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Sato S, Sasabuchi Y, Okada A, Yasunaga H. Association between self-reported difficulty in chewing or swallowing and frailty in older adults: A retrospective cohort study. GeroScience 2024:10.1007/s11357-024-01325-7. [PMID: 39212786 DOI: 10.1007/s11357-024-01325-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
Oral frailty can contribute to physical and mental health disorders. Previous research has shown an association between frailty and self-reported difficulty in chewing or swallowing. However, their combined assessment has obscured their specific impact on frailty-related outcomes. To investigate the independent associations between difficulty in chewing or swallowing and 1-year frailty outcomes, while also examining their interactions. This retrospective cohort study utilized the DeSC database to identify older adults aged ≥ 75 years who underwent health checkups between April 2014 and November 2022. Multivariate Cox regression analyses were conducted to assess the association between self-reported difficulty in chewing or swallowing and outcomes, including hospitalization due to aspiration pneumonia, all-cause hospitalization, and all-cause mortality within 1 year. Interactions between chewing and swallowing difficulties were also evaluated. Among 359,111 older adults, 39.0% reported oral function difficulties. Swallowing difficulty alone lacked significant outcome association. However, chewing difficulty alone was significantly associated with higher risks of hospitalization due to aspiration pneumonia (hazard ratio (HR), 1.35; 95% confidence interval (CI), 1.15-1.58; P < 0.001), all-cause hospitalization (HR, 1.08; 95% CI, 1.05-1.11; P < 0.001), and all-cause mortality (HR, 1.28; 95% CI, 1.14-1.44; P < 0.001) compared with no self-reported difficulty. A significant positive interaction between self-reported difficulty in chewing and swallowing was observed for all-cause mortality (P = 0.009). Self-reported difficulty in chewing was significantly associated with higher risks of hospitalization due to aspiration pneumonia, all-cause hospitalization, and all-cause mortality among older adults. Chewing and swallowing difficulties showed a synergistic effect, significantly increasing all-cause mortality risk.
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Affiliation(s)
- So Sato
- Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1130033, Japan.
| | - Yusuke Sasabuchi
- Department of Real-World Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1130033, Japan
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Koenig A, Porzelt S, Behrens-Potratz A, Stratmeyer P, Schellhammer S, Schmage P, Konnopka C, Scherer M, Konnopka A, Zimmermann T. Assessing oral health-related quality of life among older people in home-based care - survey results of the InSEMaP study in Germany. BMC Oral Health 2024; 24:734. [PMID: 38926675 PMCID: PMC11209957 DOI: 10.1186/s12903-024-04500-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Older people receiving home-based care (HBC) often face barriers to access preventive oral health care (OHC) and dental treatments. Leading to deterioration of their oral healthcare. It is further deteriorated by factors such as increasing burden of systemic diseases, medicinal side effects, limited mobility, financial constraints and lack of professional OHC at home. Older people also struggle to maintain necessary daily oral hygiene, leading to malnutrition, weight loss, and a risk of a further health degradation. This cross-sectional survey aimed to investigate the oral health-related quality of life (OHRQoL) and their associated factors in HBC recipients. METHODS 5,280 older people (≥ 60 years) living in Hamburg, who were in need of care and insured with statutory health insurance DAK-Gesundheit received the questionnaire, which included the German version of the Oral Health Impact Profile (OHIP G-14) and, the EQ-5D health-related quality of life (HRQoL) measure as well as further questions regarding the extent of informal social support, subjective oral health status, oral health behaviour, subjective cognitive status, and socio-demographic variables. RESULTS The participants (n = 1,622) had a median age of 83.2 years, with 72.0% of the sample being female. Nearly two thirds of the sample reported that their independence or abilities were significantly impaired (care level 2). Regarding oral health impacts, 40.0% of the participants reported experiencing at least one of the fourteen possible prevalent impacts of the OHIP-G14 fairly often or very often. A multivariate regression model on the severity of oral health impacts revealed, that a better HRQoL, a positive perception of one's own dental status, fewer visits to dental practices, and no need for support in OHC were associated with better OHRQoL. Conversely, respondents with a negative perception of their oral health status, more frequent visits to a dental practice, a need for support in OHC, and subjective memory impairment showed poorer OHRQoL. CONCLUSIONS The results highlight the risk for poor oral health among older people in HBC. We conclude that there is an urgent need to prioritise oral health, especially as poor oral health can further compromise the systemic wellbeing of these already care dependent population.
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Affiliation(s)
- Alena Koenig
- Department of Nursing and Management, Cooperative Process Management in Social and Health Care RTC (KoPM-Zentrum), Faculty of Business and Social Sciences, Hamburg University of Applied Sciences, Alexanderstraße 1, 20099, Hamburg, Germany.
| | - Sarah Porzelt
- Department of General Practice and Primary Care, Centre for Psychosocial Medicine, University Medical Centre Hamburg- Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Anja Behrens-Potratz
- Department of Nursing and Management, Cooperative Process Management in Social and Health Care RTC (KoPM-Zentrum), Faculty of Business and Social Sciences, Hamburg University of Applied Sciences, Alexanderstraße 1, 20099, Hamburg, Germany
| | - Peter Stratmeyer
- Department of Nursing and Management, Cooperative Process Management in Social and Health Care RTC (KoPM-Zentrum), Faculty of Business and Social Sciences, Hamburg University of Applied Sciences, Alexanderstraße 1, 20099, Hamburg, Germany
| | - Stefanie Schellhammer
- Department of Health Care Research and Innovation, Deutsche Angestellten Krankenkasse - Gesundheit (DAK-Gesundheit), Nagelsweg 27, 20097, Hamburg, Germany
| | - Petra Schmage
- Department of Periodontics, Preventive and Restorative Dentistry, Centre for Dental and Oral Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Claudia Konnopka
- Department of Health Economics and Health Services Research, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Martin Scherer
- Department of General Practice and Primary Care, Centre for Psychosocial Medicine, University Medical Centre Hamburg- Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Thomas Zimmermann
- Department of General Practice and Primary Care, Centre for Psychosocial Medicine, University Medical Centre Hamburg- Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
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Julkunen L, Saarela R, Roitto HM, Kautiainen H, Pitkälä K, Mäntylä P, Hiltunen K. Oral frailty among dentate and edentate older adults in long-term care. BMC Geriatr 2024; 24:48. [PMID: 38212720 PMCID: PMC10782602 DOI: 10.1186/s12877-023-04605-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The objectives of this study were to compare oral frailty (OFr) among edentate and dentate older adults living in long-term care facilities (LTCF) and to clarify how edentulism and oral disease burden (ODB) of dentate older adults are associated with OFr. METHODS The population of this study comprised 94 edentate and 209 dentate residents in LTCF in Helsinki, Finland, who had previously participated in a nutritional study. The participants underwent a clinical oral examination. The dentate residents were further divided into three ODB groups based on asymptotic dental score. The edentate and different ODB groups were compared with each other regarding demographics and oral and medical findings. OFr was defined as ≥ 2 of following: having a diet of soft/pureed food, residue of food in the oral cavity, inability to keep the mouth open during examination, unclearness of speech, dry mouth. The association between OFr and edentulousness and various levels of ODB was analyzed by a multivariate logistic model. RESULTS Participants with low ODB had significantly less OFr than their edentate peers (p = 0.009). Furthermore, the edentate and dentate with high ODB had similar odds for OFr. CONCLUSIONS Edentulousness and high ODB are equally harmful conditions and may predispose to OFr. This study suggests that maintaining healthy natural teeth and good oral health (low ODB) may protect against OFr. TRIAL REGISTRATION The Ethics Committee of the Hospital District of Helsinki and Uusimaa approved the protocols for the nutritional status and oral healthcare studies and the merging of the data, including patient medical records (Register number HUS/968/2017).
