Update and review of the gerodontology prospective for 2020's: Linking the interactions of oral (hypo)-functions to health vs. systemic diseases

Exploring ageism and elderly care in dentistry: A comprehensive scoping review

OBJECTIVES

This scoping review aims to investigate the perceptions of dental professionals regarding aging and geriatric dentistry, as well as to identify studies focused on ageism in dental care.

DATA

The review followed guidelines from the Joanna Briggs Institute and PRISMA-ScR. A systematic search was conducted in the databases, covering the period from 2019 to 2024.

SOURCES

PubMed, Scopus, and Web of Science were searched.

STUDY SELECTION

Articles focusing on ageism or oral health in the elderly were included, while those with methodological flaws, duplicates, or unrelated content were excluded.

CONCLUSIONS

A total of 28 articles were included in the final analysis. The results reveal significant cultural differences in how ageism impacts dental care, with many dental professionals unprepared to treat elderly patients with physical and cognitive limitations. Geriatric dentistry remains underrepresented in dental curricula in some countries, leading to a shortage of specialized professionals. This review underscores the need for further research on the perspectives of practicing dentists and elderly patients to improve care and address the barriers caused by ageism.

CLINICAL SIGNIFICANCE

The review emphasizes the critical need to address ageism in dental care to enhance the quality of treatment for elderly patients. Effective strategies to counteract age-related biases can lead to improved clinical outcomes and more equitable care for all age groups.

Gender differences in oral health among prisoners: a cross-sectional study from Taiwan

BACKGROUND

The prevalence of oral diseases among Taiwanese prisoners has rarely been investigated. This study aimed to estimate the gender-specific prevalence of oral disease in a sample of Taiwanese prisoners.

METHODS

We included 83,048 participants from the National Health Insurance (NHI) Program. Outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision (ICD-9-CM). For prevalence, we provide absolute values and percentages. We also performed a χ2 test to assess sex and age group differences in the percentage of disease in the oral cavity, salivary glands, and jaw.

RESULTS

The prevalence rate of oral diseases was 25.90%, which was higher than that of the general population. The prevalence of oral diseases in female prisoners was higher than that in male prisoners (p < 0.001), and the prevalence of oral diseases in prisoners aged ≤ 40 was higher than that of prisoners aged > 40. Among all cases of diagnosed oral diseases, the top three diseases were dental hard tissue diseases (13.28%), other cellulitis and abscesses (9.79%), and pruritus and related conditions (2.88%), respectively. The prevalence of various oral diseases in female prisoners was significantly higher than that in male prisoners.

CONCLUSION

Oral disease is common among Taiwanese prisoners. Female prisoners had a higher prevalence of oral, salivary gland, and jaw diseases than male prisoners. Therefore, early prevention and appropriate treatment are required and also a need for gender-specific oral disease products given the differences in the prevalence of oral disease among male and female prisoners.

Associations of general health conditions with masticatory performance and maximum bite force in older adults: A systematic review of cross-sectional studies

OBJECTIVES

To give an overview of the current evidence on the associations of general health conditions with masticatory performance and maximum bite force in older adults.

DATA/SOURCES

Three electronic databases (Medline via PubMed, Embase via Ovid and CINAHL Plus via EBSCOhost) were searched up to September 2021 for cross-sectional studies on general health conditions and masticatory performance or maximum bite force in older adults. Methodological quality of the included studies was independently evaluated based on Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between general health conditions and masticatory performance or maximum bite force were extracted.

STUDY SELECTION

Of the 5133 records identified, 39 studies (43 articles) were included in this review. Significant negative associations were found between masticatory performance and stroke, sarcopenia, amyotrophic lateral sclerosis, chronic obstructive pulmonary disease, dyspepsia, dysphagia, anorexia, and carotid atherosclerosis. Significant negative association was found between maximum bite force and sarcopenia. There were equivocal results on the association between masticatory performance and diabetes mellitus, and between maximum bite force and stroke, and amyotrophic lateral sclerosis. There was no significant association between masticatory performance and metabolic syndrome, and between maximum bite force and progress of Parkinson's disease. Most studies revealed positive associations of physical function with masticatory performance and maximum bite force.

CONCLUSIONS

Negative associations between masticatory function of older adults and presence of several systemic diseases have been reported in a number of studies while there are positive associations between masticatory function and some physical function indicators.

CLINICAL SIGNIFICANCE

This study provides valuable information on the association of masticatory function with general health, which draws clinicians' attention to the masticatory function of older adults who suffer from certain systemic diseases or physical dysfunction, and to the need to improve their masticatory ability to achieve healthy aging.

The Impact of Community Empowerment Programs on Oral Health Education for Knowledge Improvement in the Elderly

Objective This study aims to assess whether community empowerment as a health promotion program can improve the knowledge of the elderly and develop self-awareness about their oral health. The elderly population has increased in number and needs special attention, especially regarding the improvement of hygiene and health. Community empowerment is a type of health promotion program that can take the form of counseling and providing knowledge about oral health to the elderly.

