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2.
Rev. ADM ; 77(1): 17-21, ene.-feb. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1087830

RESUMO

La caries es una infección que afecta a cualquier persona sin importar edad, género o clase social. Es importante enfocar la atención odontológica a pacientes de tercera edad ya que tienden a un crecimiento anual de 3.8% de la población mexicana. Actualmente, se han realizado campañas de salud bucal para esta población; a pesar de los múltiples esfuerzos realizados para la prevención y erradicación de dicha enfermedad existe un descuido en los tratamientos para pacientes de la tercera edad, lo cual puede favorecer la pérdida de dientes. El objetivo del estudio fue determinar la prevalencia y severidad de caries en adultos mayores en la clínica de odontología de la Universidad Popular Autónoma del Estado de Puebla (UPAEP). Se realizó un estudio descriptivo, retrospectivo; se revisaron 345 expedientes de pacientes de tercera edad del 2017 al 2018, que asistieron por primera vez a consulta. Se obtiene la prevalencia y severidad a través del índice CPOD (cariados, perdidos y obturados). La prevalencia de dientes cariados fue 79%; se obtuvo un CPOD de 18.63 (alto riesgo). Se concluye el implementar medidas preventivas que impacten en mayor dimensión a la caries, para su disminución o erradicación en pacientes geriátricos (AU)


Caries is an infection that affects anyone regardless of their age, gender or social class. It is, however, important to focus dental care on elderly patients as that part of the Mexican population is growing at 3.8% annually. Currently, oral health campaigns have been carried out for this population, but despite the multiple efforts undertaken for prevention and eradication of the disease, treatment for elderly patients is often overlooked. The consequence of this lack of treatment can be the loss of teeth. The objective of this study is to determine the prevalence and severity of caries in elderly patients at the dental clinic of the Universidad Popular Autónoma del Estado de Puebla (UPAEP). A descriptive, retrospective study was carried out where the records of 345 elderly, first-time patients were reviewed for the 2017-2018 period. The prevalence and severity of caries was determined using the DMFT index (decay, missing, filled). The prevalence of carious teeth was 79% with a DMFT of 18.63 indicating high risk. We conclude that preventive measures should be implemented to impact and decrease caries in geriatric patients (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Índice CPO , Assistência Odontológica para Idosos , Cárie Dentária/patologia , Cárie Dentária/epidemiologia , Faculdades de Odontologia , Epidemiologia Descritiva , Estudos Transversais , Análise Estatística , Estudos Retrospectivos , Suscetibilidade à Cárie Dentária , Distribuição por Idade e Sexo , México
3.
Prim Dent J ; 8(3): 20-27, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31666169

RESUMO

The UK has an increasingly ageing population, many of whom are retaining more of their own teeth. This has led to an increase in the prevalence of tooth wear and the need to replace pre-existing failing restorations. In many cases this will be achieved by fixed prosthodontics. This paper provides a brief overview of important occlusal concepts that should be considered when providing non-implant fixed prosthodontics using either a conformative or reorganised approach. The aim is to give general dental practitioners the confidence to provide these types of restorations in primary care. Clinical cases demonstrate how the occlusion can be controlled to optimise clinical outcomes.


Assuntos
Assistência Odontológica para Idosos , Oclusão Dentária , Prótese Dentária Fixada por Implante , Prostodontia , Envelhecimento , Humanos , Dente , Atrito Dentário , Desgaste dos Dentes
4.
Ned Tijdschr Tandheelkd ; 126(11): 599-606, 2019 Nov.
Artigo em Holandês | MEDLINE | ID: mdl-31730137

RESUMO

To improve oral health for frail and care-dependent older people, both intra- and extramurally, in the Euregio Rhine-Waal area in the Netherlands and Germany, we inventoried barriers to oral care for the target group according to the literature, the organisation of oral care in both countries and the implications of this organisation for daily and professional (oral) healthcare and oral care. Results show most identified barriers are common to both countries, but the organisation of oral healthcare differs in both countries. The main differences lie in the financing and organisation of oral care in the intramural situation. In the Netherlands, this is to a large degree regulated and organised on the basis of the Chronic Care Act (Wlz), using the Verenso Oral Care Directive for care-dependent clients as a base for enforcement. In Germany, on the other hand, the provision of oral care in the home situation is more effectively facilitated. In both countries, various initiatives have recently been employed to improve, among other things, information supply, education and financing of oral healthcare.