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Affiliation(s)
- Lina Julkunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Riitta Saarela
- Social Services, Health Care and Rescue Services Division, Oral Health Care, City of Helsinki, Finland
| | - Hanna-Maria Roitto
- Faculty of Medicine (Clinicum), University of Helsinki, Helsinki, Finland
- Geriatric Clinic, Helsinki Hospital, Helsinki, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Kaisu Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
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Kytridou V, Gkikas I, Garcia MN, Cepeda O, Hildebolt CF. A literature review of local and systemic considerations for endodontic treatments in older adults. Gerodontology 2023; 40:410-421. [PMID: 36971290 DOI: 10.1111/ger.12679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 11/17/2023]
Abstract
OBJECTIVES The aim of this literature review was to summarise the clinical important findings on the endodontic treatment outcome in older patients (≥60 years old) with pulpal/periapical disease considering local and systemic factors from a body of knowledge that is heterogeneous in methods or disciplines. BACKGROUND Due to the increasing number of older patients in the endodontic practice, and the current trend for tooth preservation, the need for clinicians to have a better understanding of age-related implications that may influence the required endodontic treatment in older adults to retain their natural dentition is indispensable. METHODS PubMed/Medline and Embase was searched by a medical librarian using specific terms based on inclusion/exclusion criteria. The reference list was hand-seached for additional relevant publications between 2005-2020. A combination of these terms was performed uing Boolean operators and MeSH terms. RESULTS Of the 1577 publications identified manually and electronically, 25 were included to be fully reviewed by the examiners. The data was derived from three systematic reviews, one systematic and meta-analysis, three case series, four prospective and 14 retrospective cohorts. Overall, there was heterogeneity in reporting as well as limitations in most studies. CONCLUSIONS The outcome of endodontic treatment (ET) either nonsurgical or surgical or combination of these is not affected by older age. ET can be the treatment of choice in older patients wiht pulpal/periapical disease. There is no evidence that older age per se affects the outcome of any type of endodontic treatment.
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Affiliation(s)
- Vasiliki Kytridou
- Section Head of Endodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Ioannis Gkikas
- Section of Oral and Maxillofacial Surgery, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Miryam Nathalia Garcia
- Applied Dental Medicine Department, Section of Periodontics, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Oscar Cepeda
- Division of Geriatric Medicine, St. Louis VA Medical Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Charles F Hildebolt
- Washington University School of Medicine, Saint Louis, Missouri, USA
- Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
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Janssens B, Tsakos G, De Visschere L, Verté D, De Witte N. Frailty as a determinant of dental attendance among community-dwelling older adults. Gerodontology 2023; 40:363-371. [PMID: 36336964 DOI: 10.1111/ger.12664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/05/2022] [Accepted: 10/24/2022] [Indexed: 08/15/2023]
Abstract
OBJECTIVES The aim of this study was to assess the association between different levels of frailty and dental attendance among home-dwelling older adults, in Belgium. BACKGROUND While many determinants of dental attendance among older adults have been identified, no study has focused on the role of frailty. MATERIALS AND METHODS This was a cross-sectional study on a random sample of home-dwelling adults aged 60 and over from two Belgian cities. Data were collected with a structured questionnaire through a participatory peer-research method. Time since the last dental attendance was the dependent variable. The independent variable was frailty, assessed with the Comprehensive Frailty Assessment Instrument, including physical, psychological, social, and environmental subdomains. Covariates were age, gender, having a partner, educational level, and household income, as well as self-perceived oral health. Data analysis included descriptive, bivariate (Chi-Square, ANOVA, and Kruskal-Wallis), and binomial logistic regression analyses. RESULTS The sample consisted of 1329 older adults with a mean age of 72.5 years (SD 8.9, range 60-103). In the low frailty group, 73% attended the dentist in the previous 12 months, while it was 62% and 54% in the medium and high frailty groups, respectively. In the fully adjusted model, the initial gradient in the relationship between overall frailty and dental attendance remained; those in the medium and the high frailty groups were respectively 1.46 (95% CI: 1.09, 1.95) and 1.67 (95% CI: 1.15, 2.43) times more likely to report no dental attendance in the previous year than the low frailty group. Similar associations could be seen in the physical and environmental frailty subdomains. CONCLUSION Frailty is consistently associated with less favourable dental attendance, independent from age, gender, socioeconomic factors, family composition, and self-perceived oral health. Once frailty has been detected, good interprofessional communication and care are needed to avoid the drop-out of older adults from the oral healthcare system.
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Affiliation(s)
- Barbara Janssens
- Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Gent, Belgium
| | - Georgios Tsakos
- UCL Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Luc De Visschere
- Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Gent, Belgium
| | - Dominique Verté
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussel, Belgium
| | - Nico De Witte
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussel, Belgium
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussels, Brussel, Belgium
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Srinivasan M, Kamnoedboon P, Angst L, Müller F. Oral function in completely edentulous patients rehabilitated with implant-supported dental prostheses: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:196-239. [PMID: 37750517 DOI: 10.1111/clr.14068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/10/2023] [Accepted: 03/30/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults. MATERIALS AND METHODS Systematic literature searches were performed to identify records reporting on oral function in completely edentulous adults rehabilitated with implant-supported prostheses. Meta-analyses were performed on various outcomes including bite force, masticatory performance, muscle activity, mandibular movement/chewing pattern, and salivary flow. RESULTS 5507 records were identified. Thirty studies qualified for data extraction and analysis. The kappa (𝛋) for the search and identification strategy ranged between 0.50 and 1.00. Meta-analysis was performed grouping the studies by outcomes and split by time points of 6-12 months, 12-36 months, and >36 months after implant therapy. The meta-analyses revealed a significant improvement in oral function of completely edentulous adults after rehabilitation with implant-supported prostheses at 6-12 months (Z = -4.895, p < .001; 95% CI: -0.703, -0.301; τ2 = .609; Q = 114.953, df = 17, p < .001; I2 = 85.2%), at 12-36 months (Z = -4.886, p < .001; 95% CI: -0.580, -0.248; τ2 = .908; Q = 280.611, df = 35, p < .001; I2 = 87.5%) and at more than 36 months (Z = -9.108, p < .001; 95% CI: -1.472, -0.951; τ2 = .019; Q = 7.918, df = 7, p = .340; I2 = 11.6%). The included studies demonstrated a low to moderate risk of bias. CONCLUSIONS This systematic review concluded that the oral function of completely edentate adults significantly improved with implant-supported/retained prostheses, even when only one jaw received implant therapy. Therefore, implant therapy should be promoted for edentulous adults to alleviate the shortcomings of conventional complete removable dental prostheses.
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Affiliation(s)
- Murali Srinivasan
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Porawit Kamnoedboon
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Lea Angst
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Janssens L, Petrauskiene E, Tsakos G, Janssens B. Clinical and Subjective Oral Health Status of Care Home Residents in Europe: A Systematic Review. J Am Med Dir Assoc 2023; 24:1013-1019.e40. [PMID: 37105236 DOI: 10.1016/j.jamda.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Several studies demonstrated the poor oral health of care home residents in Europe but there is no systematic overview of the relevant literature. The objective of this study was to systematically review the evidence on the clinical and subjective oral health outcomes of care home residents in Europe. DESIGN The study design is a systematic review. METHODS AND PARTICIPANTS All included publications presented data on clinical and/or subjective oral health outcomes in care home residents in Europe with no restrictions for language or study design. MEDLINE, Embase, and CINAHL were searched, including publications from January 2010 onward. Data extraction and quality assessment (Qualsyst tool) was performed by 2 researchers independently. Findings were synthesized narratively, lack in data homogeneity restricted the relevance of a meta-analysis. RESULTS Eighty-three papers from 18 countries were included in the systematic review, with a sample size ranging from 39 to 92,827 participants. Their mean age was older than 80 years. The residents had few natural teeth, with fewer than a third a functional natural dentition. Removable dentures were present in half to 80% of residents. A high prevalence of dental caries was reported. Oral hygiene was insufficient, for both natural teeth and removable dentures. Few residents had a healthy periodontium. Clinical treatment needs were found in most residents. Perceived treatment needs were high with at least one-third of care home residents reporting a need for care due to poor oral health. A fifth to half of the residents reported negative impacts of their oral condition on their everyday lives. CONCLUSION AND IMPLICATIONS This systematic review clearly highlights the poor oral health and high burden of oral conditions among care home residents across Europe, irrespective of country or health care system. There is need for substantial policy actions to improve oral health in care homes.
