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1.
J Community Health ; 49(2): 314-323, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37932629

RESUMEN

BACKGROUND AND OBJECTIVE: Older persons with low socioeconomic status in the United States have different and unique health needs compared to younger persons. As part of a student-led, interprofessional partnership, we performed a needs assessment of community dwelling older persons with low socioeconomic status in an urban location within Ohio, USA. METHODS: Three entities participated in the needs assessment: a student-run health clinic, a Federally Qualified Health Center, and an apartment complex of the study population. Health professional students from medical, dental, nursing, social work, nutrition, and physician assistant programs led the needs assessment process. The process consisted of multiple phases, which included preliminary literature review, survey development, data collection, and analysis. The final survey was multidisciplinary, with six content areas covered in 37 items. RESULTS: One hundred nineteen survey responses were received, and multiple areas of need were identified including food insecurity, dental care access, and mental health. 93% of participants had at least one unmet health need and 39% of respondents met our classification for high need. The needs of the local study population had key differences from previously published data in more generalized populations of older community-dwelling individuals in the United States, notably lower utilization of dental care (43% vs. 66%), increased prevalence of possible food insecurity (30% vs. 17%), and increased use of age-appropriate preventive cancer screening services. CONCLUSIONS: Multiple areas of need were successfully identified through a student-led interprofessional needs assessment. Future student teams can address the identified needs, again through interprofessional collaborations. This process may have unique benefits to help build robust community-academic partnerships, while fostering interprofessional collaborative opportunities among healthcare students.


Asunto(s)
Relaciones Interprofesionales , Estudiantes , Humanos , Anciano , Anciano de 80 o más Años , Evaluación de Necesidades , Ohio , Atención a la Salud
2.
Clin Oral Investig ; 28(7): 398, 2024 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-38918223

RESUMEN

OBJECTIVES: We perform special-need dental treatment at outpatient department (OPD), under general anesthesia (GA) when necessary, and provide domiciliary dental care. We aim to evaluate the profile and the characteristics of special needs patients (SNPs). MATERIALS AND METHODS: We consecutively enrolled 3117 SNPs from January 1, 2019 to December 31, 2022. Eighty patients with rare or genetic diseases were excluded. Demographic data were retrospectively collected. RESULTS: There were totally 3037 SNPs (mean age: 48.2 years; range, 1-100; male-to-female ratio, 1.5); 89.1% (n = 2705) SNPs received dental care at the OPD (OPD-SNPs), 7.9% (n = 239) received dental treatment under GA, and 3.0% (n = 93) received domiciliary dental care. Among those SNPs who received dental treatment under GA (n = 239), 91.2% (n = 218) were mental/intellectual disabled, and most underwent cavity filling (69.5%) and dental extractions (56.5%). OPD-SNPs with mental/intellectual disabilities (n = 1340) received significantly more items of dental treatment than those without (n = 1365). SNPs with more severe disabilities received more fluoride application and ultrasonic scaling (both p < 0.001, trend tests). Interestingly, among OPD-SNPs with mental/intellectual disabilities (n = 1340), more severe patients received more fluoride application (p < 0.001) and ultrasonic scaling (p < 0.001) but fewer root canal treatment (p = 0.007, trend test). CONCLUSIONS: GA benefited SNPs with more dental procedures, including invasive items. SNPs with mental/intellectual disabilities can tolerate more measures and SNPs with more severe mental/intellectual disabilities received more preventive measures but less invasive measures. Similarly, more severe SNPs with other disabilities received more preventive measures but not invasive measures. CLINICAL RELEVANCE: Our findings may provide useful information for special needs dentists and for doctor-patient communication.


