Oral health of older people admitted to hospital for needs assessment.

OBJECTIVES: To describe the clinical oral health status, treatment needs and oral-health-related quality of life (OHRQoL) of older people admitted to older persons' wards at Dunedin Public Hospital due to a sudden worsening of their general health. Participants and methods: A systematic oral assessment was undertaken for a consecutive case series of 200 patients (59.5% female; mean age 82.6 years, sd 6.6) admitted to older person's wards at Dunedin Public Hospital. The Oral Health Impact Profile-20 (OHIP-20) was used to assess OHRQoL. RESULTS: One in three (36.0%) had been living independently at home prior to admission, and over half (55.0%) had been admitted for a medical reason which required assessment. Half (50.0%) of the participants were dentate (with an average of 16.8 teeth). There was an average of 1.9 decayed teeth present in the dentate group; 70.7% of individuals required restorations or extractions, and about 90% required only simple scaling of the teeth and prophylaxis. A reline or a replacement denture were required by three-quarters of those with dentures. Almost two-thirds of participants did not have a regular dentist, and fewer than one in three had made a dental visit in the previous year. One in six described their oral health as 'fair' or 'poor', and just under one-third reported dry mouth. Dentate participants, those without xerostomia, and those reporting better oral health had better OHRQoL, reflected in lower OHIP-20 scores. Affecting 37.1% of participants, functional limitation was the most commonly experienced of the OHIP-20 domains, followed by physical disability and physical pain (18.0% and 15.6% respectively). CONCLUSIONS: The oral health of medically compromised and functionally dependent but cognitively competent older people in this study is generally poor. If transfer to long-term care is indicated, early and proper preventive measures and appropriate dental contact should be advocated in order to reduce morbidity and improve quality of life for older people.

Five years of community preventive dentistry and health education in the county of Sutherland, Scotland.

Examination of 11-year-old Scots children who had participated in a 5-year, fortnightly dental health education and preventive dentistry programme showed that, compared with a similar age-matched group, the regimen produced mean DMF and DMFS reductions of 48.6% and 42.1%, respectively. In addition, the plaque and gingival indices differed significantly and 22.5% of test children were caries-free compared with only 7.6% of controls.

Orofacial granulomatosis--a 10 year review.

The granulomatous disorder, termed oro-facial granulomatosis, includes a localised condition affecting the mouth and face as well as the oral manifestations of Crohn's disease and sarcoidosis. The clinical presentation is variable and the apparent increase in the number of patients presenting in recent years probably reflects a greater diagnostic awareness. The aetiology remains to be established but some patients have been found to be intolerent of certain foods, the elimination of which from their diet leads to a resolution of the facial swelling.

Oral hairy leukoplakia-like lesions in an HIV-negative male: a case report.

Oral hairy leukoplakia is generally found only in HIV-seropositive individuals or in those who are at risk of developing this infection; its occurrence is accepted to be a reliable predictor for the development of AIDS in those patients who are not already suffering from this disease. This report describes an 18-year-old male who was proven to be HIV-seronegative, was not in any of the at-risk groups associated with this infection, but who had the typical features of oral hairy leukoplakia, clinically and histologically. In such individuals these lesions should be described as hairy leukoplakia-like lesions.

The oral health of long-term residents of a hospital for the intellectually handicapped and psychiatrically ill.

The oral health of 207 intellectually handicapped and psychiatrically ill people resident in a long-term hospital was examined. Almost three-quarters of the population were mentally retarded, a similar proportion had secondary medical problems in addition to their main reason for admission, and almost all were taking at least one medication. Half of the population was edentulous and one-quarter of the edentulous wore a denture or were considered capable of wearing a denture. The dentate population had a mean of 22.8 (SD, 7.6) teeth, but their condition was poor with a mean of 3.2 (SD, 4.4) decayed teeth. There were fewer filled teeth than in the national population of similar age, and more teeth were decayed and missing. Although root caries was not a significant problem, oral hygiene and periodontal disease were--83.5 percent of subjects required scaling and cleaning and 17.7 percent complex periodontal therapy. Two-thirds of the population were amenable to treatment in the dental surgery, and one-third required a general anaesthetic for most dental treatment. A greater proportion of people who were mentally retarded or had Down's Syndrome required special facilities or an escort nurse to facilitate dental treatment than those who were psychiatrically ill. The findings have implications for those seeking to provide care for these groups of people living in the community.

Dens in dente associated with infective endocarditis.

This article describes an 11-year-old patient in whom infective endocarditis developed after the occurrence of a dental abscess associated with a dens in dente affecting the maxillary left lateral incisor. Dens in dente has not been reported in the literature previously as a source of infection associated with infective endocarditis. A prolonged period of hospitalization was required to control the infective endocarditis, which was caused by a strain of nutritionally deficient streptococci.

Food intolerance in patients with oro-facial granulomatosis.

The study was initiated to investigate the role of food intolerance in the aetiology of oro-facial granulomatosis. Firstly, retrospective data were examined in 85 patients and in 16 of them it was evident that a food or flavouring was provoking the disorder. In a second series, eight patients completed a very-low-allergen diet: seven individuals were found to be intolerant of certain foods, ingestion of which resulted in facial swelling. It is concluded that food intolerance is an aetiological factor in some patients with oro-facial granulomatosis.

Reduction of UV-induced erythema in normal subjects by applying methimazole.

Since free radicals are probably involved in the induction of erythema following ultraviolet (UV) irradiation, a study was conducted to investigate the influence of a topical application of methimazole (a free radical scavenger), before and at different times up to 2 h, after exposure to UV radiation. Seven subjects took part and erythema was assessed 6 h after exposure by a quantitative reflectance technique. Erythema was reduced at the sites that received methimazole 15 min prior to exposure and, although the trend was towards a decrease in erythema at the sites where methimazole was applied after exposure, the mean differences in these cases were not significant. It is believed that methimazole may have a useful role in the reduction of erythema following UV irradiation.

Salivary gland dysfunction following radioactive iodine therapy.

Radioactive iodine is used extensively for the treatment of thyrotoxicosis and thyroid carcinoma. Iodine is actively taken up by the salivary glands and, following its use, salivary dysfunction may result as a consequence of radiation damage. The literature is reviewed and a case is reported in which a patient presented with a significant increase in caries rate attributed to salivary dysfunction following radioactive iodine therapy for a thyroid carcinoma.