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Affiliation(s)
- Lynn Janssens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium.
| | - Egle Petrauskiene
- UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Georgios Tsakos
- UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Barbara Janssens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium
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Schuller AA, Hoeksema AR. Determinants and barriers for visiting a dental clinic among (frail) older individuals. Acta Odontol Scand 2023; 81:227-234. [PMID: 36112367 DOI: 10.1080/00016357.2022.2118166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
AIMS With increasing age, the proportion of older individuals visiting a dental clinic decreases. The aim was to gain insight into a) whether frailty or dental status were associated with visiting a dental clinic and b) their perceived barriers to accessing oral health care. METHODS Individuals eligible for the yearly influenza vaccination in Winschoten, The Netherlands, were invited to participate in a questionnaire survey about dental visits and perceived barriers to such visits. RESULTS A total of 1027 individuals aged 60+ completed the questionnaire - 80% of the non-frail, 71% of the mildly frail and 60% of the moderately to severe frail individuals visited a dental clinic in the previous year. Dental status was the crucial determinant for not visiting a dental clinic. Edentate individuals were more likely to drop out of the dental care system than dentate individuals or individuals with partial prostheses. A higher proportion of moderately and severe frail people were edentate than non-frail or mildly frail people. Barriers to visiting a dentist were making an appointment, costs, and services available. Conclusions: Dental clinicians should pay attention to the barriers that they can influence. The influenza vaccination seems to be an interesting momentum for identifying people who have dropped out of the oral healthcare system.
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Affiliation(s)
- Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center, Groningen, The Netherlands
- TNO Child Health, Leiden, The Netherlands
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Kaneko H, Hanamoto A, Yamamoto-Kataoka S, Kataoka Y, Aoki T, Shirai K, Iso H. Evaluation of Complexity Measurement Tools for Correlations with Health-Related Outcomes, Health Care Costs and Impacts on Healthcare Providers: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16113. [PMID: 36498188 PMCID: PMC9741446 DOI: 10.3390/ijerph192316113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/24/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Various tools to measure patient complexity have been developed. Primary care physicians often deal with patient complexity. However, their usefulness in primary care settings is unclear. This study explored complexity measurement tools in general adult and patient populations to investigate the correlations between patient complexity and outcomes, including health-related patient outcomes, healthcare costs, and impacts on healthcare providers. We used a five-stage scoping review framework, searching MEDLINE and CINAHL, including reference lists of identified studies. A total of 21 patient complexity management tools were found. Twenty-five studies examined the correlation between patient complexity and health-related patient outcomes, two examined healthcare costs, and one assessed impacts on healthcare providers. No studies have considered sharing information or action plans with multidisciplinary teams while measuring outcomes for complex patients. Of the tools, eleven used face-to-face interviews, seven extracted data from medical records, and three used self-assessments. The evidence of correlations between patient complexity and outcomes was insufficient for clinical implementation. Self-assessment tools might be convenient for conducting further studies. A multidisciplinary approach is essential to develop effective intervention protocols. Further research is required to determine these correlations in primary care settings.
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Affiliation(s)
- Hiromitsu Kaneko
- Faculty of Medicine, Osaka University, Suita, Osaka 565-0871, Japan
| | | | - Sachiko Yamamoto-Kataoka
- Department of Health Informatics, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Tanaka Asukai-cho 89, Kyoto 606-8226, Japan
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka 541-0043, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Shogoin Kawara-cho 54, Kyoto 606-8507, Japan
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Kyoto 606-8501, Japan
| | - Takuya Aoki
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Shogoin Kawara-cho 54, Kyoto 606-8507, Japan
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Kokoro Shirai
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Hiroyasu Iso
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
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Dai J, Li A, Liu Y, Chen Y, Tjakkes GHE, Visser A, Xu S. Denture wearing status, cardiovascular health profiles, and mortality in edentulous patients: A prospective study with a 27-year follow-up. J Dent 2022; 126:104287. [PMID: 36126778 DOI: 10.1016/j.jdent.2022.104287] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/14/2022] [Accepted: 09/13/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Life's Simple 7 (LS7) metrics provide insight into improving cardiovascular health (CVH) and help reduce mortality risks. Edentulous older adults have a higher mortality risk than dentulous ones, probably due to worse oral function. It is reported that wearing dentures will decrease the mortality risk factor by improving oral function. This prospective study aimed to investigate if denture wearing could modify the association between CVH profile and mortality risk among edentulous elderly. METHODS From the Third National Health and Nutrition Examination Survey (NHANES III), 1,735 edentulous older adults (mean age 69.4 years old) with CVH profiles and data on denture wearing status were selected for this study. CVH profiles according to LS7 metrics were classified into poor, intermediate, or ideal. Denture wearers were defined as those wearing complete dentures in both arches all the time or only when awake. Multivariable Cox proportional-hazards regression was conducted to estimate the association of CVH profiles with all-cause and cardiovascular mortality. Stratified analyses and the testing of interaction terms were used to evaluate the difference between the association in edentulous patients with and without dentures. RESULTS A total of 1,420 (81.8%) older adults died during the 27-year follow-up, with 475 (27.6%) cases attributable to heart disease. After controlling for potential confounders, edentulous patients with an ideal CVH (LS7 = 10-14) had a lower mortality risk than those with poor CVH (LS7 = 0-4). Furthermore, we observed an effect modification by denture use (Pinteraction = 0.046), with the role of ideal CVH in mitigating mortality among the denture wearers (Hazard Ratio = 0.440 [0.329-0.588]), while no significant association among those without dentures. Similar results were achieved for cardiovascular mortality, but there was no effect modification of denture use (Pinteraction = 0.352). CONCLUSION In this study, a favorable cardiovascular health profile presents a protective effect on all-cause mortality only among edentulous patients wearing dentures instead of non-wearer. CLINICAL SIGNIFICANCE Denture usage could improve oral function (e.g., chewing, smiling, speaking, etc.) and promote general health. Effect modification found in this study indicates having ideal CVH alone cannot substantially reduce mortality risk among edentulous patients. Therefore, health care professionals should keep an eye on the elderly not wearing dentures as they are probably more at risk for adverse health outcomes. It remains unclear if denture wearing has a causal relation with lower mortality risks, and further research is needed.
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Affiliation(s)
- Jingtao Dai
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China; Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
| | - Yang Liu
- Department of Oral Medicine, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Yuntao Chen
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Geerten-Has E Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Anita Visser
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands; Department for Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China.
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Prognosis of Implants with Implant-Supported Fixed Dental Prostheses in the Elderly Population: A Retrospective Study with a 5- to 10-Year Follow-Up. Healthcare (Basel) 2022; 10:healthcare10071250. [PMID: 35885775 PMCID: PMC9317632 DOI: 10.3390/healthcare10071250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/11/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
This retrospective study aimed to investigate the survival rate of implants from 5 to 10 years after the placement of implant-supported fixed dental prostheses (ISFDPs) and the management of implant loss in the elderly population. Elderly patients (≥65 years old) who had been treated with ISFDPs and followed up with for at least 5 years between October 2009 and March 2020 were enrolled. Patient profiles and implant-related data were extracted. The survival rate of implants up to 5 years as well as the 10-year cumulative survival rate were evaluated. The management of implant loss and prosthetic interventions were also investigated. In total, 195 patients (mean age: 70.1 ± 4.5 years old) and 687 implants (287 ISFDPs) were assessed. The 5-year survival rate was 99.0% and the 10-year cumulative survival rate was 98.1%. Seven of the eleven implants lost were lost due to peri-implantitis. Only three implants in two patients were placed after the loss of the implants; most were restored using non-invasive procedures. Two patients underwent a conversion from ISFDPs to removable prostheses. This study showed that high survival rates were observed in an elderly population with ISFDPs and that non-invasive procedures were often applied after the loss of an implant.
