Clinical factors and self‐perceived oral health

Self‐perceived oral health is affected not only by awareness of the clinical status but also by comparisons with people of a similar age. This study explored the relative contributions of clinical variables assessing caries, periodontal status, and prosthetic status to self‐perceived oral health within two age groups. Data of 891 adults (35–44 yr of age) and 760 older people (65–74 yr of age) from the Fourth German Oral Health Study (DMS IV, 2005) were evaluated. Self‐perceived oral health was obtained from questionnaires. Numbers of decayed, filled, and unreplaced teeth, mean attachment loss, bleeding on probing (BOP), the presence of a fixed denture, and the presence of a removable denture were assessed. Multinomial logistic regression models were developed for both age groups, separately, using stepwise methods. For adults, unreplaced teeth, filled teeth, decayed teeth, the presence of a removable denture, and mean attachment loss were added to the final model. For older people, the presence of a removable denture, unreplaced teeth, decayed teeth, mean attachment loss, filled teeth, and BOP were included in the final model. Awareness of the relative contributions of clinical variables to self‐perceived oral health is important for obtaining a clearer understanding of patients' subjective and objective self‐perceptions of oral health.     

Oral Health-Related Quality of Life in institutionalized elderly in Barcelona (Spain)

Objective: The objective of this study is to describe the oral health status and the factors associated with oral health-related quality of life (OHRQoL) in people aged 65 and older institutionalized in Barcelona in 2009. Study Design: Cross sectional study in 194 elderly. The dependent variable was poor OHRQoL, according to the Geriatric Oral Health Assessment Index (GOHAI). The independent variables were socio-demographic data, last dental visit, subjective and objective oral health status. Robust Poisson regression analysis was used to determine the factors associated with OHRQoL as well as the strengths of association (Prevalence Ratios with respective confidence intervals at 95%). Results: According to GOHAI, 94 women (68.1%) and 36 men (64.3%) had poor OHRQoL. The average DMFT index (number of decayed, missing and filled teeth) was 22.8, with mean 10.2 remaining teeth. According to the Community Periodontal Index only 1.9% were healthy. 33.8% of the sample (35.5% of women and 30.4% of men) presented edentulism, 54.2% needed upper dental prostheses (51.1% of women and 60.7% of men) and 64.7% needed lower ones (61.6% of women and 71.4% of men). Only 7.2% had visited a dentist in the past year (8.8% of women and 3.6% of men). After fitting several multivariate adjusted robust Poisson regression models, poor OHRQoL was found to be associated to self-reporting problems with teeth or gums, self-reporting poor opinion about teeth/gums/denture and also associated to functional edentulism, needing upper denture, but not to socio-demographic factors or time since last dental visit. Conclusions: The study population has poor objective oral health. A high percentage has poor OHRQoL associated to subjective and objective oral health conditions. Dental care is required and these services should be included in the Spanish National Health System. Key words:Oral health, homes for the aged, elderly, self-assessment, quality of life, geriatric oral health assessment index (GOHAI).     

上海市嘉定区65~74岁老年人群牙列缺损及修复现状调查

目的: 调查上海市嘉定区65~74岁老年人群的牙列缺损、缺失情况和修复需求,为政府的口腔保健项目提供依据。方法: 对上海市嘉定区嘉定镇、安亭镇、南翔镇65~74岁老年人进行整群抽样,抽取3260人进行一般情况与口内情况调查,从牙列缺损、缺失人群中随机抽取824人,采用EpiData 3.1软件对修复需求、未修复原因和口腔修复知识进行描述性统计分析。结果: 上海市嘉定区65~74岁老年人有80.4%牙列缺损,4.8%牙列缺失。牙列缺损的修复率为60.8%,牙列缺失的修复率为91.0%。其中28.0%为固定修复,39.5%为活动修复,24.4%为固定+活动修复,8.2%为全口义齿修复。牙缺失和修复情况无性别差异（P>0.05）。未修复的首要原因为价格过高,占32%;其余依次为医院挂号困难（24%）、担心拔牙疼痛及并发症（20%）、行动不便（10%）。关于修复需求,29.7%需要种植牙,64.8%需要烤瓷牙;43.2%选择医院就诊,51.0%选择私人门诊;25.5%选择费用自付,42.2%希望部分减免费用,32.3%希望全部免费。绝大多数老年人口腔修复知识匮乏,仅有18.2%得分在3分以上,15.5%得分为0~3分,66.3%得分为0分以下。结论: 上海市嘉定区老年人缺牙和修复情况面临严重挑战,老年人口腔修复知识匮乏,需要政府加大口腔保健科普教育,投入资金,改善缺牙修复状况,提高老年人的口腔保健水平。     

