ORAL TISSUE CONDITION IN PROSTHODONTIC GERIATRIC PATIENTS

Abstract

The world population is continuously getting older in developed and undeveloped countries. According to WHO over 20% of the population in Europe is over 65 years old. Geriatric population in North Macedonia is presented with 16% and with high prevalence of anodontia over 45, 1%, poor oral hygiene and urgent demand of prosthodontics treatment. Aging is a process with different and specific changes of all systems and organs, including the orophacial system. In this population, the number of remaining teeth is evidently reduced, their condition has changed, and soft and hard oral tissues are affected. It is very important to discover all the factors that lead to the development of leukoplakia and other precancerous lesions as early as possible. Precancerous lesions and oral carcinoma are more common in the elderly compared to the younger population. Almost 90% of oral cancers occur in patients older than 50 years. Early detection of oral mucosa diseases in elderly and potentially malignant disorders requires careful examination because of high malignant transformation frequency. The aim of the study was to determine the condition of oral soft tissues in geriatric prosthodontics patients, their general health and the impact of oral health on their quality of life. The value of the VELscope instrument as an adjunct to oral examination in geriatric prosthodontics patients was also evaluated. The study was performed in the University Dental Clinic Ss’ Panteleimon in Skopje, NM. Clinical protocol for 300 patients over 60 years old was questionnaire with risk factors, clinical intra and extraoral observation and VELscope mucosal tissue examination. Tissue changes were classified as inflammatory, traumatic, dysplastic and other. Abnormal tissue was associated with auto fluorescence loss and dark appearance in contrast to the surrounding healthy tissue. In 21% of patients abnormal premalignant lesions were detected. Leukoplakia was the most common premalignant disorder 42 (12, 6%), 16 (4, 8%) had lichen planus, 6 (1, 8%) cheilitis actinica and 5 patients (1, 5%) were diagnosed with squamous cell carcinoma. We found 118 inflammatory lesions (35, 4%) where 58 (17, 4%) were denture stomatitis, 18 (5, 4%) angular cheilitis, traumatic lesions were found in 38 patients (11, 4%) and 4 (1, 2%) were diagnosed with epulis fissuratum. In 54 patients (16, 2%) we diagnosed infectious changes from which aphtous ulcerations and candidiasis were most common. The VELscope fluorescence instrument can be used as a part of diagnostic process to detect abnormal tissue and oral lesions that might have been overlooked. A validation of the study was carried out and it was approved by the ethics committee of the Faculty for dentistry Ss Cyril and Methodius University Skopje on 18.12.2018. No. 02-38363.