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12
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Dros C, Sealy MJ, Krijnen WP, Weening-Verbree LF, Hobbelen H, Jager-Wittenaar H. Oral Health and Frailty in Community-Dwelling Older Adults in the Northern Netherlands: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7654. [PMID: 35805314 PMCID: PMC9265776 DOI: 10.3390/ijerph19137654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022]
Abstract
The aim of this study was to explore the association between oral health and frailty in community-dwelling Dutch adults aged 55 years and older. Included were 170 participants (n = 95 female [56%]; median age 64 years [IQR: 59−69 years]). Frailty was assessed by the Groningen Frailty Indicator. Oral health was assessed by the Oral Health Impact Profile-14-NL (OHIP-NL14). OHIP-NL14 item scores were analyzed for differences between frail and non-frail participants. Univariate and multivariate logistic regression analyses were performed to assess the association between oral health and presence of frailty. The multivariate analysis included age, gender, and depressive symptoms as co-variables. After adjustment, 1 point increase on the OHIP-NL14 scale was associated with 21% higher odds of being frail (p = 0.000). In addition, significantly more frail participants reported presence of problems on each OHIP-NL14 item, compared to non-frail participants (p < 0.003). Contrast in prevalence of different oral health problems between frail and non-frail was most prominent in ‘younger’ older adults aged 55−64 years. In conclusion: decreased oral health was associated with frailty in older adults aged ≥55 years. Since oral health problems are not included in most frailty assessments, tackling oral health problems may not be sufficiently emphasized in frailty policies.
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Affiliation(s)
- Coen Dros
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.D.); (W.P.K.); (L.F.W.-V.); (H.H.); (H.J.-W.)
| | - Martine J. Sealy
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.D.); (W.P.K.); (L.F.W.-V.); (H.H.); (H.J.-W.)
- FAITH Research, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.D.); (W.P.K.); (L.F.W.-V.); (H.H.); (H.J.-W.)
- FAITH Research, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
- Johan Bernoulli Institute for Mathematics and Computer Science, University of Groningen, 9700 AK Groningen, The Netherlands
| | - Lina F. Weening-Verbree
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.D.); (W.P.K.); (L.F.W.-V.); (H.H.); (H.J.-W.)
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, Antonius Deusinglaan 1, FB 21, 9713 AV Groningen, The Netherlands
| | - Hans Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.D.); (W.P.K.); (L.F.W.-V.); (H.H.); (H.J.-W.)
- FAITH Research, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.D.); (W.P.K.); (L.F.W.-V.); (H.H.); (H.J.-W.)
- FAITH Research, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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13
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Uchida Y, Sato Y, Kitagawa N, Furuya J, Osawa T, Isobe A, Terazawa M, Hatanaka Y, Shichita T. Comparison of oral hypofunction tests and determination of reference values for a subjective masticatory function test. BMC Oral Health 2022; 22:223. [PMID: 35668400 PMCID: PMC9171963 DOI: 10.1186/s12903-022-02252-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Japan, oral hypofunction has been recognized as a disease since 2018. An alternative to occlusal force testing for assessing oral hypofunction is the evaluation of the number of natural teeth. Subjective masticatory function testing, which evaluates the ease or difficulty in chewing foods, is an effective alternative to occlusal force testing. However, no reference values have been established for this test. We determined the reference values of the subjective masticatory function test and evaluated its potential as a substitute for the number of natural teeth for assessing oral hypofunction. METHODS The sample consisted of 184 older adults who visited the Department of Geriatric Dentistry, Showa University Dental Hospital, from July 2018 to January 2020. The subjective masticatory function test (table for evaluation of chewing function in complete denture wearers [Chewing Score 20]) was performed using 20 foods. The occlusal force test and a receiver operating characteristic curve were used to determine the reference values for Chewing Score 20. The sensitivity, specificity, and positive and negative predictive values were calculated and compared with the occlusal force test and the number of natural teeth. RESULTS A significant correlation (r) was found between the occlusal force test and the Chewing Score 20 (r = 0.526, p < 0.001). The reference value for Chewing Score 20 was < 85. Although the Chewing Score 20 was less sensitive than the number of natural teeth, it demonstrated a higher specificity and a positive predictive value. CONCLUSION Herein, a score of < 85 on the subjective masticatory function test was determined to be the optimal quantitative reference. The subjective masticatory function test may be used as an alternative for assessing oral hypofunction.
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Affiliation(s)
- Yoshiki Uchida
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan.
| | - Yuji Sato
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Noboru Kitagawa
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Tokiko Osawa
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Akio Isobe
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Mayumi Terazawa
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Yukiko Hatanaka
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Toshiharu Shichita
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
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14
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Bots-VantSpijker PC, van der Maarel-Wierink CD, Schols JMGA, Bruers JJM. Oral Health of Older Patients in Dental Practice: An Exploratory Study. Int Dent J 2022; 72:186-193. [PMID: 34238570 PMCID: PMC9275187 DOI: 10.1016/j.identj.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Some older people stop visiting the dentist when they get older. This study aims to identify the characteristics and oral health status of older people who do visit community dental practices. METHODS In this exploratory cross-sectional study, the oral health of Dutch community-dwelling older people was assessed. A random sample of general dental practitioners and older people who visit the dental practice was drawn. The dentists were asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to complete a questionnaire. Data were described for 3 distinct groups of older people. Statistical measures for distribution and dispersion were used to describe the oral health of community-dwelling older patients in relation to the age. RESULTS A total of 373 (40.4%) dentist registration forms and 372 (40.3%) patient questionnaires were returned. Data were available for 364 (39.4%) dentist-patient couples. Amongst the patients, 52.8% were female and most had a high socioeconomic status. About 65.7% had one or more problems related to general health, and 75.2% used medication. Regarding the overall oral health status, the average number of teeth was 20, 3.5% were edentulous. Oral health problems were more common in the older patient group (aged 75+), in whom frailty was also most common. CONCLUSIONS Older people who visit community dental practices are still relatively healthy, non-frail, and highly educated. Even in this group, there is a turning point in both general and oral health from the age of 75.
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Affiliation(s)
- Pieternella C Bots-VantSpijker
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology (NVGd), Bunnik, The Netherlands; Department Oral Public Health (OPH), Acadamic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.
| | - Claar D van der Maarel-Wierink
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology (NVGd), Bunnik, The Netherlands; Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Jos M G A Schols
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology (NVGd), Bunnik, The Netherlands; Caphri - Dept. Health Services Research and Dept. Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Josef J M Bruers
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology (NVGd), Bunnik, The Netherlands; Department Oral Public Health (OPH), Acadamic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands; Royal Dutch Dental Association (KNMT), Utrecht, The Netherlands
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15
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de Sire A, Ferrillo M, Lippi L, Agostini F, de Sire R, Ferrara PE, Raguso G, Riso S, Roccuzzo A, Ronconi G, Invernizzi M, Migliario M. Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review. Nutrients 2022; 14:nu14050982. [PMID: 35267957 PMCID: PMC8912303 DOI: 10.3390/nu14050982] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
Frailty is a highly prevalent condition in the elderly that has been increasingly considered as a crucial public health issue, due to the strict correlation with a higher risk of fragility fractures, hospitalization, and mortality. Among the age-related diseases, sarcopenia and dysphagia are two common pathological conditions in frail older people and could coexist leading to dehydration and malnutrition in these subjects. “Sarcopenic dysphagia” is a complex condition characterized by deglutition impairment due to the loss of mass and strength of swallowing muscles and might be also related to poor oral health status. Moreover, the aging process is strictly related to poor oral health status due to direct impairment of the immune system and wound healing and physical and cognitive impairment might indirectly influence older people’s ability to carry out adequate oral hygiene. Therefore, poor oral health might affect nutrient intake, leading to malnutrition and, consequently, to frailty. In this scenario, sarcopenia, dysphagia, and oral health are closely linked sharing common pathophysiological pathways, disabling sequelae, and frailty. Thus, the aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: (A.d.S.); (M.F.)
| | - Martina Ferrillo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: (A.d.S.); (M.F.)
