% CI = -1 835.7 to -125.5) for preventive or treatment visits. CONCLUSIONS: Dental visits, particularly preventive visits, were associated with lower cumulative LTCI costs. Maintaining oral health through dental visits may effectively reduce LTCI costs.


Asunto(s)
Seguro de Cuidados a Largo Plazo , Cuidados a Largo Plazo , Humanos , Masculino , Anciano , Femenino , Japón , Cuidados a Largo Plazo/economía , Seguro de Cuidados a Largo Plazo/economía , Estudios de Cohortes , Salud Bucal/economía , Costos de la Atención en Salud/estadística & datos numéricos , Cuidado Dental para Ancianos/economía , Cuidado Dental para Ancianos/estadística & datos numéricos , Anciano de 80 o más Años , Atención Odontológica/economía , Atención Odontológica/estadística & datos numéricos , Pueblos del Este de Asia
4.
Geriatr Gerontol Int ; 24(7): 706-714, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38830832

RESUMEN

AIM: This study examined the oral status and the presence of teeth requiring treatment among older adults receiving home medical care. METHODS: This cross-sectional study was conducted at a Japanese dental clinic specializing in geriatric treatment. We recruited older adults receiving home medical care in the community who had begun to receive domiciliary dental care. The Japanese version of the Oral Health Assessment Tool (OHAT-J), as well as the presence of teeth requiring extraction and the need for assistance in maintaining oral hygiene were used to evaluate the participants' oral health and its association with other items. RESULTS: Ninety-three participants (44 male and 49 female, median age: 87.0 years) were surveyed. The median OHAT-J score was 6. The duration since the previous dental visit was 23 months. Sixty-two (73.8%) of 84 participants with ≥1 natural tooth had severe caries or teeth with severe mobility that required extraction. Logistic analysis revealed that requiring assistance in maintaining oral hygiene, mild dementia, severe dementia, and depression were significantly associated with an OHAT score of ≥6. CONCLUSIONS: Older adults receiving home medical care had poor oral health, with approximately 70% of them requiring tooth extraction. The need for assistance in maintaining oral hygiene and poor mental status contribute to poor oral health. Geriatr Gerontol Int 2024; 24: 706-714.


Asunto(s)
Servicios de Atención de Salud a Domicilio , Salud Bucal , Higiene Bucal , Humanos , Femenino , Masculino , Estudios Transversales , Anciano de 80 o más Años , Japón/epidemiología , Anciano , Evaluación Geriátrica/métodos , Cuidado Dental para Ancianos/estadística & datos numéricos , Extracción Dental
5.
J Am Geriatr Soc ; 72 Suppl 3: S68-S75, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38661080

RESUMEN

BACKGROUND: Implementing the Age-Friendly Health System (AFHS) framework into dental care provides a significant opportunity to link oral health to healthy aging. This project aimed to implement the AFHS 4Ms (what matters, medications, mentation, and mobility) in the provision of oral health care. This article describes the planning, integration, training development, and outcome measurements supporting a 4Ms approach at an academic dental clinic. METHODS: The Eastman Institute for Oral Health (EIOH) implemented screening instruments based on the 4Ms framework recommended for ambulatory care clinics by the Institute for Health Care Improvement (IHI). These ambulatory instruments were integrated into the workflows of a Specialty Care Clinic through the development of a plan-do-study-act cycle, utilization of available clinic resources, and creation of interdisciplinary collaborations. RESULTS: This project demonstrated the feasibility of implementing an AFHS checklist and tracking forms in dental practice by integrating available resources and prioritizing the 4Ms elements. This effort necessitated interdisciplinary collaborations between dental, medical, and social service professionals. It also created a new age-friendly focused education and training curriculum for dental residents and faculty. CONCLUSIONS: This pilot project is the first to establish dental standards for AFHS implementation, adapting the 4Ms assessment and metrics to oral health. This AFHS underscores key oral health processes, including assessment, planning, and personalized oral health care, adapted to the unique needs of the older adult population, especially those with cognitive impairment.