Asunto(s)
Atención Dental para la Persona con Discapacidad , Humanos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Adulto , Anciano , Taiwán , Adolescente , Anciano de 80 o más Años , Niño , Anestesia General , Lactante , Preescolar , Centros Médicos Académicos
3.
Dent Traumatol ; 40 Suppl 2: 23-32, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38459657

RESUMEN

Munchausen syndrome by proxy (MSbP) is a form of abuse in which a caregiver with Factitious Disorder Imposed on Another (FDIA) fabricates or induces signs or symptoms in a person under their care to satisfy a self-serving psychological need. Unnecessary clinical evaluations, procedures, and treatments that are initiated based on falsification by the abuser inadvertently add to the trauma experienced by the victim. It is a form of abuse and the impact on victims can be severe, sometimes fatal, and far-reaching such as prolonged neglect and extension to affected siblings. The long-term exposure to MSbP may predispose the victim to eventually developing factitious disorder imposed on self (FDIS). While MSbP often involves child victims, elderly, adults, and pets have also been reported as victims. MSbP can be a diagnostic challenge, and the important keys to timely identification of MSbP include the ability to detect deception by caregivers through awareness, clinical suspicion, and careful review of available health records; it also involves collecting collaborative information from other relevant healthcare providers including dentists, schoolteachers, and social workers. To date, there are limited published cases of MSbP with oral findings. This paper provides a narrative review of the current understanding of MSbP with a section on cases with oral findings. This paper aims to increase awareness about the clinical presentations and management considerations for MSbP among dentists and other healthcare professionals.


Asunto(s)
Síndrome de Munchausen Causado por Tercero , Adulto , Humanos , Niño , Anciano , Síndrome de Munchausen Causado por Tercero/diagnóstico , Síndrome de Munchausen Causado por Tercero/terapia , Síndrome de Munchausen Causado por Tercero/psicología , Atención a la Salud , Odontólogos
4.
Gerodontology ; 41(1): 149-158, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37254273

RESUMEN

BACKGROUND: The oral health of care-dependent older people living in residential care facilities is generally suboptimal. To facilitate adequate daily oral care and timely referral to a dental professional, studies emphasise the need for sustainable, structured oral healthcare policies in aged care organisations. The effect of such interventions is often limited or uncertain owing to a lack of understanding of how effective the integration and implementation of the policy has been within the facilities. This study reports on the development of a method to adequately implement an oral healthcare policy in long-term care organisations for older adults. MATERIALS AND METHODS: An intervention mapping protocol was used to develop a theory- and practise-based methodology. This step-by-step approach combined findings from a literature review, experiences from earlier projects and behaviour change theories in a multilevel programme. RESULTS: Intervention mapping yielded a systematic programme for implementing an oral healthcare policy in aged care organisations. The Oral Health Care Track or "De Mondzorglijn" comprises seven phases, each subdivided into several tasks. The programme's implementation is guided by oral healthcare coaches. CONCLUSION: By using intervention mapping, it was possible to combine behaviour change theories, information derived from needs assessment and earlier experiences into a comprehensive programme to improve the oral health and quality of life of older residents in residential care facilities. Further research is needed to evaluate the use of coaches in the implementation of the Oral Health Care Track.


Asunto(s)
Cuidados a Largo Plazo , Salud Bucal , Humanos , Anciano , Calidad de Vida , Bélgica , Atención a la Salud , Política de Salud
5.
Gerodontology ; 41(1): 28-39, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36790065

RESUMEN

OBJECTIVES: The aim of this study was to explore oral health experiences and priorities in a diverse group of adults aged over 60 in North West England, an area with high oral health inequality. METHODS: Participants were selected using purposive sample from multiple settings across the North West: community, primary dental care and residential care home. Data were collected between October 2018 and March 2019 and involved eight focus groups and three individual interviews with a total of 47 participants. The data were analysed using thematic analysis. RESULTS: Four key themes were identified. The first was issues important to people over 60, which included the appearance of one's teeth, communication, continuity of care and the treatment experience. These were informed by two further themes, past experiences of treatment, which were not always favourable, and perceived barriers, such as accessing NHS dentistry, cost, physical access and oral care in institutional settings. The fourth, connected theme focussed on how oral healthcare messages for different audiences should be disseminated. CONCLUSIONS: There are shortfalls in the provision of oral healthcare to older adults in the UK. Communication and continuity of care with a trusted oral healthcare provider are key priorities for this population. However, our participants felt that current public provision of dental services is not meeting their needs.