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy;
| | - Roberto de Sire
- Department of Clinical Medicine and Surgery, University Federico II of Naples, 80126 Naples, Italy;
| | - Paola Emilia Ferrara
- University Polyclinic Foundation Agostino Gemelli IRCSS, Catholic University of Sacred Heart, 00168 Rome, Italy; (P.E.F.); (G.R.)
| | - Giuseppe Raguso
- Department of Otolaryngology-Head and Neck Surgery, University of Verona, 37129 Verona, Italy;
| | - Sergio Riso
- Dietetic and Clinical Nutrition Unit, Maggiore della Carità Hospital, 28100 Novara, Italy;
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland;
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Gianpaolo Ronconi
- University Polyclinic Foundation Agostino Gemelli IRCSS, Catholic University of Sacred Heart, 00168 Rome, Italy; (P.E.F.); (G.R.)
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Mario Migliario
- Dental Clinic, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy;
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16
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van der Heijden EM, Klüter WJ, van der Maarel-Wierink CD, Gobbens RJJ. Exploring associations between multidimensional frailty and oral health in community-dwelling older people. A pilot study. SPECIAL CARE IN DENTISTRY 2022; 42:361-368. [PMID: 35014046 PMCID: PMC9545350 DOI: 10.1111/scd.12691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 12/02/2022]
Abstract
Objective To determine the associations between four validated multidimensional self‐report frailty scales and nine indices of oral health in community‐dwelling older persons. Materials and Methods This pilot study was conducted in a sample of 208 older persons aged 70 years and older who visited two dental practices in the Netherlands. Frailty status was measured by four different self‐report frailty questionnaires: Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), Sunfrail Checklist (SC), and the Sherbrooke Postal Questionnaire (SPQ). Oral health was assessed by two calibrated examiners. Results The prevalence of frailty according to the four frailty measures TFI, GFI, SC, and SPQ was 32.8%, 31.5%, 24.5%, and 49.7%, respectively. The SC correlated with four oral health variables (DMFT, number of teeth, percentage of occlusal contacts, Plaque Index), the TFI with three (number of teeth, percentage of occlusal contacts, Plaque Index), the GFI only with DPSI, and the SPQ with the number of teeth and the number of occlusal contacts. Conclusion Of the studied multidimensional frailty scales, the SC and TFI were correlated with most oral health variables (four and three, respectively). However, it should be noticed that these correlations were small. Clinical relevance The SC and TFI might help to identify older people with risk of poor oral health so that preventive care can be used to ensure deterioration of oral health and maintenance of quality of life. Vice versa early detection of frailty by oral care professionals could contribute to interprofessional management of frailty.
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Affiliation(s)
| | - Wim J Klüter
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,College of Dental Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Claar D van der Maarel-Wierink
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Robbert J J Gobbens
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, Netherlands.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Janakiram C, Ayoob A, Neelamana S. Impact of oral frailty on general frailty in geriatric population: A scoping review. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Villeneuve R, Meillon C, Dartigues JF, Amieva H. Trajectory of Quality of Life Before and After Entering a Nursing Home: A Longitudinal Study. J Geriatr Psychiatry Neurol 2022; 35:102-109. [PMID: 33030109 DOI: 10.1177/0891988720964259] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The objective of this longitudinal study was to compare the trajectory of subjective quality of life in 2 groups of older adults: those who entered a nursing home and those who remained living in the community with similar clinical conditions. METHOD PAQUID is a prospective population-based study. It included, at baseline, 3777 community-dwelling participants aged 65 years and over. Participants were followed-up for up to 27 years. Among people living at home at baseline, 2 groups were compared: participants who entered a nursing home over a 20-year follow-up (n = 528) and those who remained community dwellers (n = 2273). We used latent process mixed models to estimate the relationship between mean trajectory of subjective quality of life and admission into a nursing home. We computed univariate and multivariate models taking into account potential confounders (age, gender, education, income, comorbidities, dementia, disability and depression). RESULTS Nursing home placement was significantly associated with a drop in quality of life between the last visit before and after institutionalization. Nevertheless, we found no difference in quality of life trajectory after this initial drop. CONCLUSION Older adults exhibit an acute drop in quality of life after nursing home admission, probably reflecting the associated psychological distress. Even though their quality of life does not go back to pre-admission levels, the residents do not show a steeper decline when compared to the "natural" evolution of quality of life in older adults living in the community, which suggests a relative adaptation to their new living conditions.
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Affiliation(s)
- Roxane Villeneuve
- Inserm U1219 Bordeaux Population Health Center, Université de Bordeaux, Bordeaux, France
| | - Céline Meillon
- Inserm U1219 Bordeaux Population Health Center, Université de Bordeaux, Bordeaux, France
| | | | - Helene Amieva
- Inserm U1219 Bordeaux Population Health Center, Université de Bordeaux, Bordeaux, France
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Andrade LEL, New York BSDAC, Gonçalves RSDSA, Fernandes SGG, Maciel ÁCC. Mapping instruments for assessing and stratifying frailty among community-dwelling older people: a scoping review. BMJ Open 2021; 11:e052301. [PMID: 34937719 PMCID: PMC8704957 DOI: 10.1136/bmjopen-2021-052301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To map in the current literature instruments for the assessment and stratification of frailty in community-dwelling older people, as well as to analyse them from the perspective of the Brazilian context. DESIGN Scoping review. STUDY SELECTION The selection of studies took place between March and April 2020. Includes electronic databases: Medline, Latin American and Caribbean Literature in Health Sciences, Scopus, Web of Science and Cumulative Index of Nursing and Literature Health Alliance, in addition to searching grey literature. DATA EXTRACTION A data extraction spreadsheet was created to collect the main information from the studies involved, from the title to the type of assessment and stratification of frailty. RESULTS In summary, 17 frailty assessment and stratification instruments applicable to community-dwelling older people were identified. Among these, the frailty phenotype of Fried et al was the instrument most present in the studies (45.5%). The physical domain was present in all the instruments analysed, while the social, psychological and environmental domains were present in only 10 instruments. CONCLUSIONS This review serves as a guideline for primary healthcare professionals, showing 17 instruments applicable to the context of the community-dwelling older people, pointing out advantages and disadvantages that influence the decision of the instrument to be used. Furthermore, this scoping review was a guide for further studies carried out by the same authors, which aim to compare instruments.
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20
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Relationship between Oral Hypofunction, and Protein Intake: A Cross-Sectional Study in Local Community-Dwelling Adults. Nutrients 2021; 13:nu13124377. [PMID: 34959928 PMCID: PMC8705970 DOI: 10.3390/nu13124377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 01/09/2023] Open
Abstract
Few studies have investigated the relationship between nutritional status and comprehensive assessment of oral hypofunction, especially protein intake-related sarcopenia. Thus, we explored these relationships in a large-scale cross-sectional cohort study using the seven-item evaluation for oral hypofunction and Diet History Questionnaire for nutritional assessment. We used the data from 1004 individuals who participated in the 2019 health survey of the residents of Tarumizu City, Kagoshima Prefecture, Japan for analysis. We found that individuals with oral hypofunction were significantly older with a lower skeletal muscle index. Although there were few foods that had a significant difference between the groups with and without oral hypofunction, the consumption of beans and meats was significantly lower in women and men in the oral hypofunction group, respectively. According to the lower limit of the tentative dietary goal defined in Japan, comprehensive evaluation of oral hypofunction was significantly and independently associated with protein intake in both men and women (odds ratio, 1.70; 95% confidence interval, 1.21-2.35). In conclusion, we found that oral hypofunction was associated with targeted protein intake for sarcopenia and frailty prevention in middle-aged and older community-dwelling adults. Comprehensive evaluation of oral function with intervention in cases of hypofunction could inform clinicians to better prevent sarcopenia.