Asunto(s)
Clínicas Odontológicas , Salud Bucal , Humanos , Salud Bucal/educación , Anciano , Clínicas Odontológicas/organización & administración , Proyectos Piloto , Cuidado Dental para Ancianos , Masculino , Envejecimiento Saludable , Femenino , Lista de Verificación
6.
J Dent Educ ; 88(5): 573-586, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38321860

RESUMEN

PURPOSE/OBJECTIVES: Older adults frequently report unmet oral healthcare needs. Current research suggests a lack of provider willingness to perform geriatric dental care plays a role in limiting older adults' access to dental services. To better understand the acceptance of geriatric dentistry programming in Ontario, and to explore considerations for successful implementation, we completed consultations with dental students and dental education stakeholders. Findings from a scoping review we conducted previously (Alicia C. Brandt and Cecilia S. Dong) were used to guide this research. METHODS: Consultations involved a questionnaire and semi-structured individual interviews. Descriptive and parametric statistics such as Pearson's bivariate correlation and One-way analysis of variance were completed on questionnaire data using SPSS V.28. Interview data were transcribed verbatim, and the content was analyzed using emergent coding and thematic analysis in NVivo. Student and faculty data were analyzed separately and then consolidated. RESULTS: Ten students and 12 dental faculty members completed the questionnaire of which ten students and nine faculty members also participated in interviews. Themes were organized into barriers and facilitators, with a subsection on interprofessional collaboration. Barriers included: 1. Student anxiety and skill level; 2. Constraints of the learning environment; 3. Patient factors; and 4. Knowledge gaps. Facilitators included: 1. Learning environment and culture; 2. Volume of exposure; 3. Soft skills; and 4. Desired interventions. CONCLUSIONS: Both students and faculty stakeholders demonstrated acceptance of geriatric dentistry programming at the undergraduate dentistry level that supports improved access to care for this population. Pilot programs integrating different intervention elements which were viewed as most promising would be beneficial.


Asunto(s)
Educación en Odontología , Odontología Geriátrica , Estudiantes de Odontología , Humanos , Estudiantes de Odontología/psicología , Educación en Odontología/métodos , Odontología Geriátrica/educación , Ontario , Entrevistas como Asunto , Encuestas y Cuestionarios , Cuidado Dental para Ancianos , Anciano , Actitud del Personal de Salud , Docentes de Odontología , Curriculum , Participación de los Interesados , Masculino
7.
Spec Care Dentist ; 44(4): 1135-1145, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38217073

RESUMEN

PURPOSE/AIM: Improve content validity of the Ageism Scale for Dental Students (ASDS) and identify barriers to using the scale. METHODS: Thematic analysis of transcripts of three purposively sampled focus groups of 1) geriatric dentistry specialists, 2) older adult dental patients, and 3) dental students. RESULTS: Twenty-five participants engaged in focus groups. No new concepts to define ageism were identified. Experts found the scale acceptable and appropriate, yet they raised specific potential revisions to scale questions. Commonly reported themes already addressed by ASDS included the importance of tailoring decision-making to patient preference and not making assumptions about older adults' capacity or preferences for dental care. Barriers to identifying ageism or using the scale included experiential differences in interpreting scale items, cultural differences in attitudes towards older adults, and potential overlap with social determinants of health. Secondary findings include recommendations for older-adult focused training for dental students to provide positive, concrete guidance on caring for older adults. CONCLUSION: There are opportunities to refine the Ageism Scale for Dental Students and to allow tailoring of the scale for specific national or cultural contexts.


Asunto(s)
Ageísmo , Grupos Focales , Estudiantes de Odontología , Humanos , Estudiantes de Odontología/psicología , Masculino , Femenino , Adulto , Anciano , Cuidado Dental para Ancianos , Reproducibilidad de los Resultados , Persona de Mediana Edad , Actitud del Personal de Salud
8.
Int Dent J ; 74(4): 816-822, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38220512