Asunto(s)
Disparidades en el Estado de Salud , Salud Bucal , Humanos , Persona de Mediana Edad , Anciano , Atención a la Salud , Investigación Cualitativa , Inglaterra/epidemiología
6.
BMC Oral Health ; 24(1): 1163, 2024 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-39350130

RESUMEN

BACKGROUND: In recent years, the proportion of elderly people in the total patient population has been increasing owing to the rapid aging of Japanese society. However, little is known about the age-specific healthcare communication challenges within the field of dentistry. Therefore, this study aimed to examine the relationship between dentists' explanations and patient-dentist communication among elderly patients. METHODS: The study included 146 dentist-elderly patient pairs from Fukuoka Prefecture, Japan. A questionnaire was administered to pairs of dentists and patients. The survey was conducted between June 2021 and April 2022. We examined the relationships among the survey items: dentist demographics, patient demographics and sufficiency of the dentist explanations, and patient-dentist communication. The logistic regression analysis was conducted to examine the patient's mode of visiting the dentist as the objective variable, sufficiency of the dentist explanations, patient-dentist communication, dentist, and patient factors as explanatory variables. RESULTS: About 30% of patients felt that explanations of "Comparison with other treatment methods," "Treatment period," and "Treatment prognosis" were not sufficient. Among these items, a significantly higher percentage of respondents found the dentist's explanations sufficient when they were treated by more than one dentist. Many good communication factors were significantly associated with the dentist being younger and having a preventive practice. Multivariate analysis revealed a significant association between sufficiency of the dentist explanations and patients' regular dental visits. CONCLUSION: Adequate explanations by dentists for elderly patients were significantly associated with the dentist factor. Improving the quantity and quality of the dentists' explanations of treatment may improve patient satisfaction and promote regular dental visits.


Asunto(s)
Comunicación , Relaciones Dentista-Paciente , Odontólogos , Humanos , Japón , Anciano , Femenino , Masculino , Encuestas y Cuestionarios , Odontólogos/psicología , Persona de Mediana Edad , Cuidado Dental para Ancianos , Anciano de 80 o más Años
7.
BMC Oral Health ; 24(1): 794, 2024 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-39004749

RESUMEN

BACKGROUND: This retrospective clinical study was undertaken to comparatively evaluate the number of restorative treatments, endodontic treatments, and tooth extractions performed for patients under general anesthesia due to dental anxiety or special needs between 2015 and 2022 and to examine the pain, bleeding, nausea, and vomiting data of those patients. METHODS: In total, 1165 patients underwent dental treatment under general anesthesia in the faculty hospital. Those under the age of 15 and with no endodontic procedure planned (n = 918) were excluded, followed by those with incomplete data (n = 25) and those without endodontic treatment (n = 25). Patients who underwent at least one endodontic treatment were finally included in the study (n = 184). Patients were divided into two groups: healthy and with special needs. Dental treatments were recorded as endodontic, restorative, and teeth extractions. Endodontic treatments were classified according to the tooth type (premolar, molar, and incisors). The composite restorations were classified as anterior, occlusal (O), occluso-distal (OD) or occluso-mesial (OM), and mesio-occluso-distal (MOD) restorations and patients' post-treatment pain, nausea, vomiting, and bleeding were recorded. The data were analyzed statistically. RESULTS: Among the 184 patients included in the study, 70 (38%) were healthy, and 114 (62%) had special needs. Postoperative bleeding was observed more in patients with special needs (χ2 = 4.189, p < 0.05), whereas pain was observed more in healthy patients (U = 2922.00, p < 0.05). While the number of anterior, O, and MOD restorations was higher in patients with special needs, the number of OD or OM restorations was higher in healthy patients (χ2 = 74.877, p < 0.05). CONCLUSIONS: Patients with special needs undergo a greater number of restorative treatments compared to control patients, which may be associated with the inadequate oral hygiene care of such patients. However, restorative treatment is mostly indicated for such patients in our faculty hospital, which may indicate that a conservative approach is taken. Additionally, the finding that postoperative bleeding was more severe in this group of patients compared to the control group in this study may emphasize the need to consider more possible complications after general anesthesia in these patients.