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Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312360. [PMID: 34886085 PMCID: PMC8656978 DOI: 10.3390/ijerph182312360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 12/23/2022]
Abstract
Dental caries and periodontal disease represent a health problem and a social cost for the entire population, and in particular for socio-economically disadvantaged individuals who are less resistant to disease. The aim of this review is to estimate the prevalence and severity of the two dental pathologies, caries and periodontal disease, in the different classes of socio-economically disadvantaged subjects and to understand which of them are most affected. A systematic search of the literature was performed in MEDLINE (via PubMed), EMBASE and Web of Science after establishing a suitable search strategy for each database, using keywords related to socio-economically vulnerable classes and health outcomes. Socio-economically disadvantaged individuals are more susceptible to tooth decay and periodontal disease (with relative tooth loss) than non-vulnerable people. Additionally, when multiple vulnerabilities are combined in the same subject, these oral diseases worsen. There is no type of vulnerability more affected by caries and periodontitis than others, since overall they all have severe disease indices. The data from this systematic literature review might be useful for health policy makers looking to allocate more resources and services to socially disadvantaged individuals, resulting in making them more resilient to oral disease due to their social marginalization.
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Gennai S, Izzetti R, Pioli MC, Music L, Graziani F. Impact of rehabilitation versus edentulism on systemic health and quality of life in patients affected by periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2021; 49 Suppl 24:328-358. [PMID: 34761419 DOI: 10.1111/jcpe.13526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/27/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022]
Abstract
AIM To investigate the effect of rehabilitation in fully/partially edentulous patients with stage IV periodontitis on oral-health-related quality of life (OHRQoL) and systemic health. MATERIALS AND METHODS A systematic electronic and manual search was conducted. Three authors independently reviewed, selected, and extracted the data. Outcomes were OHRQoL (Oral Health Impact Profile 14 [OHIP-14] and OHIP-49, General Oral Health Assessment Index [GOHAI], visual analogue scale, symptoms registration) and systemic health-related outcomes (incidence and prevalence of systemic diseases, values of systemic disease indicators). Qualitative data were synthesized for OHRQoL and systemic health-related outcomes. Meta-analysis was conducted on available quantitative data. RESULTS The search identified 59 articles (6724 subjects in total). OHRQoL improved across all the studies, irrespective of the number of missing teeth, their location, or treatment modality. Meta-analysis showed significant improvement of OHIP-49 (36.86, p < .01) in manuscripts including subjects affected by periodontitis, consistently with the remaining literature (reduction of score points post rehabilitation: OHIP-14 = 10.52, OHIP-49 = 56.02, GOHAI = 5.40, p < .01 for all). Non-rehabilitated subjects exhibited inferior cognitive status, higher medication intake, and frailty. However, our data are limited and should be interpreted with caution. CONCLUSIONS Oral rehabilitation improves OHRQoL and, potentially, systemic health in edentulous patients. It is unclear whether these findings may be extrapolated to patients with stage IV periodontitis.
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Affiliation(s)
- Stefano Gennai
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Rossana Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Maria C Pioli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Larisa Music
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
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Andersson P, Kragh Ekstam A. Impaired Oral Health in Older Orthopaedic In-Care Patients: The Influence of Medication and Morbidity. Clin Interv Aging 2021; 16:1691-1702. [PMID: 34566411 PMCID: PMC8457442 DOI: 10.2147/cia.s326095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/24/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction Fall-related injuries are prevalent in older patients and often lead to increased morbidity, medication, and impaired functions. We studied older trauma patients with the aim to describe their oral health in comparison to morbidity and medication. Material and Methods The study included 198 patients, ≥65 years, admitted with an orthopedic trauma. Oral examinations included number of natural teeth, dental implants, missing, decayed and restored teeth, root remnants, and pocket depth. Data on comorbidities and medication were assembled. Statistical analyses were carried out with logistic regression models, adjusted for age, gender, comorbidity, and polypharmacy. Results Overall, 198 patients participated, 71% women, mean age 81 years (±7.9), 85% resided in their own homes, 86% had hip fractures. Chronic diseases and drug use were present in 98.9%, a mean of 6.67 in Charlson comorbidity index (CCI), 40% heart diseases, 17% diabetes, and 14% dementia. Ninety-one percent were dentate (181), mean number of teeth 19.2 (±6.5), 24% had decayed teeth, 97% filled teeth, 44% <20 teeth, and 26% oral dryness. DFT (decayed, filled teeth) over mean were identified in patients with diabetes (p=0.037), COPD (p=0.048), polypharmacy (p=0.011), diuretics (p=0.007), and inhalation drugs (p=0.032). Use of ≥2 strong anticholinergic drugs were observed in patients with <20 teeth and DFT over mean (p=0.004, 0.003). Adjusted for age, gender, CCI, and polypharmacy. Conclusion The study showed that impaired oral health was prevalent in older trauma patients and that negative effects on oral health were significantly associated with chronic diseases and drug use. The results emphasize the importance of identifying orthogeriatric patients with oral health problems and to stress the necessity to uphold good oral care during a period when functional decline can be expected.
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Affiliation(s)
- Pia Andersson
- Department of Health Sciences, Kristianstad University, Kristianstad, SE-291 88, Sweden
| | - Annika Kragh Ekstam
- Department of Orthopaedics, Region Skåne Office for Hospitals in North-Eastern Skåne, Kristianstad, SE-291 85, Sweden
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Bakker MH, Vissink A, Raghoebar GM, Peters LL, Visser A. General health, healthcare costs and dental care use of elderly with a natural dentition, implant-retained overdenture or conventional denture: an 8-year cohort of Dutch elderly (aged 75 and over). BMC Geriatr 2021; 21:477. [PMID: 34481474 PMCID: PMC8418734 DOI: 10.1186/s12877-021-02427-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 08/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background Cross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design. Methods This prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures. Results At baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs – but higher dental care use – than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures. Conclusions It was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02427-z.
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Affiliation(s)
- Mieke H Bakker
- Department of Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Arjan Vissink
- Department of Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Department of Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Lilian L Peters
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, the Netherlands.,Epidemiologist/Researcher, Midwifery Science, AVAG, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, 1081BT, Amsterdam, the Netherlands
| | - Anita Visser
- Department of Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands.,Department of Gerodontology, Center for Dentistry and oral Hygiene, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, the Netherlands
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25
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Dibello V, Zupo R, Sardone R, Lozupone M, Castellana F, Dibello A, Daniele A, De Pergola G, Bortone I, Lampignano L, Giannelli G, Panza F. Oral frailty and its determinants in older age: a systematic review. THE LANCET HEALTHY LONGEVITY 2021; 2:e507-e520. [DOI: 10.1016/s2666-7568(21)00143-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/01/2023]
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Provision of Oral Health Care by Dentists to Community-Dwelling Older Patients. Int Dent J 2021; 72:169-178. [PMID: 34281699 PMCID: PMC9275299 DOI: 10.1016/j.identj.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/18/2021] [Accepted: 05/18/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Research into oral health care for older people has shown that dental care in general decreases with increasing age and frailty and, therefore, oral health care provision may be complex. The aim of this study is to identify the oral health care dentists provide to community-dwelling older people and which barriers they experience in doing this. METHODS In this cross-sectional study, a representative sample of dentists in the Netherlands was asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to fill out a questionnaire. The relationship between experienced barriers in providing oral health care to older patients and characteristics of the dentists and the patients was studied by means univariate and multivariate logistic regression analysis. RESULTS In total, 923 dentists were asked to participate in the study. Data were available for 39.4% dentist-patient pairs. In most cases (87.4%), oral health care was focussed on conservation of the dentition. In all, 14.0% of the dentists experienced barriers in providing oral health care for older people. Some patient factors increase the risk of experiencing barriers, eg, the more difficult behaviour of older patients and the greater disease burden. CONCLUSIONS Oral health care was mostly focussed on conservation of the dentition, and dentists especially experience barriers in oral health provision to older patients if they are already frail.