RESUMEN

BACKGROUND: Aspiration pneumonia has a high recurrence rate, and oral care by dentists has been found effective in preventing its onset; however, this has not been evaluated using prospective studies. Therefore, we conducted a prospective study to evaluate the effectiveness of professional oral care by dentists in reducing aspiration pneumonia recurrence in older adult patients. METHODS: In this prospective cohort study, we evaluated a dental oral care intervention, using a historical control group (control group). It was conducted at a single-centre regional core hospital in Japan that serves a large number of patients aged older than 80 years. Patients who were hospitalised for aspiration pneumonia were included in this study. During the study period (1 April 2021 to 31 March 2022), the clinical group received weekly professional cleaning by a dentist and the control group received standard oral care by a nurse as usual from 1 April 2020 to 31 March 2021. The dentist oral care group received weekly professional oral care from a dentist and was followed prospectively for 1 year. A Kaplan-Meier analysis was used to evaluate the timing of recurrent aspiration pneumonia or death. A Cox proportional hazards model was used to obtain a hazard ratio and determine the 95% confidence intervals. RESULTS: There were 91 participants in the clinical group and 94 in the control group. The mean age of participants was 85 years, and 75 (40.5%) were female. The recurrence rate was 27.5% in the clinical group and 44.7% in the control group (P = .005). Professional cleaning by a dentist reduced the risk of recurrence of aspiration pneumonia by approximately 50% (adjusted hazard ratio, 0.465; 95% confidence interval, 0.278-0.78). CONCLUSIONS: Professional cleaning by a dentist was associated with a lower rate of aspiration pneumonia recurrence than nurse-provided conventional oral care.


Asunto(s)
Neumonía por Aspiración , Recurrencia , Humanos , Estudios Prospectivos , Femenino , Neumonía por Aspiración/prevención & control , Masculino , Anciano de 80 o más Años , Japón , Anciano , Atención Odontológica , Modelos de Riesgos Proporcionales , Higiene Bucal , Estimación de Kaplan-Meier , Cuidado Dental para Ancianos
9.
Community Dent Oral Epidemiol ; 52(3): 344-352, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38251785

RESUMEN

OBJECTIVES: Oral healthcare service is not well integrated with existing healthcare policy in nursing homes (NHs) globally. This qualitative study aimed to identify dentists' perspectives on structural and system barriers that hinder oral healthcare (OHC) provision to seniors in NHs in Singapore and to understand the consequences of these barriers. METHODS: Nineteen dentists (8 males and 11 females, 36.0 [IQR: 32.0-48.5] years old) were recruited through combination of purposive and snowball sampling. Four focus group discussions were conducted via teleconferencing, and each discussion had 4-5 anonymised participants. Sessions lasted 90-120 min and were audio-recorded and transcribed verbatim. Thematic analysis was conducted on data collected using NVivo software (Version12, QRS International). RESULTS: Participants agreed that the current OHC system for seniors in NHs is not well developed. The challenges dentists faced were categorised in three themes: [1] general oral healthcare system level; [2] local nursing home setting level; and [3] geriatric oral healthcare education level. These challenges are complexly intertwined and have contributed to several consequences such as a shortage of dentists in NHs and their diminished motivation to serve. It has also limited the quality of dental service they are able to provide in NHs, contributing to the current poor access of dental services for seniors in NHs. CONCLUSIONS: Dentists in Singapore face many structural and systemic barriers in providing OHC to seniors in NHs, some of which are unique to the local context. Newfound understanding of these barriers and its consequences will be helpful in developing strategic approaches to overcome these challenges.


Asunto(s)
Odontólogos , Grupos Focales , Casas de Salud , Humanos , Masculino , Femenino , Persona de Mediana Edad , Odontólogos/psicología , Odontólogos/estadística & datos numéricos , Adulto , Singapur , Actitud del Personal de Salud , Accesibilidad a los Servicios de Salud , Investigación Cualitativa , Cuidado Dental para Ancianos , Anciano
10.
Sante Publique ; 35(HS1): 77-82, 2023 12 01.
Artículo en Francés | MEDLINE | ID: mdl-38040648

RESUMEN

Good oral health preservation in nursing homes is hampered by the lack of caregivers, who are often inadequately trained, which has an impact on patients' quality of life. The aim was to assess caregivers' practices and the objective and perceived oral care needs of patients in nursing homes. A cross-sectional survey was conducted between September 15 and November 24, 2021, in three nursing homes in Mayenne (France). A self-administered questionnaire was used to identify oral care practices and caregivers' training needs. The care needs and oral health related quality of life of patients were assessed by a single dental surgeon using the OHAT and the GOHAI questionnaire. Assessments were done with 30.8 percent of caregivers, and 40.0 percent and 36.2 percent of patients for OHAT and GOHAI respectively. Oral cavity and prosthesis examinations were systematically carried out by 4.9 percent and 24.4 percent of caregivers respectively. Fifty percent of the nurses had never performed oral care. A need for practical training was expressed by 75.6 percent of the caregivers. The mean GOHAI and OHAT scores were 56.17 ± 5.69 and 6.01 ± 2.42. These scores were significantly correlated (rho=-0.34; p=0.002). Preventive oral care in nursing homes is necessary to maintain residents' quality of life. Efforts must be made to provide training for caregivers and to simplify oral care procedures for patients.