Asunto(s)
Anestesia General , Dolor Postoperatorio , Tratamiento del Conducto Radicular , Extracción Dental , Humanos , Estudios Retrospectivos , Femenino , Masculino , Adulto , Tratamiento del Conducto Radicular/efectos adversos , Extracción Dental/efectos adversos , Dolor Postoperatorio/etiología , Persona de Mediana Edad , Atención Dental para la Persona con Discapacidad , Ansiedad al Tratamiento Odontológico , Adolescente , Restauración Dental Permanente/métodos , Restauración Dental Permanente/efectos adversos , Adulto Joven , Anciano , Náusea y Vómito Posoperatorios/etiología
8.
Health Expect ; 26(1): 256-267, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36415161

RESUMEN

INTRODUCTION: Unfinished nursing care (UNC), as the care required by patients that delayed or not delivered, has been investigated mainly from the perspective of nurses, while little is still known from the side of patients. Some studies have involved patients to measure which elements of care are mostly unfinished (e.g., mouth care), whereas a few studies have investigated the reasons for UNC as perceived by them. Their involvement in understanding the reasons for UNC is crucial to advance the knowledge and co-develop possible strategies to prevent or minimize UNC. METHODS: This is a descriptive qualitative study performed according to COnsolidated criteria for REporting Qualitative research guidelines in 2022. A purposeful sample of Italian hospitalized patients in two medical and two surgical units was involved. A face-to-face semistructured interview was used to merge reasons for UNC. Qualitative content analysis was conducted to merge subthemes and themes as factors leading to UNC according to the experience of patients. RESULTS: A total of 23 patients (12 surgical and 11 medical) were involved (12/23 male) with an age average of 66.2 years, educated mainly at secondary school, and with previous hospitalizations (20/23), and dependent on nursing care in daily activities (14/23). Reasons for UNC have been identified at four levels: (1) 'New health-care system priorities' and 'Pre-existing frailty of health-care facilities' were reasons identified at the health-care system level; (2) 'Lack of resources attributed to wards', 'Ineffective ward organization' and 'Leadership' were identified at the unit level; (3) 'Nurses' attitudes and behaviour' were reported at the nurses' level and (4) 'Increased nursing care expectations' were pinpointed at the patient level. CONCLUSION: Patients can be involved in identifying UNC, but also in recognizing the underlying reasons. Engaging them in such investigations might broaden our understanding of the phenomenon and the possibility of identifying strategies to minimize and prevent UNC. PATIENT OR PUBLIC CONTRIBUTION: Patients from four hospital units (two medical and two surgical) were involved in face-to-face interviews to merge the reasons perceived by them as triggering UNC. All factors (as themes and subthemes) have derived from their words, thus enhancing the evidence available from the side of the patients.


Asunto(s)
Atención a la Salud , Atención de Enfermería , Humanos , Masculino , Anciano , Pacientes , Hospitales , Investigación Cualitativa
9.
Gerodontology ; 40(2): 200-206, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35445763

RESUMEN

OBJECTIVE: The UK National Institute of Clinical Excellence (NICE) guidelines recommend that care staff who provide daily personal care to residents: "Understand the importance of residents' oral health and the potential effect on their general health, well-being and dignity." The aim of this study was to explore residents' views and perspectives of dental care in care homes in order to understand how to deliver this care. METHOD: Care homes were identified using care home inspection reports for Wales, the UK. Care homes for older people with residents having mental capacity to consent were invited to participate. Data were collected using semi-structured one-to-one interviews with care home residents, care home managers and oral healthcare leads. Interviews were audio recorded, transcribed and analysed using a thematic approach to data. Analysis was assisted by NVivo 10 software. Data collection was completed when no new themes emerged. RESULTS: This analysis presents findings from 26 interviews with residents, across five care homes. Going into care was associated with a loss of identity. Having teeth and looking after teeth (natural teeth or dentures) was part of keeping that identity. All prioritised privacy, pride and independence above effective oral hygiene. Oral hygiene was viewed as a very private event. Carers adapted oral care, to balance time constraints, care, privacy and dignity. Teeth were a part of personal pride to the extent that two residents said they did not want to die without dentures in their mouths. CONCLUSION: Whilst oral care is important to residents, dignity and privacy are often more important; care routines and practices are adapted around this. Carers need to adopt an individualised, pragmatic and sensitive approach to oral care to account for personal dignity when looking after residents to be able to provide appropriate oral care in accordance with guidance. Members of the dental team need to support carers to provide effective oral care, which allows dignified and effective care.