Tooth loss and dental caries in institutionalized elderly in Italy

An epidemiological survey of dental health status and needs was conducted in a group of 234 randomly selected institutionalized elderly people in Naples, Italy. The mean age of the patients was 81.4 yr, 71.4% were women and 28.6% men. A total of 140 (59.8%) people were totally edentulous; an additional 13.7% were edentulous in one jaw. A significant increase in prevalence of edentulousness with increasing age was recorded. 44.3% of the edentulous in both jaws wore complete dentures. The mean number of remaining sound teeth, decayed teeth and root remnants in the elderly with maxillary and mandibular natural teeth decreased with increasing age. Of the 94 dentate elderly, 29.8% had no need of dental treatment. Of all dentate patients 68.1% needed one or more dental extractions with a mean need of 3.9 per patient; 37.2% needed restorative treatment for one or more teeth with a mean need per patient of 2.9. Analysis of the results showed poor dental health in this target group and the necessity of improving the dental health services programs for the elderly living in institutions.     

Oral health status in a population in Northern Norway.

Information concerning oral health status was obtained through a clinical and radiographic examination of 297 persons aged 20--69 years out of a population of 358 persons living in a coastal community in Northern Norway. The oral health was generally poor. 71% had one or more remaining teeth and the dentulous persons had a mean number of 18 remaining teeth. The mean number of DMF teeth was 27,3 while the mean number of decayed teeth was 4,9 and filled teeth 12,0 giving a percent of decayed and filled teeth of 27 and 65 respectively. Only every fourth dentulous person had one or more crowns and/or bridge units and 4% of all teeth had been treated endodontically. 41% of the teeth had visible plaque and 56% of the teeth had one or more gingival margins bleeding after gentle probing. One fourth of all teeth had gingival pockets exceeding 3 mm and 17% of all teeth showed a bone loss of 20% or more. The number of remaining teeth decreased with increasing age and decreasing income and/or social class. In general, women, young people and people with a high socioeconomic status had less caries, better oral hygiene and periodontal condition and had received more restorative dental care than the remaining part of the population.     

Effect of Molar Occlusal Balance on Cognitive Function in the Elderly

BackgroundElderly people with dementia, who are increasing at a rate comparable to the rate at which theelderly population is growing, are becoming a serious social problem in Korea. Therefore, the purpose of this study was to investigate the association between molar occlusal balance and cognitive function among Koreans aged 65 years and older.MethodsA total of 308 participants aged 65 years and older who attended a senior center were recruited for the study with their consent. The Korean version of the Mini-Mental State Examination (MMSE-DS) was used to assess cognitive function, and masticatory ability was measured according to the ability to chew food, the number of remaining teeth, and the self-perceived perceived masticatory function. Relative molar occlusal balance was measured using the T-scan Ⅲ system. All collected data were analysed using SPSS version 23.0.ResultsThere was a significant association between cognitive function and molar masticatory ability (P < .05). The participants with relative molar occlusal balance had a higher MMSE-DS score when compared to those with relative incision occlusal balance, adjusted for sociodemographic factors and number of remaining teeth, subjective masticatory ability, chewing ability, occlusion time, and denture use. Cognitive function was higher when relative molar occlusion was greater compared to anterior occlusion in anterior-posterior teeth balance.ConclusionsCognitive function in elderly people was higher when the relative molar occlusal balance was greater. Mastication with posterior teeth may have a more important effect on stimulation of cognitive function. Therefore, oral health care focusing on maintenance of molar teeth may be crucial for elderly persons.     