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Bakker MH, Vissink A, Raghoebar GM, Visser A. General health status of Dutch elderly receiving implant-retained overdentures: A 9-year big data cross-sectional study. Clin Implant Dent Relat Res 2021; 23:228-235. [PMID: 33554462 PMCID: PMC8248181 DOI: 10.1111/cid.12984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/18/2020] [Accepted: 01/11/2021] [Indexed: 12/28/2022]
Abstract
Background Very little information is available on the general health of elderly who are provided with an implant‐retained overdenture (IOD). Purpose The general health status of three groups of elderly (≥75 years) were compared: those with a natural dentition (ND), those treated with an implant‐retained overdenture (IOD), and those wearing a conventional denture (CD). Materials and methods Data on healthcare costs were obtained from records of Dutch health insurers that are collected by Vektis. Data on general health (chronic diseases, medication use, and polypharmacy) were acquired for elderly patients with a ND, an IOD, and a CD in 2009 and 2017. Data on the general health of elderly who received an IOD were also acquired from 2010 through 2016. Results On average, the general health of elderly who received an IOD was comparable to general health of elderly with a ND and was better than the general health of elderly with a CD (lower prevalence of diabetes, cardiac disease, and hypertension). The general health profile of elderly receiving an IOD was consistent during all years. Conclusions The general health of elderly with a ND or IODs is better than those with CDs.
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Affiliation(s)
- Mieke H Bakker
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anita Visser
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Gerodontology, Dental School, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Rai S, Misra D, Misra A, Jain A, Bisla S. Impact of oral health factors on quality of life of geriatric population - A systematic review. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2021. [DOI: 10.4103/jiaomr.jiaomr_98_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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29
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van de Rijt LJM, Stoop CC, Weijenberg RAF, de Vries R, Feast AR, Sampson EL, Lobbezoo F. The Influence of Oral Health Factors on the Quality of Life in Older People: A Systematic Review. THE GERONTOLOGIST 2020; 60:e378-e394. [PMID: 31729525 DOI: 10.1093/geront/gnz105] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The number of people aged 65 years or older is growing substantially. As a result of increased health burden and tooth retention, more oral health problems are expected in this age group. A poor oral health-related quality of life (OHQoL) can compromise a person's psychological state, social relationships, personal beliefs, and physical health. The aim of this systematic review was to identify oral health factors associated with OHQoL in people aged 65 years or older and to give a comprehensive overview of the body of literature for each oral health factor separately. RESEARCH DESIGN AND METHODS A comprehensive search was performed in five databases. The following terms were used as index terms or free-text words: "Oral Health," "Quality of Life," "Older People." Two researchers independently assessed studies for eligibility based on predefined criteria. RESULTS Of 3,702 references retrieved from the databases, 68 studies were eligible and included (9 randomized clinical trials, 6 cohort studies, and 53 cross-sectional studies). All results were reported descriptively. OHQoL in people aged 65 years or older is positively associated with higher number of teeth, higher number of occluding pairs, implant-retained overdentures, and the shortened dental arch concept and negatively associated with xerostomia, orofacial pain, and poor chewing ability. In the current literature, there is no consensus on the association between edentulism, caries, and periodontal conditions and OHQoL. DISCUSSION AND IMPLICATIONS Having a functional dentition (either natural or prosthetic) is important for a good OHQoL, whereas painful or functional complaints are associated with impaired OHQoL.
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Affiliation(s)
- Liza J M van de Rijt
- Faculty of Dentistry, Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Celine C Stoop
- Faculty of Dentistry, Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Roxane A F Weijenberg
- Faculty of Dentistry, Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit Amsterdam, The Netherlands
| | - Alexandra R Feast
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College Londen, UK
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College Londen, UK.,Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, London, UK
| | - Frank Lobbezoo
- Faculty of Dentistry, Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
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Abstract
BACKGROUND The purpose of this study was to review the different types of maxillary fractures and highlight their diagnostic and therapeutic differences. METHODS A retrospective chart review of patients who sustained maxillary fractures was conducted through the Einstein Healthcare Network during the years 2016-2017. Descriptive statistics and chi-square analysis were used to categorize continuous and categorical variables, respectively. RESULTS The cohort of patients (n = 141) were predominately African American (62%) and male (75%) with a mean age 45.3 years. The most common maxillary fracture was maxillary sinus (29%), followed by zygomaticomaxillary complex (ZMC) (26%), frontal process (20%), dentoalveolar (16%), and LeFort (9%). Dentoalveolar fractures were mostly evaluated by the oral maxillofacial surgery service (74%), while ZMC and LeFort fractures were more commonly referred to an otolaryngologist (56% and 67%, respectively). Patients with dentoalveolar fractures were more likely to undergo wire splinting (61%). All patients with frontal process and maxillary sinus fractures were managed non-operatively. Most patients with ZMC fractures were managed non-operatively (78%) while the remainder underwent open reduction internal fixation (ORIF) (22%). Patients with LeFort fractures more commonly underwent maxillomandibular fixation (MMF)/ORIF (83%). Dentoalveolar fractures were the most likely to be operated on the same day (93%) while ZMC and LeFort fractures were repaired within 1 week (88% and 100%, respectively). CONCLUSION Maxillary trauma is very heterogenous in comparison to other maxillofacial trauma patterns. Each fracture type is treated uniquely and can involve one or more provider teams depending on the extent and severity of the injury, as well as hospital resources.
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Bakker MH, Vissink A, Spoorenberg SLW, Wynia K, Visser A. Self-reported oral health problems and the ability to organize dental care of community-dwelling elderly aged ≥75 years. BMC Oral Health 2020; 20:185. [PMID: 32615975 PMCID: PMC7331152 DOI: 10.1186/s12903-020-01175-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/25/2020] [Indexed: 12/21/2022] Open
Abstract
Background It is unclear how many community-dwelling elderly (≥75 years) experience oral health problems (e.g. pain, dry mouth, chewing problems) and how they manage their dental care needs. This study aimed to assess self-reported oral health problems in elderly who are frail or have complex care needs, and their ability to organize dental care when reporting oral pain. Methods Three thousand five hundred thirty-three community-dwelling elderly participating in the “Embrace” project were asked to complete questionnaires regarding oral status and oral health problems. Frailty was assessed with the Groningen Frailty Indicator (GFI). Intermed for Elderly Self-Assessment (IM-E-SA) was used to determine complexity of care needs. Next, elderly who reported oral pain were interviewed about their oral pain complaints, their need for dental care, and their ability to organize and receive dental care. For statistical analyses Chi2-tests and the one-way ANOVA were used. Results One thousand six hundred twenty-two elderly (45.9%) completed the questionnaires. Dry mouth (11.7%) and oral pain (6.2%) were most frequently reported. Among the elderly reporting oral pain, most were registered at a local dentist and could go there when needed (84.3%). Robust elderly visited the dentist independently (87%), frail (55.6%) and complex (26.9%) elderly more often required assistance from caregivers. Conclusions Dry mouth and oral pain are most reported oral health problems among community-dwelling elderly. Elderly with complex care needs report most oral health problems. In case an elderly seeks dental treatment to alleviate an oral pain complaint, most elderly in this study were able to organize dental care and transport to the dentist. Frail and complex elderly often need assistance from caregivers to visit the dentist. Therefore caretakers should keep in mind that when frailty progresses, visiting a dentist may become more and more difficult and the risk for poor oral health increases.