Assuntos
Assistência à Saúde , Assistência Odontológica para Idosos , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Idoso Fragilizado , Alemanha , Humanos , Países Baixos
5.
Ned Tijdschr Tandheelkd ; 126(7-8): 363-368, 2019 Jul.
Artigo em Holandês | MEDLINE | ID: mdl-31309934

RESUMO

A family dentist established that the oral self-care of a 58-year-old man was suddenly inadequate. The dental hygienist who had been recruited subsequently noticed that the dexterity of the man was inadequate. The man's general medical practitioner referred him to a neurologist, who diagnosed Parkinson's disease. Due to this problematic situation, the man was off the family dentist's radar for approximately 1 year. Thereafter, a course of intensive support for his oral health behaviour was initiated. Given the progressivity of Parkinson's disease, it makes sense to aim at an oral health plan resistant to the patient's life course. The family dentist should be aware of his continuing responsibility to provide care and supervision until such time when informal and professional domiciliary care are no longer satisfactory or achievable and admission to a care facility is unavoidable. Only then can the family dentist hand over his responsibility to the geriatric dentist allied to that specific care facility.


Assuntos
Assistência Odontológica para Idosos , Saúde Bucal , Doença de Parkinson , Idoso , Higienistas Dentários , Odontólogos , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações
6.
Clin Interv Aging ; 14: 1141-1151, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308640

RESUMO

Objective: The aim of this study was to compare the perceived oral health of elderly persons and the clinical reality of their oral status. Background: Persons aged over 60 have considerable need for oral health care; a need that increases over time. However, this population appears to be unaware of their state of oral health, and this may be a further obstacle to professional management. We thought it useful to examine the objective and the perceived oral health of these patients. Understanding what may influence their perception can help us to improve their management. Methods: The data analyzed in this work are the findings of a field survey carried out in elderly nursing home residents. Their objective oral health was evaluated by using two variables: oral profile, determined by clinical examination, and the oral health index determined using the Oral Health Assessment Tool (OHAT). Perceived oral health was evaluated using the various categories and fields of the General Oral Health Assessment Index (GOHAI). Results: Our clinical study showed a discrepancy between perceived oral health and the clinical reality: although a significant association can be demonstrated between the OHAT and the GOHAI, there are considerable variations. It also appeared that the number of teeth and total edentation considerably influence perceived oral health and that findings vary according to different situations. Conclusion: Numerous factors influence elderly persons' perception of their true oral health. In order to improve our elders' quality of life, the necessary measures must be taken for the follow-up and regular monitoring of their oral health. At the same time, all possible means should be used and awareness should be raised to improve the health behavior and perception of patients and their entourage.


Assuntos
Assistência Odontológica para Idosos/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , França , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Masculino , Qualidade de Vida , Inquéritos e Questionários
7.
J Can Dent Assoc ; 84: i7, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31199728