Le maintien d'une bonne santé orale en EHPAD se heurte au manque de soignants, de surcroît souvent insuffisamment formés, ce qui impacte la qualité de vie des patients. L'objectif était d'évaluer les pratiques des soignants et les besoins en soins oraux des patients objectifs et ressentis en EHPAD. Une enquête transversale a été réalisée du 15 septembre au 24 novembre 2021 dans 3 EHPADs de Mayenne. Un auto-questionnaire a été utilisé pour identifier les pratiques de soins et les besoins de formation des soignants. Les besoins de soins et la qualité de vie en lien avec la santé orale des patients ont été évalués par un seul chirurgien-dentiste à partir de la grille OHAT et du questionnaire GOHAI. Les évaluations ont concerné 30,8% des soignants ainsi que 40,0% et 36,2% des patients pour l'OHAT et le GOHAI. Les examens de la cavité orale et des prothèses dentaires étaient systématiquement réalisés par respectivement 4.9% et 24,4% des soignants. Les soins de bouche n'étaient jamais réalisés par 50,0% des infirmiers. Un besoin de formation pratique était exprimé par 75,6% des soignants. Les scores GOHAI et OHAT moyens étaient de 56,17 ± 5,69 et 6,01 ± 2,42. Ces scores étaient significativement corrélés (rho=-0,34 ; p=0.002). Les actions de prévention orale dans les EHPADs sont nécessaires pour maintenir la qualité de vie des résidents. Des efforts doivent être consentis pour la formation des soignants et la simplification du parcours de soins bucco-dentaires des patients.


Asunto(s)
Cuidadores , Cuidado Dental para Ancianos , Calidad de Vida , Humanos , Estudios Transversales , Casas de Salud , Salud Bucal
11.
Stomatologiia (Mosk) ; 102(3): 55-60, 2023.
Artículo en Ruso | MEDLINE | ID: mdl-37341083

RESUMEN

THE AIM OF THE STUDY: Was an improvement of dental health by optimizing dental medical examination in socially significant groups of the population. MATERIALS AND METHODS: A continuous sample of 500 patients aged 65 to 95 years who applied to selected private dental organizations and public dental organizations in the period 2017-2020 was made. The clinical study was carried out by taking an anamnesis and a dental examination. The results of a retrospective analysis of the prevalence and intensity of the main dental diseases in elderly and senile people are presented, a scheme for dental medical examination of the study group is proposed. RESULTS: In a comprehensive dental examination of groups of elderly and senile people, the DMFT in the age group of 65-74 years is 18.8 [14.35-24.4], in the group of 75-84 years 20.5 [13.7-27.3], while in people from the group over 85 years 24.9 [19.05-28] teeth, in order to reduce high dental morbidity we have developed an original scheme for the procedure for conducting preventive medical examinations of older age groups of the adult population. CONCLUSIONS: The results of the study indicate the insufficiency of preventive programs and therapeutic measures among the elderly and senile. The data obtained are aimed at substantiating the main directions for improving dental care for patients of the older age group in the current conditions of the healthcare system.


Asunto(s)
Cuidado Dental para Ancianos , Salud Bucal , Anciano , Anciano de 80 o más Años , Humanos
13.
Clin Geriatr Med ; 39(2): 191-205, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37045528

RESUMEN

The population of older adults is projected to increase dramatically as Baby Boomers continue to reach age 65 into 2029. This article discusses key shifts in this demographic, including changes in overall health status and living arrangements, that can aid in defining older adults and their medical needs. It also highlights the changes in dental use patterns and the increase in demand for comprehensive dental services for older adults in recent years. The article focuses on the fact that oral health contributes to overall health and the dental workforce must be prepared to treat older adults in their practices.