Asunto(s)
Atención a la Salud , Higiene Bucal , Respeto , Humanos , Hogares para Ancianos , Casas de Salud , Salud Bucal , Anciano de 80 o más Años , Investigación Cualitativa
10.
Gerodontology ; 40(4): 410-421, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36971290

RESUMEN

OBJECTIVES: The aim of this literature review was to summarise the clinical important findings on the endodontic treatment outcome in older patients (≥60 years old) with pulpal/periapical disease considering local and systemic factors from a body of knowledge that is heterogeneous in methods or disciplines. BACKGROUND: Due to the increasing number of older patients in the endodontic practice, and the current trend for tooth preservation, the need for clinicians to have a better understanding of age-related implications that may influence the required endodontic treatment in older adults to retain their natural dentition is indispensable. METHODS: PubMed/Medline and Embase was searched by a medical librarian using specific terms based on inclusion/exclusion criteria. The reference list was hand-seached for additional relevant publications between 2005-2020. A combination of these terms was performed uing Boolean operators and MeSH terms. RESULTS: Of the 1577 publications identified manually and electronically, 25 were included to be fully reviewed by the examiners. The data was derived from three systematic reviews, one systematic and meta-analysis, three case series, four prospective and 14 retrospective cohorts. Overall, there was heterogeneity in reporting as well as limitations in most studies. CONCLUSIONS: The outcome of endodontic treatment (ET) either nonsurgical or surgical or combination of these is not affected by older age. ET can be the treatment of choice in older patients wiht pulpal/periapical disease. There is no evidence that older age per se affects the outcome of any type of endodontic treatment.


Asunto(s)
Atención Odontológica , Enfermedades Periapicales , Anciano , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Resultado del Tratamiento
11.
Gerodontology ; 40(3): 288-298, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36440580

RESUMEN

OBJECTIVE: To assess whether, and if so, which oral health care services for community-dwelling older people with dementia are available. BACKGROUND: Oral health in people with dementia is poor compared with people without dementia. Although multiple oral health care interventions have previously been studied for older people living in nursing homes, little is known about interventions or services for community-dwelling older people with dementia. MATERIALS AND METHODS: A literature search was performed in the databases Pubmed, Embase and CINAHL. The following search terms were used: "Dementia", "Oral health", "Dental health services" and "Older person". The term "dental health services" was intended to be an as broad as possible construct because limited search results were expected. RESULTS: The search generated 1624 unique references, of which seven studies were eligible for inclusion (four cohort studies, one cross-sectional study, and two qualitative studies). The included studies described two actual oral health care services: a telephone help line on oral health and dementia, and a mobile geriatric dental programme in adult day health centres. A need was found for services and strategies specific to community-dwelling older people with dementia. One identified solution was an intervention with individually tailored daily oral hygiene self-care supported by the informal caregiver. Furthermore, increasing accessibility of oral health care professionals with treatment at other locations than their own practices, better collaboration between health care professionals and preventive oral health care are highly necessary. CONCLUSION: There is limited evidence on the availability of oral health care services for community-dwelling older people with dementia, while a need was found for oral health care services that focus on good accessibility, oral hygiene self-care, preventive strategies and collaboration among health care professionals.


Asunto(s)
Vida Independiente , Salud Bucal , Humanos , Anciano , Estudios Transversales , Higiene Bucal , Atención a la Salud
12.
Gerodontology ; 40(4): 422-462, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37694292

RESUMEN

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.