RESUMO

PURPOSE: This study aimed to examine the oral health status of seniors residing in Providence Health Care (PHC) long-term care facilities in 2002 and 2012. METHODS: Staff dentists with the University of British Columbia Geriatric Dentistry Program made a complete oral health assessment of 799 elderly residents of 7 long-term care PHC facilities in 2002 and 381 residents in the 5 remaining PHC facilities in 2012. The 2012 data were divided into those for 275 residents who had received treatment in previous years and 106 new residents. All consenting residents were examined by dentists using the clinical oral disorder in elders (CODE) index detailing their medical and oral health status and medications. On completion of the oral health assessment, the dentist documented the need for specific dental treatment and reassessment. RESULTS: Comparing the cohorts from 2002 and 2012, the mean age of the residents who had CODE assessments increased from 85 years to 86 years, the proportion of men increased from 31% to 35%, the mean number of medical conditions per resident remained unchanged (2.6 to 2.5), but the mean number of prescribed medications has increased from 4.0 to 4.6. The percentage of residents with natural teeth increased from 56% to 76%. The proportion of edentulous residents recommended for denture-related treatment decreased from 21% to 10%. The 106 new residents in 2012 had higher treatment needs than the 275 original residents, but fewer required extractions than in 2002. Although the mean number of teeth per resident examined increased from 14.6 to 17.4 over the study period, the need for restorations remained at 20%, and the need for extraction of teeth decreased from 22% to 6%. The proportion of residents with healthy periodontium increased from 14% to 21%, but the need for dental hygiene services increased from 43% to 80%. CONCLUSIONS: The profile of long-term care residents who consented to an oral health assessment changed over the first decade of the new millennium, with an increase in mean age and number of prescribed medications, number of retained natural teeth and the need for dental hygiene services, but a decrease in the need for extractions.


Assuntos
Assistência Odontológica para Idosos , Doenças da Boca , Idoso , Idoso de 80 Anos ou mais , Assistência Odontológica , Humanos , Assistência de Longa Duração , Masculino , Saúde Bucal , Higiene Bucal
8.
Aust Dent J ; 64 Suppl 1: S63-S70, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31144322

RESUMO

As our population ages, dentists face challenges in maintaining compromised teeth in aging patients. For the most part, elderly patients (i.e., over 65 years of age) prefer to keep their natural teeth and in some cases, avoid removable dentures altogether. Ideally, patients should not be rendered edentate late in life, as they are unlikely to successfully adapt to the limitations of complete replacement dentures. However, this is not always possible and care should ideally be planned to avoid edentulism, or at least, to carefully manage the transition to the edentate state. In the course of planning care, the dentist needs to recognise the need for age appropriate care, factoring in the impact of the elderly patient's health status and social circumstances. For elderly patients with a compromised dentition, the dentist should try to provide care which is minimally invasive and with as low a burden of maintenance as possible. In this paper, principles of pragmatic care for elderly patients with a compromised dentition will be outlined using clinical cases. Three pathways will be outlined: (i) maintenance of a functional natural dentition using adhesive restorative techniques; (ii) use of overlay prostheses and complete replacement overdentures to manage toothwear and toothloss, complete replacement overdentures, and; (iii) staging a transition to the edentate state using transitional removable partial dentures.


Assuntos
Assistência Odontológica para Idosos/métodos , Arcada Parcialmente Edêntula , Boca Edêntula , Idoso , Prótese Dentária Fixada por Implante , Dentição , Revestimento de Dentadura , Prótese Parcial Removível , Humanos , Arcada Parcialmente Edêntula/prevenção & controle , Arcada Parcialmente Edêntula/reabilitação , Boca Edêntula/prevenção & controle , Boca Edêntula/reabilitação
9.
Aust Dent J ; 64 Suppl 1: S59-S62, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31144323

RESUMO

BACKGROUND: In an ageing population, tooth wear is likely to increase. It is increasing in prevalence in the younger population and a greater number of patients are retaining their teeth into old age. METHODS: This paper is a narrative review of the clinical presentation, the epidemiology and the restorative intervention for erosive tooth wear. The dilemmas in managing this common condition with the aging dentition in mind are described. The paper discusses evidence-based prevention methods and highlights how preventive intervention may be preferable over extensive restorative care and high maintenance needs. Patient wishes, expectations and commitment to treatment and maintenance require consideration during clinical decision making. CONCLUSION: Successful management of erosive tooth wear in an ageing population depends on effective diagnosis, preventive intervention and holistic advice regarding restorative intervention.