Asunto(s)
Cuidado Dental para Ancianos , Necesidades y Demandas de Servicios de Salud , Humanos , Anciano , Atención a la Salud , Aceptación de la Atención de Salud , Demografía
15.
Ned Tijdschr Tandheelkd ; 130(1): 17-24, 2023 Jan.
Artículo en Holandés | MEDLINE | ID: mdl-36637014

RESUMEN

Many frail older adults have a poor oral health: unrestorable broken teeth and root remnants with open root canals, commonly associated with periapical and periodontal inflammation, are often seen. Improving oral health in this growing group of frail older adults is a considerable challenge for dental care professionals. Dentists are often uncertain how to deal with root remnants and unrestorable broken teeth in psychogeriatric and/or medically compromised frail older adults. Decisions about the extraction or retention of root remnants should not only be made on the basis of preventing pain and inflammation, but also on the course of disease, life expectancy, cooperation, laws and regulations and other factors that are an issue in geriatric patients but not in regular (healthy) patients. To help oral health care professionals in their treatment choice for this complex patient group, a decision tree was developed in which both root and patient-related factors were included.


Asunto(s)
Anciano Frágil , Salud Bucal , Anciano , Humanos , Estado de Salud , Inflamación , Esperanza de Vida , Cuidado Dental para Ancianos
16.
Rev. Flum. Odontol. (Online) ; 1(60): 1-14, jan.-abr. 2023. ilus
Artículo en Portugués | LILACS, BBO | ID: biblio-1411180

RESUMEN

O equilíbrio sistêmico e a saúde bucal são condições clínicas que estabelecem entre si uma relação multidimensional capaz de exercer grande impacto sobre o bem-estar cotidiano do indivíduo. As disfunções metabólicas associadas ao estado nutricional e a perda da capacidade muscular geram uma maior necessidade de cuidados em pessoas idosas. Sob o ponto de vista odontológico a presença de dentes naturais bem como o grau de doença periodontal, estão associados a competência mastigatória e, desta forma, são fatores determinantes na saúde da população acima dos 60 anos de idade. O presente estudo teve como objetivo avaliar, através da análise retrospectiva dos últimos 05 anos, a relação entre a saúde bucal e as condições sistêmicas de indivíduos acima de 60 anos residentes na Baixada Fluminense (Rio de Janeiro/Brasil) com evidente crescimento demográfico populacional. Para isso foram analisados 11.390 prontuários de pacientes usuários da Clínica Odontológica da Universidade Iguaçu/RJ sendo selecionados 1.125 que atendiam aos critérios de inclusão. Os resultados destacam a presença de doença periodontal em cerca de 56% dos indivíduos diabéticos, além de 43% com quadro hipertensivo no momento do atendimento apontando para uma importante relação entre a atenção com a saúde bucal da população assistida nessa região e suas condições sistêmicas.


Systemic balance and oral health are clinical conditions that establish a multidimensional relationship capable of having a great impact on the individual's daily well-being. Metabolic dysfunctions associated with nutritional status and loss of muscle capacity generate a greater need for care in the elderly. From the dental point of view, the presence of natural teeth, as well as the degree of periodontal disease, are associated with masticatory competence and, thus, are determining factors in the health of the population over 60 years of age. The present study aimed to describe descriptively, through the retrospective analysis of the last 05 years, the relationship between oral health and the systemic conditions of individuals over 60 years old living in the Baixada Fluminense (Rio de Janeiro / Brazil) with evident population demographic growth. For that purpose, 11,390 medical records of patients who were users of the Clínica Odontológica of Universidade Iguaçu / RJ were analyzed, 1,125 who met the inclusion criteria were selected. The results highlight the presence of periodontal disease in about 56% of diabetic individuals, in addition to 43% with the hypertensive condition at the time of care, pointing to an important relationship between the attention to the oral health of the assisted population in this region and their systemic conditions.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Signos y Síntomas , Anciano , Registros Médicos , Salud Bucal , Cuidado Dental para Ancianos , Atención a la Salud
17.
J Am Geriatr Soc ; 71(3): 756-764, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36334034

RESUMEN

BACKGROUND: Pneumonia is common in nursing home residents and is a leading cause of hospitalization and death. Nursing home residents with cerebrovascular diseases and impaired consciousness are at high risk of aspiration pneumonia. Professional and mechanical oral care by dentists and hygienists in addition to daily oral care by caregivers was shown to be effective in preventing pneumonia in nursing home residents. However, professional and mechanical oral care has not been widely provided in Japan, while daily oral care by caregivers has been widely provided as a basic service in nursing homes. This study aimed to evaluate the cost-effectiveness of providing professional and mechanical oral care for preventing pneumonia in nursing home residents. METHODS: Using a decision tree and Markov modeling, we conducted a cost-effectiveness analysis from the payer's perspective (social insurers and patients) in Japan. RESULTS: The incremental cost-effectiveness ratio for professional and mechanical oral care compared with daily oral care only was calculated as 4,079,313 Japanese yen (¥; 33,994 United States dollars [US$], US$1 = ¥120) per quality-adjusted life year. CONCLUSIONS: Using the official value of social willingness to pay for a one-quality-adjusted life year gain in Japan of ¥5 million (US$41,667) as the threshold to judge cost-effectiveness, providing professional and mechanical oral care is cost-effective. Our results suggest professional and mechanical oral care for preventing pneumonia in nursing home residents could be justifiable as efficient use of finite healthcare resources. The results have implications for oral care in nursing homes both in Japan and worldwide.