Asunto(s)
Antiinfecciosos Locales , Antiinfecciosos , Desinfectantes , Humanos , Anciano , Desinfectantes/uso terapéutico , Agua , Atención a la Salud
13.
Gerodontology ; 40(3): 326-333, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36151752

RESUMEN

OBJECTIVES: This register-based study on public sector patients aged 60 years and over assessed annual age-specific volume of and reasons for tooth extractions as well as changes in these across the period 2007-2015. BACKGROUND: Alongside the rapidly ageing population, the demand for public oral healthcare services is growing. Damaged teeth may induce a long-lasting inflammation burden in old age. MATERIALS AND METHODS: Data used the electronic documentation of oral healthcare procedures recorded according to healthcare regulation. The study population consisted of all patients over 60 years of age (n = 216 059) who were treated 2007-2015 in public oral health care available to all citizens of Helsinki, Finland. Data for the 9-year time series included reasons for tooth extractions and were aggregated by patient age into 5-year groups. Statistical analyses included rates and proportions, mean values, correlation coefficients and linear regression modelling. RESULTS: Extraction patients (n = 48 623) were more likely in the older age groups: 21.8% in the age group 60-64 and 27.5% in the age group 90+. Mean number of tooth extractions among all patients was 0.4 per patient and 1.7 per extraction patient. Among all tooth extractions (n = 82 677), main reasons were caries 29.5%, apical periodontitis 19.4%, tooth remnant 19.4% and periodontitis 18.0%. Tooth remnant predominated as extraction reason in the oldest age groups, while apical periodontitis displayed an upward trend by calendar year. CONCLUSION: Tooth extractions attributable to caries were common in all old-age groups, tooth remnant extractions were most common in older age groups, and apical periodontitis abounded as extraction reason during 2007-2015.


Asunto(s)
Caries Dental , Periodontitis Periapical , Periodontitis , Humanos , Persona de Mediana Edad , Anciano , Extracción Dental , Caries Dental/epidemiología , Atención a la Salud
14.
Adv Gerontol ; 36(1): 83-88, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37192359

RESUMEN

The object of the study was senile people, who sought dental orthopedic care in municipal healthcare institutions of the town of Cheboksary, the Chuvash Republic. The sample size was 1 000 people. The obtained quantitative indicators were subjected to statistical processing using parametric and nonparametric statistical methods. The analysis of mounted orthopedic dent prosthetic structures manufactured and installed in elderly and senile patients shows that the choice of material and method of manufacture is largely determined by such a social factor as the average monthly income. This, in turn, largely depends on income-generating employment and the possibility of obtaining additional financial support from family members in which the patient lives. Social factors have a significant impact on the quality of life in elderly and senile people.


Asunto(s)
Envejecimiento , Calidad de Vida , Humanos , Anciano , Familia , Atención a la Salud , Empleo
15.
BMC Oral Health ; 23(1): 830, 2023 11 03.
Artículo en Inglés | MEDLINE | ID: mdl-37924058

RESUMEN

BACKGROUND: Health status and health care utilization in people with disabilities are more likely to be poorer than those without disabilities. Previous studies showed that there were gaps in health-related conditions by sociodemographic information and gender but the association between these factors was not explained. This study aims to analyze the relationship between sociodemographic information and the unmet dental care needs of people with disabilities and explore the effect of sex within this relationship. METHODS: The 2014 national survey on persons with disabilities was used, which separated unmet healthcare needs into medical and dental services. Unweighted samples included 6,824 people with disabilities in total and 6,555 (96.1% of the total, weighted as 6,583) people aged 20 years or older were selected as the study population. Frequency and chi-square tests were conducted to determine differences in the prevalence of unmet dental needs based on socioeconomic information, chronic diseases, and behavioral factors after applying weights. Logistic regressions were performed using an adjusted model with sociodemographic information, chronic diseases, and behavioral variables. All analyses were performed using IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, N.Y., USA). RESULTS: Analysis of the sociodemographic factors related to unmet dental care revealed that they were higher in women and the elderly. In the fully adjusted logistic model, most of the sociodemographic information was significantly associated with unmet dental needs. The lowest group was 4.18 times more likely to have unmet dental care needs than the richest group, and females and middle-school graduates were almost twice as likely to experience unmet dental care needs than males and university graduates. Considering the interaction effect of age on unmet dental needs depending on sex differences, the odds ratio decreased for females with every annual increase in both models. Compared with the younger group, the older group showed a lower risk of having unmet dental needs, especially in females. CONCLUSIONS: The factor most closely related to the unmet dental care needs of disabled people was socioeconomic problems. Its influence also differed by sex and age. Therefore, economic support measures and sexual differences are needed for long-term policy consideration to reduce the unmet dental care needs of disabled people.