Assuntos
Assistência Odontológica para Idosos , Atrito Dentário , Erosão Dentária , Desgaste dos Dentes , Envelhecimento , Humanos , Prevalência , Dente
10.
Aust Dent J ; 64 Suppl 1: S71-S79, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31144327

RESUMO

The population is ageing and people are keeping their own teeth for much longer due in part to the efforts of the dental profession in restoring teeth and reducing the number of teeth being extracted. Along with this there is now an increasing expectation by patients that they will retain their own teeth as they age and that dental practitioners will have the knowledge and skills to help them retain their own teeth. Contemporary restorative materials and techniques have increased the range of options available to assist with maintaining the dentition, and many of these procedures enable minimally invasive and cost effective management of the teeth as an alternative to complex and expensive procedures. This paper discusses the restoration of compromised and failing teeth in the ageing patient, and looks at the various issues facing the ageing dentate patient and the dilemma of when to restore or when to extract. Ultimately it is hoped that maintaining healthy teeth for life may not only improve oral function and quality of life, but may in fact reduce the impact of the physical and psychological aspects of ageing.


Assuntos
Assistência Odontológica para Idosos , Falha de Restauração Dentária , Restauração Dentária Permanente , Qualidade de Vida , Envelhecimento/patologia , Materiais Dentários , Dentição Permanente , Humanos , Dente
11.
J Dent Educ ; 83(9): 1039-1046, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31133617

RESUMO

The aim of this study was to assess older adults' experience of care in an academic dental practice to identify opportunities to improve the patient experience for older adults. A cross-sectional descriptive survey design with a sample of adults aged 65 and older was conducted using the Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) 12-month survey 2.0, with supplemental survey item sets addressing cultural competence and health literacy. A total of 850 older adults were invited to participate in the survey in fall 2016, and a 43% response rate was achieved. Overall, participants reported a positive experience of care and high ratings for their dental providers. Significant differences were found based on age, education level, race, and health status. A significantly more favorable experience of care was reported by patients aged 75 and older, as well as adults without any college education. Non-white patients were less likely to highly rate their dental providers and gave lower ratings for experiencing trust with their dental providers than white patients. Patients reporting good/fair/poor health were also less likely than those reporting very good/excellent health to highly rate their dental providers, and they gave lower ratings for patient-provider communication. This study demonstrated the feasibility of using the CG-CAHPS survey to assess the patient experience for older adults in an academic dental practice. Results identified opportunities for improving the dental practice and underscored the importance of enhancing dental curricula in areas of cultural competence, health literacy, and diversity.


Assuntos
Competência Cultural , Assistência Odontológica para Idosos , Clínicas Odontológicas , Pacientes/psicologia , Qualidade da Assistência à Saúde , Faculdades de Odontologia , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Estudos Transversais , Relações Dentista-Paciente , Feminino , Pesquisas sobre Serviços de Saúde , Nível de Saúde , Humanos , Masculino , Satisfação do Paciente , Assistência Centrada no Paciente , Inquéritos e Questionários , Confiança , Estados Unidos
12.
Cad Saude Publica ; 35(4): e00191718, 2019 05 02.
Artigo em Português | MEDLINE | ID: mdl-31066780

RESUMO

This article sought to measure lack of access and use of oral health services by elderly residents of Pelotas, Rio Grande do Sul State, Brazil. This is a cross-sectional population study carried out in 2014, in the city's urban zone, including individuals aged 60 years or more. Sociodemographic and self-reported needs variables were associated with outcomes. We used Poisson regression for the crude and adjusted analyses. We interviewed 1,451 elderly individuals using a structured questionnaire. The prevalence of lack of access in the previous year was of 1.8% (95%CI: 0.7-3.0). Elderly individuals who never had a consultation were 3.1% (95%CI: 2.2-4.0) and the prevalence of use of oral health services in the previous years was 38.3%(95%CI 36.0-41.0). Use in the previous year was positively associated with the following variables: younger age (PR = 1.16), having a partner (PR = 1.28), high educational level (PR = 1.31), mouth or teeth problems (PR = 1.93), need for dental prosthesis (PR = 1.36) and being edentulous (PR = 3.11). Lack of access in the previous year was low. Oral health service use was higher than that observed in other states. Findings seem to reflect the expansion of oral health services in the city, especially in the public network, and are useful for health policy planning.