Asunto(s)
Cuidado Dental para Ancianos , Hogares para Ancianos , Casas de Salud , Salud Bucal , Neumonía , Análisis Costo-Beneficio , Hospitalización , Japón , Neumonía/prevención & control , Cepillado Dental , Humanos , Masculino , Femenino , Anciano de 80 o más Años
18.
Braz. j. oral sci ; 22: e236637, Jan.-Dec. 2023. ilus
Artículo en Inglés | LILACS, BBO | ID: biblio-1424811

RESUMEN

Xerostomia is defined as the perception of dry mouth, and dysgeusia, as a change in taste. Both are common complaints in the elderly, especially among those making use of polypharmacy drug combinations. Aim: This study aimed to determine the prevalence of xerostomia and dysgeusia and to investigate their association with polypharmacy in the elderly. Methods: older people under follow-up at the Multidisciplinary Elderly Center of the University Hospital of Brasília were interviewed and asked about health problems, medications used, presence of xerostomia and dysgeusia. Descriptive statistics were used to determine the prevalence of the symptoms surveyed. The chi-square test was used to investigate the relationship between xerostomia and dysgeusia and polypharmacy. Secondary associations were performed using binomial logistic regression. Results: Ninety-six older people were evaluated and of these, 62.5% had xerostomia and 21.1%, had dysgeusia. The average number of medications used was 4±3 medications per individual. Polypharmacy was associated with xerostomia but not dysgeusia. It was possible to associate xerostomia with the use of antihypertensive drugs. Conclusion: Xerostomia was a frequent complaint among elderly people making use of polypharmacy, especially those using antihypertensives. Antihypertensives and antidepressants were used most drugs by the elderly and exhibited interactions with drugs most prescribed in Dentistry. Two contraindications were found between fluconazole and mirtazapine; and between erythromycin and simvastatin


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Xerostomía/epidemiología , Cuidado Dental para Ancianos , Polifarmacia , Interacciones Farmacológicas , Disgeusia/epidemiología
19.
Rev. bras. geriatr. gerontol. (Online) ; 26: e220191, 2023. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1441282

RESUMEN

Resumo Objetivo investigar a autopercepção das condições bucais e fatores associados em idosos quilombolas rurais do norte de Minas Gerais, Brasil. Método Trata-se de um estudo analítico e transversal de base populacional, no qual utilizou-se uma amostragem por conglomerados com probabilidade proporcional ao tamanho (n=406). A coleta de dados envolveu a realização de entrevistas e exames clínicos odontológicos. A autopercepção das condições bucais foi avaliada por meio do GOHAI (Índice de Determinação da Saúde Bucal Geriátrica). Resultados A maioria dos idosos autopercebeu a saúde bucal como ótima (46,3%) ou regular (30,2%). Os pesquisados revelaram ainda precária saúde bucal e acesso restrito aos serviços odontológicos. Verificaram-se, na análise múltipla, associações significantes (p˂0,05) entre GOHAI regular e variáveis relativas ao local da última consulta e uso de prótese, bem como entre GOHAI ruim e variáveis atinentes ao estado conjugal, religião, motivo da última consulta, índice CPO-D e uso de prótese. Conclusão Parcela expressiva dos idosos quilombolas manifestou uma autoavaliação mais positiva da saúde bucal, divergente do quadro odontológico constatado profissionalmente. Constatou-se ainda que o relato de percepção ruim das condições bucais esteve fortemente associado a uma saúde bucal mais precária entre os investigados.