Oral health: perceptions of need in a rural Iowa county

Several studies have shown that oral health problems impact the quality of life of older adults. However, few data are available to describe the oral health status, barriers to care, and patterns of care for adults and older populations living in rural areas. The purpose of this study was to evaluate the perceived need for treatment of oral health problems by adult residents in a rural county in Iowa.
The oral health component was part of a larger longitudinal health study of the residents. The sample was stratified into three groups by residence, that is, farm households, rural non-farm households and town households. The sample was subsequently post-stratified by gender and age group into young elderly, 65–74 years old, and old elderly, 75 years and older.
Dentition status varied according to age and was related to the perception of treatment needs. Edentulous persons had fewer perceived treatment needs and utilized a dentist less frequently. Place of residence, education, and marital status were not associated with the subjects' perceived problems with eating and chewing. However, persons with difficulty chewing were more likely to have some missing upper teeth, have a perceived need to have denture work, and have smoked for a number of years. The results suggest that this rural population is retaining more teeth and consequently may need and may seek dental services more often than previous more edentulous cohorts.     

Milk and vegetables in the diet of institutionalized elderly people in Finland

More than 95% of the institutionalized elderly subjects drank milk, and more than 50% ate raw vegetables one or more times a day. There were no statistical differences between the frequencies of men and women, and the mean frequency index for age groups 65 to 74, 75 to 84, and ≧ 85 years was the same for milk throughout. For vegetables, the mean value rose slightly toward the older age groups. More than half of the edentulous denture wearers and of the dentulous subjects ate raw vegetables every day, while only 38% of the edentulous without dentures did. The availability of vegetables alone is not enough; the intake of these vegetables must be actively encouraged.     

Periodontal conditions in mentally retarded children

The purpose of this investigation was to evaluate the standard of oral hygiene and periodontal health among institutionalized and non-institutionalized mentally retarded children with and without Down's syndrome in relation to dental care and socioeconomic status. A total of 329 persons, 6-19 yr old, were examined. In general, oral hygiene and periodontal health were poor and most of the children had gingival bleeding. The best, as well as the poorest, oral hygiene and periodontal health was found among subjects living at home. Children with Down's syndrome had less plaque and calculus but, in spite of this, a tendency to more gingivitis than others. Individuals who had their teeth brushed every day under teacher supervision had better periodontal health than others. Furthermore this study indicates a relationship between socioeconomic status and periodontal conditions.     

Oral disorders and treatment implications in people over 75 years

The oral health of subjects over 75 yr and living independently in the southwest of Britain was assessed. The majority (80%) of the sample were edentulous, and a large proportion of both edentate and dentate subjects were using dentures. More than half of the denture wearers were using loose, very unhygienic, or structurally defective dentures. Mucosal pathoses were quite common, although most of the lesions were denture-induced stomatitis found in association with unhygienic dentures. The dentate subjects had, on average, 11 natural teeth, frequently with evidence of root caries and deep periodontal pockets or extreme bone loss. The oral health problems suggest that there is a significant need to develop effective methods of improving oral hygiene in this age group. The prosthetic treatment is related principally to denture repairs while there is a need to control root caries among the growing population of elderly dentate people.     

Coronal caries and restorations in an elderly population in Germany

In an epidemiologic study, the dental health status of elderly persons in Germany was investigated. A total of 458 persons aged 60 yr and over participated in the study, with 89 persons being residents of old-people's homes. With a mean DMFS score of 87.3, the mean number of manifest caries was low (1.2) and the standard of conservative and prosthetic care high. Of a mean number of 17.75 filled surfaces, 59.6% were surfaces with crowns. Dental health is a social problem. The mean number of caries cavities was 10 times higher in institutionalized elderly persons of low social class than in non-institutionalized persons of the same age. Finally, initiatives to improve oral and dental hygiene in all age groups examined in this study are urgently required.     