Assuntos
Assistência Odontológica para Idosos/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Idoso , Brasil , Estudos Transversais , Feminino , Equidade em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Bucal/estatística & dados numéricos , Distribuição de Poisson , Fatores Socioeconômicos , Inquéritos e Questionários
13.
Br J Community Nurs ; 24(5): 233-235, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31059299

RESUMO

Good oral health is an essential part of ageing well. Good mouth care enables people to eat, speak and socialise without pain or embarrassment and contributes hugely to quality of life and general health. Community-dwelling older adults may find access to dental services difficult, and increasing co-morbidities can make self-care a challenge. Older adults are at increased risk of dental disease, and general health complications can make access to dental services and treatment planning difficult. Further, they may find lengthy dental procedures overwhelming. Therefore, there is a need to prevent the decline in oral health in order to maintain general health.


Assuntos
Assistência Odontológica para Idosos , Acesso aos Serviços de Saúde , Serviços de Saúde para Idosos , Idoso , Enfermagem em Saúde Comunitária , Humanos , Medicina Estatal , Reino Unido
14.
Geriatr Gerontol Int ; 19(7): 679-683, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31037823

RESUMO

AIM: Improving the availability of dental care is essential to maintain older adults' general health and wellbeing. Domiciliary dental care is a feasible alternative. The present study aimed to investigate factors affecting the use of domiciliary dental care among home-dwelling dependent older adults. METHODS: A retrospective nested case-control study was carried out. We identified long-term care recipients who used home care services between April 2012 and March 2014 using Japan's nationwide long-term care service claim database. One-to-one case-control matching was carried out between those with and without domiciliary dental care, based on sex, age and the time home care service use was started. We carried out multivariable conditional logistic regression analyses to assess various factors associated with using domiciliary dental care. RESULTS: We identified 3 377 998 eligible homebound long-term care beneficiaries aged ≥65 years. Of these, 278 302 (8.2%) received domiciliary dental care. Factors associated with a higher probability of receiving domiciliary dental care were: higher level of care need (odds ratio [OR] 1.99, 95% confidence interval [CI] 1.93-2.06), exemption from out-of-pocket payment (OR 1.35, 95% CI 1.32-1.39]), living in a group home (OR 7.93, 95% CI 7.71-8.16), using other domiciliary services such as physician visits (OR 3.15, 95% CI 3.08-3.22) and a large number of dental clinics providing domiciliary dental care in their municipality (OR 1.74, 95% CI 1.70-1.77). Significant barriers to receiving domiciliary dental care were living alone (OR 0.64, 95% CI 0.62-0.66) and dementia (OR 0.89, 95% CI 0.88-0.91). CONCLUSIONS: Our findings might help to improve the availability of dental care in this population. Geriatr Gerontol Int 2019; 19: 679-683.


Assuntos
Assistência Odontológica para Idosos , Acesso aos Serviços de Saúde/organização & administração , Serviços de Assistência Domiciliar/estatística & dados numéricos , Pacientes Domiciliares , Assistência de Longa Duração , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Assistência Odontológica para Idosos/métodos , Assistência Odontológica para Idosos/estatística & dados numéricos , Feminino , Humanos , Revisão da Utilização de Seguros , Japão/epidemiologia , Assistência de Longa Duração/métodos , Assistência de Longa Duração/organização & administração , Assistência de Longa Duração/estatística & dados numéricos , Masculino , Estudos Retrospectivos
15.
Ned Tijdschr Tandheelkd ; 126(4): 207-212, 2019 Apr.
Artigo em Holandês | MEDLINE | ID: mdl-30994117

RESUMO

The decision-making process on oral healthcare issues concerning caredependent, frail older people living in nursing homes may be complex if patients are incapable of (adequately) expressing consent or are legally incapacitated. Therefore, oral healthcare professionals providing care to cognitively impaired patients in nursing homes need background knowledge of healthcare legislation and healthcare ethics, concerning the aspects relevant to developing an individual oral care programme. In this article, attention is given to these aspects of healthcare legislation and ethics, and the guideline 'Mondzorg en verzet bij wilsonbekwaamheid ter zake' (oral healthcare and resistance of the legally incapacitated) is described. This can be applied in comparable cases.


