The Elderly's Limited Awareness of Advanced-Way Dental Procedures Hinders Access to Treatment, Resulting in Persistent Pain and Unmet Dental Needs in Pakistan.

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Oral status of older adults receiving home medical care: A cross-sectional study.

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

Exploring the acceptance of geriatric dentistry programming for undergraduate dental students through stakeholder interviews.

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

Dental Care to Reduce Aspiration Pneumonia Recurrence: A Prospective Cohort Study.

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

Dentists' perspectives on structural and system barriers hindering oral healthcare provision in residential care facilities.

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

The oral care practices and needs of older adults in nursing homes: Assessment of carers and patients / Pratiques et besoins de soins bucco-dentaires en EHPAD : évaluation des soignants et des patients

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.

[Improvement of dental medical examination of patients of older age groups]. / Sovershenstvovanie stomatologicheskoi dispanserizatsii patsientov starshikh vozrastnykh grupp.

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.

Demographics and Oral Health Care Utilization for Older Adults.

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

[Whether or not to remove root remnants in frail older adults?] / Wel of niet wortelresten verwijderen bij kwetsbare ouderen?

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.

Saúde bucal e condições sistêmicas em idosos da Baixada Fluminense: coorte retrospectivo / Oral health and systemic conditions in elderly people from Baixada Fluminense: retrospective cohort

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

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

Cost-effectiveness of professional and mechanical oral care for preventing pneumonia in nursing home residents.

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

Autopercepção da saúde bucal e fatores associados em pessoas idosas quilombolas: um estudo de base populacional / Self-perception of oral health and associated factors in quilombola older people: a population-based study

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

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

Discrepancia anteroposterior en registro de relación céntrica con apoyo central intraoral en cubetas rodetes acrílicas (BOPAYACU) e inducción manual en adultos mayores desdentados totales / Anteroposterior discrepancy in centric relation record with intraoral central support in acylic impaction cups (BOPAYACU) and manual induction in edentulous older adults

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

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

Xerostomia and dysgeusia in the elderly: prevalence of and association with polypharmacy

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

Maintenance issues of elderly patients requiring nursing care with implant treatments in dental visiting: position paper.

PURPOSE: Japan, with an increasing number of elderly people needing long-term care in a super-aged society, urgent needs to develop the clinical guidelines on implant maintenance for elderly people with declining independence. The purpose is to categorize the troubles encountered in the care of patients with dental implants and to indicate actual practices and points of note. METHODS: From the members of the Japanese Society of Oral Implantology, 12 expert panelists who were experienced with many problems of implant maintenance during dental visits and were familiar with their solutions were selected. Through repeated discussions in the many panel meetings, the problems of implant maintenance during dental visits were distilled. RESULTS: During a dental visit, the oral cavity, general conditions, and background of elderly patients who cannot orally care for themselves must be grasped, and medical staff, care managers, and patients should understand the changes in these factors as time goes by. The solutions and responses that can be made differ greatly depending on the medical care facilities, the environment, differences in the experience of medical staff, and the patient's background. Thus, it is necessary to select safe treatments appropriate to each situation. CONCLUSIONS: This paper features many opinions based on clinical experiences. However, clinical guidelines on implant management during dental visits should be formulated in the future based on the accumulation of evidence through the implementation of clinical research.

Conhecimento, necessidade e preferência acerca da odontologia domiciliar e condições de saúde bucal de idosos domiciliados: um estudo transversal / Knowledge, needs and preferences regarding home dentistry and oral health conditions of homebound elderly people: a cross-sectional study

