Autopercepción y condición de salud bucal en el anciano / Self-perception of oral health in the elderly and oral health condition

Introducción: Debido al aumento en la esperanza de vida y, en consecuencia, al aumento en el número de personas mayores, la asociación entre los estados de salud se vuelve relevante en términos de salud pública, ya que además de los años vividos, la calidad de vida de estos pacientes es importante. Objetivo: Evaluar la autopercepción y el estado de salud bucal en personas mayores. Métodos: Estudio observacional, de corte transversal (enero-julio del 2019) en el que se realizaron cuestionarios GOHAI (índice de evaluación de la salud oral geriátrica) y el cuestionario sobre el tipo, el tiempo de uso y la limpieza de las prótesis dentales, el cáncer oral y los datos socioeconómicos. La presencia de posibles lesiones orales también se evaluó mediante examen clínico. Los sujetos incluidos en la muestra eran ancianos (60 años o más) que asistían a las unidades de salud de Aracaju. Resultados: Participaron 55 mujeres y ocho hombres. Al evaluar el índice de evaluación de la salud oral geriátrica, se verificó que el 47,6 por ciento de la muestra tenía una mala percepción de la salud oral. Se encontraron asociaciones entre el índice de evaluación de la salud oral geriátrica entre la última visita al dentista, la adaptación de la prótesis dental y las heridas bucales (p < 0,05). Las lesiones orales más prevalentes fueron mucosa rojiza o irritada (35,7 por ciento) y eritroplasia (14,2 por ciento) y se detectó que el 76 por ciento de las prótesis tenían grietas o suciedad. El 77,7 por ciento de los participantes en el estudio solo utilizaban dentífrico como material de limpieza de la prótesis. Conclusión: La salud bucal autopercibida y las condiciones de salud bucal de los ancianos evaluados se consideraron deficientes, se observa la presencia de prótesis mal adaptadas y agrietadas, además de mucositis(AU)

Introduction: due to the increase in life expectancy and, consequently, to the increase in the number of elderly people, the association between health states becomes relevant in terms of public health, since in addition to the lived years the quality of life of these patients is important. Objective: evaluate the self-perception of oral health and check the oral health condition of the elderly. Methods: observational cross-sectional study (January to July / 2019) in which questionnaires were the GOHAI (Geriatric Oral Health Assessment Index) questionnaire and questionnaire about type, time of use and cleaning of dental prostheses, oral cancer and socioeconomic data. The presence of possible oral lesions was also assessed by clinical examination. The subjects included in the sample were elderly (60 years or older) attending the Aracaju Health Units. Results: fifty-five were female and eight male. When evaluating the Geriatric Oral Health Assessment Index, it is verified that 47.6 percent of the sample has poor self-perception of oral health. Associations were found between GOHAI Index for last visit to the dentist, dental prosthesis adaptation and mouth wound (p < 0.05). The most prevalent oral lesions were reddish or irritated mucosa (35.7 percent), followed by erythroplakia (14.2 percent), 76 percent of the prostheses had cracks or dirt. About the cleaning of the protests, 77.7 percent use only dentifrice as cleaning material. Conclusion: self-perceived oral health and oral health conditions of the elderly evaluated were considered poor, in the presence of poorly adapted and cracked prostheses, in addition to mucositis(AU)

Using the Beers criteria to identify potentially inappropriate medication use by older adult dental patients.

BACKGROUND: An aging population indicates that increasing numbers of older adults will seek oral health care and have multiple chronic conditions treated with a number of medications. The authors examined the Medicare Current Beneficiary Survey administrative data set to characterize potentially inappropriate medication (PIM) use by older adults visiting the dentist and related adverse experiences that may affect oral health care. METHODS: The authors used the 2015 Beers criteria to identify PIMs for older adults. The authors examined the Medicare Current Beneficiary Survey administrative data set for community-dwelling older adults with dental care visits and reported national prevalence estimates of Beers criteria medication prescribing. The authors used logistic regression to identify sociodemographic and health-related characteristics associated with potentially inappropriate prescribing. The authors described medication-related adverse experiences affecting dental care. RESULTS: Among older adults with dental care visits, 56.9% received a prescription for at least 1 Beers criteria medication, and 28.3% received a prescription for 2 or more Beers criteria medications. Beers criteria medication use was associated most strongly with the number of comorbid diseases as represented by higher Charlson Index scores (odds ratios, > 1.0). CONCLUSIONS: A substantial proportion of community-dwelling older adults visiting dentists had received prescriptions for 1 or more potentially age-inappropriate Beers criteria medications. Many of these medications have adverse effects that could affect patient safety and oral health care. PRACTICAL IMPLICATIONS: These results support the need for clinicians to be aware of PIM use by older adults, recognize associated medication-related adverse events, and avoid prescribing age-inappropriate medications to this vulnerable patient population.

Sinonasal complications resulting from dental treatment: outcome-oriented proposal of classification and surgical protocol.