Asunto(s)
Personas con Discapacidad , Necesidades y Demandas de Servicios de Salud , Anciano , Humanos , Adulto , Masculino , Femenino , Atención a la Salud , Atención Odontológica , Enfermedad Crónica , Accesibilidad a los Servicios de Salud
16.
BMC Oral Health ; 23(1): 947, 2023 11 29.
Artículo en Inglés | MEDLINE | ID: mdl-38031034

RESUMEN

BACKGROUND: Geriatric dentistry is an understudied area in dental schools in Egypt. Our study aimed to assess the knowledge and attitudes of Egyptian dentists regarding geriatric oral health and identify barriers to delivering dental care to geriatric patients. METHODS: We conducted an anonymous online cross-sectional study in November and December 2022, targeting dentists with varying levels of experience working in different Egyptian institutions. A 30-item questionnaire assessed the respondent's views on geriatric oral health, perceived knowledge, attitudes, and barriers. The Google form was distributed through emails and commonly used social media platforms. RESULTS: A total of 421 dentists responded to this online questionnaire. Of the respondents, 44.9% were male, 45.0% were between 20 and 29 years old, and 31.5% worked in more than one dental setting. Multivariate analysis revealed that female sex negatively affected attitude ß = -1.72 [95%CI,-2.43 - -1.11]. The proportion of older patients who visited the respondents' clinics per day (11-30%) and more than 30% increased perceived knowledge [ß = 1.01 (95%CI, 0.41 -1.62), ß = 1.50 (95%CI, 0.71-2.22)] and attitude [ß = 0.70 (95%CI, 0.06-1.40), ß = 0.73 (95%, 0.13-1.61)] while decreased the perceived barriers [ß = -1.10 (95%CI, -1.91 - -0.32)] respectively. On the other hand, years of experience increased perceived knowledge only after 5-10 years [ß = 1.02 (95%CI, 0.04-2.10)] and after more than 10 years [ß = 1.30 (95%CI, 0.21-2.70)]. Governmental work only increased perceived barriers [ß = 1.33 (95%CI, 0.10-2.54)], while living in the middle and west delta decreased perceived barriers [ß = -0.91 (95%CI, -2.12 - -0.01 and ß = -1.33, (95%CI, -2.22 - -0.40) respectively]. CONCLUSIONS: Our study highlights the need to improve the knowledge and attitudes of young dentists towards geriatric dentistry. Furthermore, working conditions in dental facilities, particularly in the government sector and Upper Egypt, need to be improved to reduce barriers to delivering dental care to geriatric patients.


Asunto(s)
Odontólogos , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Femenino , Anciano , Adulto Joven , Adulto , Estudios Transversales , Egipto , Atención a la Salud , Encuestas y Cuestionarios , Actitud del Personal de Salud
17.
Br J Community Nurs ; 28(5): 244-246, 2023 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-37130720

RESUMEN

Oral health is an essential part of a person's wellbeing. However, with increasing community nursing caseloads and more severe issues to tend to, dental hygiene might be overlooked in patients who are in the community. In this article, Sarah Jane Palmer discusses how nurses in the community can assess oral health, the types of assistance and provisions available/given to older adults/disabled individuals, and the extent of research and advice available for community nurses.


Asunto(s)
Personas con Discapacidad , Salud Bucal , Humanos , Anciano , Atención a la Salud , Casas de Salud
18.
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
19.
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
20.
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
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