Assuntos
Tomada de Decisões , Assistência Odontológica para Idosos , Autonomia Pessoal , Idoso , Idoso de 80 Anos ou mais , Assistência à Saúde , Humanos , Casas de Saúde
16.
Curr Aging Sci ; 11(4): 202-215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30836931

RESUMO

Telemedicine is now in vogue, allowing computer and communication tools to be deployed in different fields of health, such as Cardiology, Dermatology, areas in which it has received interest, and in international studies. As the population ages, older people are increasingly concerned about this innovative practice. This is a narrative review of both the literature and Internet pertaining to telemedicine projects within the field of geriatric subjects in France. Since the beginning of the 2000's, several telemedicine projects and trials focused on chronic heart failure have been developed in the elderly, and also in the field of dermatology. The potential contribution of second-generation telemedicine projects in terms of mortality, morbidity, and the number of hospitalizations avoided is currently under study. Their impact in terms of health economics is likewise being investigated, taking into account that the economic and social benefits brought up by telemedicine solutions were previously validated by the original telemedicine projects. We take a look at telemedicine projects in France concerning the elderly.


Assuntos
Geriatria/métodos , Telemedicina/métodos , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/fisiopatologia , Arritmias Cardíacas/terapia , Comorbidade , Assistência Odontológica para Idosos/métodos , Assistência Odontológica para Idosos/tendências , Dermatologia/métodos , Dermatologia/tendências , Feminino , França , Psiquiatria Geriátrica/métodos , Psiquiatria Geriátrica/tendências , Geriatria/tendências , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/terapia , Instituição de Longa Permanência para Idosos , Humanos , Masculino , Casas de Saúde , Medicina Preventiva , Consulta Remota/métodos , Consulta Remota/tendências , Telemedicina/tendências , Telemetria
17.
Adv Clin Exp Med ; 28(9): 1209-1216, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30843673

RESUMO

BACKGROUND: The oral condition can functionally, socially and psychologically influence the quality of life. Oral dryness often occurs in the elderly due to the presence of systemic diseases and medications, which favors the development of many lesions and complaints, including dental caries, candidiasis, retention of full removable denture, taste disturbance and it enforces a change in nutrition. OBJECTIVES: The aim of this study was to assess the impact of oral dryness on oral health-related quality of life in older subjects. MATERIAL AND METHODS: Five hundred subjects of both genders, aged 65 and over (mean 74.4 ±7.4) were involved in the study. Oral dryness was evaluated clinically with use of the Challacombe scale (CODS, Clinical Oral Dryness Score). The oral health-related quality of life was assessed by the Oral Health Impact Profile scale (OHIP-14). RESULTS: Oral dryness occurred in 32.8% of subjects, most often on a mild level (29.6%). The average value of the OHIP-14 scale was 8.01 ±13.59. The regression analysis demonstrated a significant association between oral dryness and two domains of the OHIP-14 scale, i.e. functional limitation (p < 0.01) and psychological disability (p < 0.05). CONCLUSIONS: Oral dryness is substantially related to the oral health-related quality of life, which indicates the necessity of monitoring oral dryness as part of routine dental care.


Assuntos
Assistência Odontológica para Idosos , Cárie Dentária , Saúde Bucal , Qualidade de Vida , Idoso , Dentaduras , Feminino , Humanos , Masculino , Inquéritos e Questionários
18.
Spec Care Dentist ; 39(2): 89-96, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30604877

RESUMO

AIM: We aimed to describe time requirements and costs associated with professional dental cleaning (PDC) performed by a dental nurse in one German nursing home, and to reveal potential differences in required time for demented versus nondemented and mobile versus immobile residents. METHODS AND RESULTS: We performed a retrospective, cross-sectional analysis of treatment time and costs, including a transparent, easily adaptable path of action that allows implementation of PDC in nursing homes. Total mean (±SD) treatment time for one session per resident was documented, including differences in demented and immobile residents, and projected treatment costs (€/$) per resident. We found no differences in required time for one PDC (37 ± 11 minutes) in residents with or without dementia (P = 0.803) or, immobile versus mobile residents (P = 0.396). Mean projected treatment costs of PDC were €14.98/$17.07 per resident per cleaning session, resulting in total costs of €13.5 million ($15.4 million). CONCLUSION: Cognitive status and mobility does not affect the mean time required to perform PDC by a dental nurse in nursing home residents. Main cost factor is working time of dental staff; consumable supplies have less impact. Our data may stimulate to include PDC as initial step toward implementation of long-term oral hygiene strategies.