BACKGROUND: Odontogenic sinusitis is a relevant infectious condition of the paranasal sinuses. The widespread use of dental implants and reconstructive procedures for dental implant placement has led to new types of complication. To the authors' knowledge, no publication has extensively examined sinonasal complications resulting from dental treatment, and no classification system allowing standardization and comparison of results is currently available. This study was designed to (a) analyze the results obtained from surgical treatment of complications resulting from dental procedures combining functional endoscopic sinus surgery (FESS) and an intraoral approach and (b) propose a new classification system and standardized treatment protocols for sinonasal complications resulting from dental procedures. METHODS: A total of 257 patients consecutively treated with FESS (136 in conjunction with oral surgery) were included in the study. Different clinical situations were integrated into a new classification system based on the pathogenesis and clinical aspects of each case, with the aim of identifying homogenous treatment groups. Results were evaluated for each class. RESULTS: Of the 257 patients, 254 were successfully treated with surgery performed according to the proposed protocols. Three of 257 patients required a second surgery, after which they completely recovered. Complications of implant and preimplant surgery (maxillary sinus floor elevation) showed longer recovery times. CONCLUSION: The results obtained are very encouraging. The majority of patients (254/257; 98.8%) were successfully treated with the proposed protocols. These results seem to indicate that the rationalization of surgical treatment protocols according to the initial clinical situation may significantly improve the clinical outcome.

Short-term clinical retrospective study of implants in geriatric patients older than 70 years.

OBJECTIVES: The objectives of this study were to analyze the presence of systemic diseases, associated complications, and other problems occurring after loading of an implanted prosthesis, and to evaluate the amount of bone resorption occurring at the apex of alveolar bone. Therefore, this study analyzed these effects on dental implants in elderly patients with systemic diseases. STUDY DESIGN: In total, 35 patients over the age of 70 years who had been operated on at Seoul National University Bundang Hospital (Seongnam, Korea) between June 2003 and December 2006 were included. According to the types of additional surgical procedures, implant site, implant prosthesis, and systemic diseases, statistical comparisons were made of peri-implant bone resorption at last follow-up. RESULTS: Following the completion of prosthodontic treatment, after a mean period of 32.7 months, the mean peri-implant bone resorption was 0.27 mm, and the peri-implant bone resorption was not significantly related to the type of upper prosthesis (P = .383), the surgical procedures accompanying placement (P = .933), or the presence/absence of systemic disease (P = .484). CONCLUSIONS: According to this analysis, implant therapy in geriatric patients with controlled systemic disease should not be considered to be of particularly high risk.

Saúde bucal de idosos restritos ao domicílio: estudo descritivo de uma demanda interdisciplinar / Oral health of residence restricted elders: descriptive study of an interdisciplinary demand

No município de Londrina, a proporção de pessoas acima de 60 anos em 2002 era de 9,35%, enquanto que a média nacional, neste mesmo ano, foi de 8,52%. Do total dessa população, estima-se que 15% apresentam problemas de saúde que dificultam seu deslocamento para atendimento médico-odontológico. Somadas a essa dificuldade, a baixa renda familiar para a utilização dos serviços odontológicos privados e a falta de prioridade nos serviços públicos os coloca em uma condição de abandono. Foram selecionados 43 idosos, moradores do Conjunto Habitacional Ruy Viermond Carnascialli, e então submetidos a uma entrevista e exame clínico odontológico em seus domicílios. Foi observado que 79,1% referiram a última visita a um dentista há mais de cinco anos, e apenas 55,8% reconhecem a necessidade de um atendimento odontológico. No exame clínico, observou-se que 79,1% dos idosos já haviam perdido todos os seus dentes no arco superior e 65,1% no arco inferior, necessitando usar próteses. Quanto ao tempo de uso de uma mesma prótese, foi encontrada a média de 15 anos, sendo que ao considerar o estado geral de conservação, 67,8% das próteses superiores e 82,4% das inferiores tiveram indicação de substituição. O índice de dentes cariados, perdidos ou obturados encontrado foi de 29,7, com a média de 2,3 dentes hígidos presentes por idoso. Devido às precárias condições encontradas, serão necessários estudos considerando a restrição ao domicílio e suas implicações, como fatores de risco para a má condição e manutenção da saúde bucal em idosos.

In the city of Londrina, State of Paraná, Brazil, the proportion of people aged over 60 years in 2002 was of 9.35%, whereas the national average in the same year was 8.52%. Fifteen percent have health problems that hinder their search for health medical and dentalservices. Besides this difficulty, the low family income to afford private dental assistance and the lack of priority in public services place them in a condition of abandonment. Forty-three elders, selected in a convenience sample, were interviewed and underwent clinical dental exams in their homes. It was observed that 79.1% reported their last visit to a dentist more than 5 years ago, and barely 55.8% recognized theneed for dental treatment. In the clinical exam, 79.1% of the elders had already lost all teeth in the upper arch and 65.1% in the lower arch, and needed to use prosthesis. Concerning time of use of the same prosthesis, it was found an average of 15 years, and considering the general state of conservation, 67.8% of the upper prosthesis and 82.4% of the lower ones should be replaced. The index of decayed, lost or filled teeth was of 29.7, with an average of 2.3 teeth with no treatments or problems. Due to the precariousconditions found, more studies on the restraint to residence and its implications are needed, as risk factorsfor bad condition and maintenance of mouth health among elders.