Materials and Methods Participants are elderly aged 60 years or older. Counseling was done by oral medicine specialists and residents to provide knowledge about oral health problems. Assessment of knowledge improvement was done using pretest and posttest in a written questionnaire.

Statistical Analysis The Shapiro–Wilk test followed by the Wilcoxon test was used to compare the difference before and after counseling.

Results From a total of 38 elderly included in this study, 29 (76.32%) showed an improved score in posttest compared with pretest. Statistical analysis showed a significant difference between pretest and posttest scores of study participants (p < 0.005).

Conclusion Counseling in empowerment programs can help the elderly improve their knowledge about oral health, so that improvements can be expected to be followed by the development of self-awareness in the future.

Effects of wearing removable dentures and aging on palatal mucosa blood flow by laser doppler

Aim

The purpose of this work is to analyze the effects of removable dental prostheses and aging on blood microcirculation in the palatal mucosa.

Settings and Design

Blood flow was measured in two groups using the Laser Doppler Flowmeter at three specific anatomical sites: Retro incisive papilla, medial raphe, and Schroeder area.

Materials and Methods

Group 1 included young, healthy dentulous individuals (mean age: 23 ± 3 years), and Group 2 contained elderly edentulous individuals (mean age: 62 ± 11.69 years). For Group 1, measurements were taken in a single session; for Group 2, the measurements were taken in two sessions: The first just before the prosthetic load (E1) and again 1 week after new dentures were provider (E2).

Statistical Analysis Used

Statistical analyses were performed using SAS software, Version 9.4 of the SAS System for Windows, Copyright © 2017 SAS Institute Inc. (Cary, NC, USA). A P < 0.05 was classified as statistically significant.

Results

Measurements of blood flow of the palatal mucosa showed that the healthy young dentulous participants had significantly lower perfusion unit values than the elderly edentulous participants at all three anatomical sites (P < 0.05). For Group 2, the comparisons between the measurements taken before (E1) and after (E2) new dentures were provided showed no significant differences.

Conclusion

Our results indicate that the process of aging significantly modifies the blood flow of the palatal mucosa while wearing removable dental prostheses does not modify the blood flow of the palatal mucosa in a 1week period. These results are not influenced by systemic pathology (e.g., diabetes, cardiovascular diseases) or smoking.

Exploring the Connection between Porphyromonas gingivalis and Neurodegenerative Diseases: A Pilot Quantitative Study on the Bacterium Abundance in Oral Cavity and the Amount of Antibodies in Serum

Recent studies support the hypothesis that microbes can seed some Alzheimer’s disease (AD) cases, leading to inflammation and overproduction of amyloid peptides. Porphyromonas gingivalis (Pg) is a keystone pathogen of chronic periodontitis and has been identified as risk factor for the development and progression of AD. The present preliminary study aimed to quantify Pg abundance in neurodegenerative disease (ND) patients compared with neurologic patients without neurodegenerative disorders (no-ND) and healthy controls (HC) to determine possible association between Pg abundance and neurodegenerative process. Pg was quantified on DNA extracted from the oral samples of 49 patients and 29 HC by quantitative polymerase chain reaction (qPCR). Anti-Pg antibodies were also detected on patient serum samples by enzyme-linked immunosorbent assays (ELISA). The Pg abundance in the oral cavity was significantly different among groups (p = 0.004). It was higher in ND than no-ND (p = 0.010) and HC (p = 0.008). The Pg abundance was correlated with the antibodies (p = 0.001) with different slopes between ND and no-ND (p = 0.037). Pg abundance was not correlated with oral indices and comorbidities. These results extend our understanding of the association between oral pathogens and AD to other neurodegenerative processes, confirming the hypothesis that oral pathogens can induce an antibody systemic response, influencing the progression of the disease.

Oral Microbiota Changes in Elderly Patients, an Indicator of Alzheimer's Disease

Alzheimer’s disease (AD) is a neurodegenerative disease that usually affects older individuals. Owing to the higher incidence of root caries and missing teeth in elderly individuals, the bacteria involved in these dental concerns might potentially deteriorate their cognitive function. Altered microbiota in the oral cavity may induce neuroinflammation through migration from the oral cavity to the brain. However, the correlation between the composition of the oral microbiota and neurodegenerative disease remains unclear. In this study, we evaluated sequence to determine the relative abundance and diversity of bacterial taxa in the dental plaque of elderly patients with AD and controls. Oral samples; the DMFT index; and other clinical examination data were collected from 17 patients with AD and 18 normal elderly individuals as the control group. Patients with AD had significantly more missing teeth and higher dental plaque weight but lower microbial diversity than controls. Significantly increased numbers of Lactobacillales, Streptococcaceae, and Firmicutes/Bacteroidetes and a significantly decreased number of Fusobacterium were observed in patients with AD. In conclusion, using the PacBio single-molecule real-time (SMRT) sequencing platform to survey the microbiota dysbiosis biomarkers in the oral cavity of elderly individuals could serve as a tool to identify patients with AD.