Elderly Dental Patients Research Articles

Clinico-statistical Observation of Oral Status and Function in Elderly Dental Patients

Clinico-statistical Observation of Oral Status and Function in Elderly Dental Patients

Oral Discomfort among Elderly Dental Patients

Oral Discomfort among Elderly Dental Patients

Clinico-statistical Observation of Oral Status and Function in Elderly Dental Patients (I)

Clinico-statistical Observation of Oral Status and Function in Elderly Dental Patients (I)

Incorporating the nutrition screening initiative into the dental practice.

Older patients' nutritional status must be assessed for their morbidity and mortality to be decreased and their quality of life improved. Food and fluid intake is markedly influenced by oral health status. In turn, oral health has an interrelationship with general health. Because nutritional status and oral health exist in a symbiotic relationship, it is essential that the dental team identify older patients who are nutritionally at risk. Screening for nutritional problems in elderly dental patients is made easier with screening instruments developed by the Nutrition Screening Initiative (NSI). The NSI developed criteria to determine risk factors for poor nutritional status in older Americans. The DETERMINE Your Nutritional Health checklist, a 10-item screening instrument, followed by the Levels I and II Nutrition Screens, can be used in the dental office to ascertain which elderly patients are most likely to be in danger of experiencing nutritional problems. The dental team can then perform interventions and/or make appropriate referrals.

Oral Discomfort among Elderly Dental Patients

Oral Discomfort among Elderly Dental Patients

Pathogenesis and Prevention of Native Valve Infective Endocarditis in Elderly Dental Patients

Elderly dental patients are at risk of developing infective endocarditis. Increased longevity is associated with an increased prevalence of cardiac valvular disease and impairment of the immune system. Aortic stenosis commonly occurs in persons between 60 and 75 years of age. Degenerative calcification of the mitral valve ring leading to valve incompetency often develops in those over age 70 years. Men over the age of 60 years with mitral valve prolapse and systolic hypertension are at risk of infective endocarditis because the excessive haemodynamic load placed upon the abnormal valve causes extensive stretching of cusps and loss of valve surface endothelium. Dental procedures, that result in mucosal or gingival bleeding (most notably dental extractions, periodontal probing, scaling and surgery, endodontics and restorative procedures which extend below the gingival line), frequently produce a bacteraemia. Anaerobic strains of bacteria are isolated twice as frequently as aerobic strains. Antibiotic prophylaxis decreases the level of bacteraemia, prevents adherence of bacteria to the damaged valvular epithelium and suppresses the growth of those microbes that manage to adhere to the valve. The standard prophylactic regimen consists of amoxicillin 3g 1 hour before the dental procedure, then 1.5g 6 hours after the initial dose. Erythromycin is a good alternative for penicillin-allergic patients. Topical chlorhexidine 5 minutes before initiating dental therapy reduces the bacterial inoculum and the likelihood of endocarditis.

Ｃｏｒｎｅｌｌ Ｍｅｄｉｃａｌ Ｉｎｄｅｘにより判定した高齢歯科患者の神経症傾向と口腔内状況

The purpose of this study was to investigate the relationship between mental aspects and oral status among elderly dental patients. The subjects were 302 patients (126 males and 176 females, average age 74.4 yr) who visited the Gerodontic Clinic of Tokyo Medical and Dental University. The psychological test used in this study was the Cornell Medical Index (CMI) Health Questionnaire. The subjects were classified into four categories according to the CMI: Category I (diagnosed to be normal), category II (provisionally diagnosed to be normal), category III (provisionally diagnosed to be neurotic) and category IV (diagnosed to be neurotic).The results were as follows:1. CMI category distributions were 50.8% of the males and 35.8% of the females in category I, while 3.2% and 9.7% in category N respectively.2. The number of the residual teeth showed a tendency to be smaller in the subjects classified as category IV than in the other categories.3. The distribution of category N was higher in upper complete denture wearers than in upper partial denture wearers and subjects who wore no upper denture.The results suggested that it is important to diagnose the mental state inclusive of neurotic tendency as well as physical state among elderly dental patients in dental treatment.

Relationship between Chief Complaints and Depressive Symptoms among Elderly Dental Patients

Relationship between Chief Complaints and Depressive Symptoms among Elderly Dental Patients

高齢者のＱＯＬと抑うつ感に対する口腔内状況の影響

Depression is a mental problem in elderly dental patients. The purpose of this study was to investigate the relationship between oral status and depressive symptoms among elderly patients. The authors assessed depressive symptoms among dental patients with Zung's Self Rating Depression Scale (SDS). Subjects were 220 patients (88 men and 132 women, average age 74.5yr) who visited the Gerodontic Clinic of Tokyo Medical and Dental University. The cut-off point for depression in a geriatric population is 48. A factor analysis was done, and four factors were obtained: quality of life (QOL), depressive mood, instability of emotion and sociability.The results were as follows:1. The prevalence of depressive symptoms was 5.9%.2. The SDS and depressive mood scores were significantly higher in women than in men.3. The SDS and QOL scores were significantly higher in upper edentulous patients than in other patients.4. The SDS and QOL scores were significantly higher in upper complete denture wearers than in other patients.The results suggested that residual teeth are important for good life of the elderly.

Salivary levels of mutans streptococci, lactobacilli, yeasts, and root caries prevalence in non‐institutionalized elderly dental patients

Root caries prevalence was recorded for a consecutive sample of dental patients (n = 146), aged over 55 yr and with at least 12 natural teeth. The mean root DFS score of the males (n = 49) was 6.34 +/- 4.55 and for the females (n = 97) 3.76 +/- 3.31 (P less than 0.001). The salivary levels of mutans streptococci, lactobacilli, and yeasts were determined in addition to salivary flow rate and buffering capacity. Subjects with greater than 1 root DFS had significantly higher salivary levels of mutans streptococci, lactobacilli, and yeasts. They also had fewer teeth and more exposed root surfaces. In step-wise multivariate analyses the factors significantly related to the root DFS score were the number of exposed root surfaces, number of teeth, sex and salivary yeast levels (R2 = 0.41). In the multivariate analyses salivary levels of mutans streptococci were not significantly related to any clinical measurement of root caries experience due to the greater strength of association between the root DFS score and salivary levels of yeasts. Subjects prescribed medicines with a reported xerostomic effect had significantly fewer active root lesions than those not prescribed such medicines and salivary levels of all microorganisms studied were significantly elevated in subjects prescribed medications containing sucrose.

Survey on systemic disease in elderly dental patients

Survey on systemic disease in elderly dental patients

Associations between salivary levels of mutans streptococci, lactobacilli, yeasts and black-pigmented Bacteroides spp. and dental variables in elderly dental patients

Multivariate step-wise regression analyses demonstrated that in a population of 146 elderly dental patients (mean age 69.8 yr) the salivary level of mutans streptococci was unrelated to the root DFS score, unlike the levels of lactobacilli and yeasts. Mutans streptococci were related to the wearing of partial dentures and the number of snacks eaten per day, while salivary lactobacillus levels were also related to the number of snacks eaten per day and to denture wearing, and negatively related to saliva buffering. Salivary yeast levels were also related to the wearing of partial dentures and the number of snacks eaten per day, and negatively related to salivary neuraminidase activity. The R 2 values ranged from 0.21 to 0.28. Salivary level of black-pigmented Bacteroides spp. were related to maximum CPITN score, mean bleeding index and salivary trypsin-like activity ( R 2 was 0.08).

Special considerations in drug therapy for elderly dental patients.

This paper won first place in the third annual Arthur Elfenbaum Essay Contest, sponsored by the American Society for Geriatric Dentistry.