Abstract Objective to investigate self-perception of oral conditions and associated factors in rural quilombola older people in northern Minas Gerais, Brazil. Method This is an analytical and cross-sectional population-based study, in which cluster sampling with probability proportional to size (n=406) was used. Data collection involved conducting interviews and clinical dental examinations. Self-perception of oral conditions was assessed using the GOHAI (Geriatric Oral Health Determination Index). Results Most older people self-perceived oral health as excellent (46.3%) or regular (30.2%). Those surveyed also revealed precarious oral health and restricted access to dental services. In the multiple analysis, significant associations (p˂0.05) were found between regular GOHAI and variables related to the location of the last consultation and use of prosthesis, as well as between poor GOHAI and variables related to marital status, religion, reason for last consultation, CPO-D index and use of prosthesis. Conclusion A significant portion of the quilombola older people showed a more positive self-assessment of oral health, which differs from the professionally verified dental condition. It was also found that the report of poor perception of oral conditions was strongly associated with poorer oral health among those investigated.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Autoimagen , Servicios de Salud Dental , Odontología Geriátrica , Brasil , Salud Bucal/etnología , Cuidado Dental para Ancianos , Diagnóstico Bucal , Autoevaluación Diagnóstica , Accesibilidad a los Servicios de Salud/organización & administración
20.
Rev. Fac. Odontol. (B.Aires) ; 38(89): 31-37, 2023. ilus, tab
Artículo en Español | LILACS | ID: biblio-1552895

RESUMEN

Objetivo: Comparar la discrepancia anteroposterior medida a nivel de la platina incisiva de 2 métodos de registro intermaxilar en la misma sesión que la im-presión definitiva en adultos mayores desdentados totales. Materiales y métodos. Se incluyeron en el es-tudio 20 pacientes (n=20) con edad promedio de 70 años. En cada uno de ellos se obtuvieron registros intermaxilares con cubetas rodete de acrílico: uno con inducción manual (IM) y otro autoinducido con el sistema de cubeta rodete de acrílico y apoyo central único utilizando una superficie palatina de registro curva (BYC). Los modelos fueron montados en un ar-ticulador Whip Mix modelo 2240 al que se le adicio-nó un dispositivo de papel milimetrado, Orthodent, a nivel de la platina incisiva, para registrar las dife-rencias existentes entre las posiciones obtenidas. El análisis estadístico se llevó a cabo mediante el cálcu-lo de intervalos de confianza (95%) para las diferen-cias medias y prueba de t de student para datos apa-reados (nivel de significancia: α<0,05). Resultados. En el plano mesiodistal a nivel de la platina incisiva se encontró diferencia estadísticamente significativa entre las dos variables de registro (p<0,001). A este nivel el BYC proporcionó registros más retrusivos que IM. Media aritmética (desviaciones estándar) en milímetros: 3,82 (2,1). Conclusión. El sistema de re-gistro con cubetas rodete acrílicas y BYC incorpora-do a las mismas proporciona un registro intermaxi-lar más retrusivo que IM en adultos mayores des-dentados totales cuando se realizan dichos registros en la misma sesión que la impresión definitiva (AU)


Objective: To compare the anteroposterior discre-pancy measured at the level of the incisal plate of 2 methods of intermaxillary registration in the same session as the definitive impression in fully edentu-lous older adults. Materials and methods. Twenty pa-tients (n=20) with an average age of 70 years were included in the study. On each of them, intermaxillary recordings were obtained with acrylic rims trays: one with manual induction (MI) and the other with a self-induced system and single central support using a curved recording palatal surface (BYC). The models were mounted in a Whip Mix model 2240 articula-tor to which an Orthodent graph paper device was added, at the level of the incisal plate, to record the di-fferences between the positions obtained. Statistical analysis was carried out by calculating confidence intervals (95%) for mean differences and T-student for paired data (significance level: α<0.05). Results. On the mesiodistal plane at the level of the incisal plate, a statistically significant difference was found between the two recording variables (p<0.001). At this level the BYC provided more retrusive recordings than MI. Arithmetic mean (standard deviations) in mi-llimeters: 3.82 (2.1). Conclusions. The registration system with acrylic rim trays and BYC incorporated into them provides a more retrusive intermaxillary registration than MI in fully edentulous older adults when such registrations are made in the same ses-sion as the final impression.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Resinas Acrílicas , Cuidado Dental para Ancianos , Técnica de Impresión Dental/instrumentación , Boca Edéntula , Registro de la Relación Maxilomandibular/métodos , Argentina , Facultades de Odontología , Dentadura Completa
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