O trabalho visa compreender o conhecimento, preferência e necessidade de atendimento odontológico domiciliar, além de identificar a condição de saúde bucal dos idosos domiciliados e seus fatores associados. Trata-se de dois web surveys, sendo o primeiro com a população adulta escolarizada e o segundo com a população idosa. Além disso, também foi realizado um estudo com dados secundários de prontuários de idosos que utilizaram algum serviço de atendimento odontológico domiciliar para identificar a condição de saúde bucal destes. Nos três estudos foram realizadas análise descritiva, teste do qui-quadrado e regressão robusta de Poisson com um nível de significância de 5%, tendo sido usado no último estudo a análise de Cluster de dois passos, previamente à regressão, para identificar grupos de pessoas idosas em relação à condição dentária e de reabilitação. No primeiro estudo, 443 respondentes participaram, cuja predominância foi de mulheres (67,9%) e na faixa etária de 31 a 40 anos (38,8%). A maioria dos participantes (69,5%) não conhecem o que é atendimento odontológico domiciliar. No segundo estudo, 203 idosos participaram, sendo 67% mulheres, na faixa de idade de 60 a 69 anos. A maioria dessa população não conhece a odontologia domiciliar (79,8%), nunca fez uso desse tipo de serviço (95,6%) e preferem ser atendidos em consultório odontológico (68,5%). Houve associação significativa entre conhecer a Odontologia domiciliar e ter plano de saúde médico. Foi observado ainda que aqueles idosos que não têm plano de saúde e com nível de escolaridade mais baixo preferem ser atendidos em casa em relação ao consultório tradicional. No terceiro estudo, 207 prontuários de idosos foram avaliados, cujo sexo predominante foi o feminino (58,5%), com faixa de idade 80 a 89 anos e parcialmente dependentes para atividades básicas de vida diária. Em relação à condição de saúde bucal, o CPOD médio foi de 23,5, com 3,35 pares em oclusão, sendo 75,8% edêntulos funcionais. Nos prontuários, 53,6% das pessoas idosas possuíam sangramento à sondagem em algum sextante e cerca de 20% apresentavam lesão em tecido mole. Os pacientes com mais lesões foram os idosos mais jovens, diabéticos e que foram ao dentista há mais tempo. Em relação à questão periodontal, moradores de residência individual possuem mais sangramento à sondagem. Em relação à condição dentária e de reabilitação, dois clusters foram produzidos, sendo o primeiro com idosos edêntulos e pouco reabilitados e o segundo com idosos mais dentados e reabilitados. Idosos negros e que não possuem plano de saúde estiveram mais presentes no primeiro cluster. A população em geral e idosa pouco conhece e percebe que necessitam da atenção odontológica domiciliar. Como consequência, a população idosa mais independente ainda prefere ser atendida em consultório. Ademais, a condição de saúde bucal de pacientes que utilizam atendimento odontológico domiciliar ainda é precária, fruto de uma assistência odontológica mutiladora, caracterizando o cenário desigualdade social entre as pessoas idosas domiciliadas (AU).

The study is to understand the knowledge, preference and need for dental home care addition to identifying the oral health condition of the elderly living in residence and its associated factors. Two studies are web surveys, the first with the educated adult population and the second with the elderly population. The last study was a study with secondary data from medical records of elderly people who used a home dental care service to identify their oral health condition. In three was used studies, descriptive analysis, chi-square test and robust Poisson regression were performed with a significance level of 5%, and in the last study the two-step Cluster analysis , prior to the regression, to identify groups of people elderly in relation to dental and rehabilitation status. In study number one 443 respondents participated, whose predominance was women (67.9%) and aged between 31 and 40 years (38.8%). Most participants (69.5%) don't know about home dental care. At the study number two, 203 elderly people participated, 67% of whom were women, aged between 60 and 69 years. Most of the population doesn't know about home dentistry (79.8%), has never used this type of service (95.6%) and prefers to go to the dental office (68.5%). There is a significant association between knowing about home dentistry and having a medical health plan. And those elderly people who do not have health insurance and have little education prefer to be cared for at home compared to the traditional dental office. In study three, 207 medical records of the elderly were evaluated, whose predominant sex was female (58.5%), aged 80-89 years and partially dependent for basic activities of daily living. In terms of oral health status, the mean CPOD was 23.5, with 3.35 pairs in occlusion, 75.8% of whom were functional edentulous. In the medical records, 53.6% of the elderly had bleeding on probing in some sextant and about 20% had a soft tissue lesion. Patients with more injuries were the younger elderly, diabetics and those who had been to the dentist for a longer period of time. With bleeding the probing were residents of individual residences. Two clusters were produced, the first with edentulous and poorly rehabilitated elderly and the second with more dentate and rehabilitated elderly. Black elderly people who don't have health insurance were more present in the first cluster. The population and elderly don't know and realizes that they need home dental care. As a result, the more independent elderly population still prefers to be seen in the office. Furthermore, the oral health condition of patients who use home dental care is still precarious, as a result of mutilating dental care, characterizing the scenario of social inequality among elderly people living in domicile (AU).