Assuntos
Assistência Odontológica para Idosos , Profilaxia Dentária , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demência/complicações , Assistência Odontológica para Idosos/economia , Profilaxia Dentária/economia , Feminino , Alemanha , Humanos , Masculino , Limitação da Mobilidade , Estudos Retrospectivos , Fatores de Tempo
19.
Gerodontology ; 36(2): 149-155, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30680802

RESUMO

AIM: To report New Zealand rest home (rest home is the New Zealand term for residential aged care facilities where dependent, institutionalised, elderly people reside.) managers' opinions on access and barriers to oral health care for rest home residents. METHODS: An exploratory study using qualitative descriptive methods. Eleven rest home managers in a region of New Zealand were interviewed about admission assessments for new residents, oral health care, availability of dental facilities, staff training in oral hygiene, residents' nutritional needs and oral hygiene aids. RESULTS: Interviews with managers indicated that rest homes have no policies for the provision of oral health care and only arrange dental check-ups or treatment when requested by residents or family. Barriers to accessing care include making appointments, availability of staff and transport particularly for bedridden patients. Staff receive basic oral hygiene training only and face resistance to oral hygiene from some residents. No homes had a dental chair at their premises. All rest homes stocked oral hygiene aids such as toothbrushes and toothpastes. Electric toothbrushes were not generally promoted with cost being a key factor. CONCLUSION: While rest home managers were aware of the importance of good oral health, there are barriers to care. Finance is a challenge as dental care is not publicly funded and many residents rely on a limited income. Recommendations include policy changes to better fund oral health, specific oral health training for rest home staff, provision of mobile dental services to rest homes and the inclusion of gerodontology in the dental school curriculum.


Assuntos
Assistência Odontológica para Idosos , Saúde Bucal , Idoso , Acesso aos Serviços de Saúde , Instituição de Longa Permanência para Idosos , Humanos , Nova Zelândia , Casas de Saúde
20.
J Oral Rehabil ; 46(2): 189-199, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30307635

RESUMO

Delivering dental treatment for patients with dementia can be challenging, and the complexity of treatment provision can increase as dementia progresses. Treatment at the later stages of dementia can be associated with ethical challenges and procedural risk meaning that a comprehensive patient assessment is crucial; the presence of orofacial pain is a key indication for active intervention from dental teams. To explore the process of oro-facial pain assessment and management, a comprehensive review of qualitative literature was undertaken by searching six electronic databases. No literature specific to orofacial pain assessment was identified. The inclusion criteria were widened to explore assessment and management of pain in general for patients with dementia. Meta-ethnography with reciprocal translation was used to identify key concepts and themes and synthesise information applicable to the dental setting. Three major themes arose as follows: challenges with pain assessment, challenges with pain management and logistics and education. Healthcare teams struggle with pain identification in patients with dementia though many signs were identified which may suggest a patient is experiencing pain. The long-term knowledge of individual patients held by family members and care teams can allow identification of deviation from patients' normal states; this knowledge can assist healthcare professionals in determining whether to provide specific treatments or interventions. Pain assessment tools were found to be problematic and are unlikely to be a practical solution to use for complex patients in dental settings. Education for dental and wider care teams on orofacial pain would be highly valuable; yet, this needs to be based on suitable evidence.


Assuntos
Demência/fisiopatologia , Assistência Odontológica para Idosos , Dor Facial/diagnóstico , Manejo da Dor/métodos , Medição da Dor , Antropologia Cultural , Dor Facial/fisiopatologia , Dor Facial/terapia , Humanos , Pesquisa Qualitativa
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