Oral mucosal lesions among institutionalized elderly in Denmark

The purpose of the study was to determine the prevalence of oral mucosal lesions among institutionalized elderly. The study population comprised 486 elderly from eight nursing homes, and 199 elderly from five hospital long-term care facilities in the eastern part of Denmark. Approximately half of the subjects exhibited one or more pathologic conditions of the oral mucosa. Denture related traumatic ulcerations were found in 3.9% of the nursing home residents, compared to 8.3% among the elderly in hospital long-term care. The most prevalent finding was denture stomatitis, which was manifest in about one third of the elderly. The prevalence was strongly influenced by the denture hygiene; 54% of the elderly with poor denture hygiene suffered from denture stomatitis, as compared to only 7% of those with clean dentures. The prevalence of denture stomatitis was also related to the usage of dentures at night and to the age of the dentures. The prevalence decreased significantly with increasing age, although the oldest age group did not have better denture hygiene, or more favorable wearing habits. It did not appear that sex, type of residency, degree of urbanization, denture conditions, or the use of anticholinergic drugs influenced the prevalence of denture stomatitis. The prevalence and severity of the disease can probably be reduced if the denture hygiene is improved and if the elderly only use their dentures during the daytime.(ABSTRACT TRUNCATED AT 250 WORDS)     

Oral health condition of the population in special elderly nursing home

With the objective of making clear the oral health condition of chronic disable elderlies and thereby obtaining information for oral hygiene education and dental treatment, 77 elderlies in a special elderly nursing home attached to a private general hospital in Niigata Prefecture were studied by an interview/questionnaire method and dental examination. The following results were obtained. (1) Their mean age was 82.0 years. The major causes of chronic disability were diseases of the cerebral blood vessel and these diseases accounted for 54.5% of all diseases. The mean period of their chronic disability was 9 years. (2) 49.4% (38 persons) of them was edentulous, and 47.9% (18 persons) of them was using complete denture. (3) The average number of present teeth was 4.6 in all persons, while it was 9.0 in dentulous persons, and 3.3 of which were residual roots. (4) Salivary occult blood reaction test was positive in 87.2% in the dentulous persons and 34.2% in edentulous persons. (5) Simplified culture test using STOMASTAT was negative in 48.4% and positive in 51.6% of persons using a denture. (6) The above results indicated that dental diseases of chronic disable elderlies are not treated appropriately. This study revealed importance of dental examination, oral hygiene education and initial treatment in middle-aged and older persons.     

����ʡ35 ~ 74����Ⱥ���ܼ�����������������鱨�棨2015—2016�꣩

??Objective    To investigate the current status of periodontal diseases and remaining teeth of people aged 35-74 in Liaoning Province??in order to provide data support for the dental health care and the related studies in Liaoning Province. Methods    An equal-sized stratified multi-stage random sampling design was applied to select a total of 144 Liaoning residents in urban and rural areas??and the subjects were at the age of 35-44??55-64 and 65-74??with a gender ratio of half to half. The status of periodontal diseases and remaining teeth were assessed according to the Guideline for the Fourth National Epidemiological Survey of Oral Health. Results    The prevalence of periodontal pocket in the three groups was 51.05%??57.64% and 56.94%??and it was higher in male than in female??but there was no statistical difference between male and female ??P > 0.05??. The prevalence of attachment loss was 46.15%??74.31% and 75.69%??and the male detection rate was higher than that of female??the rural detection rate higher than that of cities. In the 35-44 age group??the fixed denture restoration was higher in rural areas??34.72%??than in cities??16.9%????and the difference was statistically significant ??P < 0.05??. In the 55-64 age group??the number of missing and unrepaired teeth in rural areas??22.22%??was significantly lower than that in urban areas??34.72%????but the difference was no statistically significant. In the 65-74 age group??the rate of fixed denture restoration was 39.58%??increasing by 18.5% compared with 2005. Conclusion    There was a high level of periodontal disease in Liaoning residents??and over half of the elderly people have several lost teeth??more prevention methods should be included.     

402名老年人口腔健康调查

目的：调查金山区敬老院内老年人的口腔健康状况,描述其现状,为老年人口腔护理提供相关依据。方法：采用分层整体抽样方法,收集金山区6家敬老院共402名老年人牙缺失、义齿修复以及刷牙次数等情况,采用SPSSl3．0软件包进行统计学分析。结果：金山区敬老院402名老年人中牙缺失人数为390人,失牙率达到97．01％,而义齿修复率仅为25．64％;其中全口无牙颌人数为102名,全口义齿修复率为72．54％;每天不刷牙的人数为180人,占到44．77％。结论：目前金山区老年人口腔健康自我重视程度不够,且缺乏保健意识,口腔状况不容乐观。建议金山区牙防所进一步加强辖区老年人的龋病和牙周病防治的宣教力度,提升居民口腔保健意识,减少失牙,改善老年人的缺牙修复水平,提高生活质量。     

402名老年人口腔健康调查

目的：调查金山区敬老院内老年人的口腔健康状况,描述其现状,为老年人口腔护理提供相关依据。方法：采用分层整体抽样方法,收集金山区6家敬老院共402名老年人牙缺失、义齿修复以及刷牙次数等情况,采用SPSSl3．0软件包进行统计学分析。结果：金山区敬老院402名老年人中牙缺失人数为390人,失牙率达到97．01％,而义齿修复率仅为25．64％;其中全口无牙颌人数为102名,全口义齿修复率为72．54％;每天不刷牙的人数为180人,占到44．77％。结论：目前金山区老年人口腔健康自我重视程度不够,且缺乏保健意识,口腔状况不容乐观。建议金山区牙防所进一步加强辖区老年人的龋病和牙周病防治的宣教力度,提升居民口腔保健意识,减少失牙,改善老年人的缺牙修复水平,提高生活质量。     

江苏省中老年人牙周健康状况及影响因素分析

目的了解江苏省35~74岁人群的牙周健康状况及其相关影响因素,为开展中老年人牙周疾病的防治提供信息支持。方法采用分层、多阶段、等容量随机抽样的方法,抽取江苏省35~74岁城乡居民447人,其中35~44岁146人,55~64岁153人,65~74岁148人。按照第四次全国口腔健康流行病学调查检查标准,采用CPI探针检查全口牙的牙龈出血、牙石、牙周袋和附着丧失状况,并进行问卷调查。结果35~44岁、55~64岁、65~74岁人群,牙龈出血人均牙数和检出率分别为11.3(95.2%)、11.3(95.4%)、8.2(87.2%),牙石人均牙数和检出率分别为21.3(100.0%)、21.5(99.4%)、18.0(98.0%),浅牙周袋人均牙数和检出率分别为1.6(38.4%)、3.0(64.1%)、2.3(53.4%),深牙周袋人均牙数和检出率分别为0.1(2.1%)、0.3(13.1%)、0.2(10.1%),牙周附着丧失人均牙数和检出率分别为1.2(32.2%)、6.0(76.5%)、6.4(87.2%),牙周健康检出率分别为2.1%、0.7%、4.1%。单因素分析显示牙周炎与年龄、性别、学历、吸烟有统计学意义(P<0.05),多元Logistic回归分析显示:年龄为牙周炎的独立危险因素(P<0.05)。结论本次调查显示江苏省中老年人牙周健康和口腔卫生状况较差。年龄、性别、学历、吸烟等可能是影响牙周健康状况的相关因素。应加强中老年人口腔预防保健工作,努力改善中老年人口腔健康状况。     

Oral candidosis in long-term hospital care: comparison of edentulous and dentate subjects

OBJECTIVE: To obtain information on the oral health status of the elderly living in a medicalized, geriatric institution.
DESIGN: A cross-sectional clinical investigation with complementary microbiological studies.
SUBJECTS AND METHODS: A cohort of 233 elderly in one long-term care ward; collection of demographic data; clinical examination to determine dental and prosthetic status and health of the oral mucosae; swabs for detection of mucosal and denture colonization by Condido; paraffin stimulated saliva for detection of colonization by mutans streptococci and lactobacilli.
MAIN OUTCOME MEASURES: Oral and denture hygiene; oral mucosal health; degree of colonization by Condida , mutans streptococci and lactobacilli.
RESULTS: Mean age of the 233 patients was 85.6 ± 6.9 years; 61% were totally dependent, 62.7% were wearing one or two complete dentures; 19.7% had natural teeth and no denture and 17.6% neither teeth nor denture. Of those wearing dentures 72% had denture stomatitis. Of those with natural teeth 72% were affected by active caries. Yeast counts were significantly correlated with the intensity of the erythema of the palatal mucosa, plaque score of the natural teeth, denture plaque score, and salivary counts of mutans streptococci and lactobacilli.
CONCLUSIONS: High oral yeast counts and frequent prevalence of oral candidosis in elderly subjects living in institutions are associated with poor oral hygiene and neglect of denture care.