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Affiliation(s)
- M H Bakker
- Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands.
| | - A Vissink
- Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands
| | - S L W Spoorenberg
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - K Wynia
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - A Visser
- Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands.,Department of Geriatric Dentistry, Dental School, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Yin Z, Yang J, Huang C, Sun H, Wu Y. Eating and communication difficulties as mediators of the relationship between tooth loss and functional disability in middle-aged and older adults. J Dent 2020; 96:103331. [DOI: 10.1016/j.jdent.2020.103331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/20/2020] [Accepted: 03/26/2020] [Indexed: 10/24/2022] Open
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Bassim C, Mayhew AJ, Ma J, Kanters D, Verschoor CP, Griffith LE, Raina P. Oral Health, Diet, and Frailty at Baseline of the Canadian Longitudinal Study on Aging. J Am Geriatr Soc 2020; 68:959-966. [PMID: 32162690 DOI: 10.1111/jgs.16377] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Poor diet due to poor oral health was proposed as a potential mediator of the association between poor oral health and frailty. This study explores the cross-sectional associations between poor oral health, poor diet, and frailty in Canadian adults, aged 45 to 85 years, and then tests whether the expected oral health-frailty association is changed by taking into account the pathway through poor diet. DESIGN Cross-sectional study. SETTING The baseline wave of the Canadian Longitudinal Study on Aging, a nationally representative population study. PARTICIPANTS Data from 28 738 community-dwelling participants, aged 45 to 85 years. MEASUREMENTS We characterized poor oral health (cumulative count of 24 items of oral health problems), poor diet (scale of poor food consumption from 7 healthy foods groups), and frailty (cumulative frailty index of 76 items). Regression-based path analyses were used to investigate associations between poor oral health, poor diet, and frailty, adjusted for age group, sex, income, smoking, living alone, education, physical activity, social support, and dental visit. RESULTS Poorer oral health was associated with low income, smoking, low physical activity, low social support, and no dental visit. There were associations between poorer oral health and poorer diet (effect size β adjusted = .40; 95% confidence interval [CI] = .20-.61) and between poorer oral health and increased frailty (β adjusted = .85; 95% CI = .68-1.02). The indirect effect through the path of poor diet was approximately 0.01 (95% CI = 0.01-0.02) (ie, explaining ∼1% of the effect of poor oral health on frailty). CONCLUSIONS Poor oral health was associated with poor diet and frailty. Each additional oral health problem was associated with an increase of approximately 1 frailty index point, even after full adjustment for poor diet. The indirect effect of poor oral health through poor diet was modest. Though poor oral health was associated with poorer diet quality, a more direct effect of poor oral health on increasing frailty may be indicated. J Am Geriatr Soc 68:959-966, 2020.
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Affiliation(s)
- Carol Bassim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra J Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - David Kanters
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Chris P Verschoor
- Northern Ontario School of Medicine, Health Sciences North Research Institute, Sudbury, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Smith LA, Smith M, Thomson WM. Barriers and enablers for dental care among dentate home‐based older New Zealanders who receive living support. Gerodontology 2020; 37:244-252. [DOI: 10.1111/ger.12464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/16/2019] [Accepted: 01/01/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Lee A. Smith
- Sir John Walsh Research Institute School of Dentistry University of Otago Dunedin New Zealand
| | - Moira Smith
- Department of Public Health University of Otago Wellington New Zealand
| | - William Murray Thomson
- Department of Oral Sciences Sir John Walsh Research Institute School of Dentistry University of Otago Wellington New Zealand
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Beker N, van der Maarel-Wierink CD, de Baat C, Holstege H. Self-reported oral health in the Dutch 100-plus Study of cognitively healthy centenarians: an observational cohort study. BMC Geriatr 2019; 19:355. [PMID: 31852469 PMCID: PMC6921395 DOI: 10.1186/s12877-019-1358-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/19/2019] [Indexed: 12/23/2022] Open
Abstract
Background Due to improved healthcare, more people reach extreme ages. Oral health in the oldest-old has thus far been poorly described. Here, we investigated self-reported oral health factors, use of professional oral health care, and associations with clinical measures in centenarians considered cognitively healthy. Methods In this observational cohort study, we included 162 (74% female) centenarians from the Dutch 100-plus Study cohort who self-reported to be cognitively healthy, as confirmed by a proxy. Centenarians were questioned about their physical well-being including medication use and their cognitive functioning was evaluated using the Mini-Mental State Examination. Questions regarding oral health included preservation of teeth, oral pain or discomfort, chewing ability, xerostomia, and time since last visit to an oral health care provider. Associations between oral health and clinical measures were investigated with ordinal logistic or linear regression analyses, adjusted for gender, age, and education. Results The majority of the centenarians indicated to have good oral health: 76% felt no oral pain/discomfort, 65% indicated to chew well; while only 18% had symptoms of xerostomia. Of all centenarians, 83% were edentulous and were wearing removable complete maxillary and mandibular dental prostheses, 1% was edentulous with no dental prosthesis, while 16% was dentate with or without removable partial dental prostheses (10 and 6% respectively). Dentate and edentulous centenarians experienced similar levels of oral pain and/or discomfort, chewing ability, xerostomia, and their cognitive functioning was similar. No relationship between cognitive functioning and chewing ability was found. Xerostomia was associated with medication use (p = .001), which mostly regarded medications for cardiovascular diseases, diuretics, anti-coagulants, and antacids. Only 18% of the centenarians visited an oral health care provider during the year prior to the interview, of whom 48% were dentate centenarians. Notably, 49% of the centenarians had not visited an oral health care provider for ≥10 years. Conclusions Most centenarians were edentulous and did not report oral complaints. Less than one-fifth of the centenarians continued to seek regular professional oral health care. Since the proportion of dentates in the oldest-old will increase in the near future, a proactive attitude toward this group is necessary.
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Affiliation(s)
- Nina Beker
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, Amsterdam, 1007 MB, The Netherlands
| | - Claar D van der Maarel-Wierink
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium and Amsterdam, The Netherlands.,Center for Special Care in Dentistry, Amsterdam, The Netherlands
| | - Cees de Baat
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium and Amsterdam, The Netherlands.,Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Henne Holstege
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, Amsterdam, 1007 MB, The Netherlands. .,Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
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36
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Tuuliainen E, Nihtilä A, Komulainen K, Nykänen I, Hartikainen S, Tiihonen M, Suominen AL. The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients. Scand J Caring Sci 2019; 34:938-947. [DOI: 10.1111/scs.12801] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 11/13/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Eveliina Tuuliainen
- Public Health Center Oral Health Care ServicesKuopio Finland
- Institute of Dentistry University of Eastern Finland Kuopio Finland
| | - Annamari Nihtilä
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Chief Dentist, Social and Health Services Espoo Finland
| | - Kaija Komulainen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre of Geriatric Care School of Pharmacy Faculty of Health Sciences University of Eastern Finland Kuopio Finland
| | - Miia Tiihonen
- Kuopio Research Centre of Geriatric Care School of Pharmacy Faculty of Health Sciences University of Eastern Finland Kuopio Finland
| | - Anna Liisa Suominen
- Institute of Dentistry Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
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Valdez E, Wright FAC, Naganathan V, Milledge K, Blyth FM, Hirani V, Le Couteur DG, Handelsman DJ, Waite LM, Cumming RG. Frailty and oral health: Findings from the Concord Health and Ageing in Men Project. Gerodontology 2019; 37:28-37. [DOI: 10.1111/ger.12438] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Eduardo Valdez
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Fredrick A. Clive Wright
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Kate Milledge
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- School of Public Health Sydney Medical School The University of Sydney Sydney NSW Australia
| | - Fiona M. Blyth
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Concord Clinical School Concord Repatriation and General Hospital The University of Sydney Concord NSW Australia
| | - Vasant Hirani
- Charles Perkins Centre School of Life and Environmental Sciences The University of Sydney Sydney NSW Australia
| | - David G. Le Couteur
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - David J. Handelsman
- ANZAC Research Institute Concord Repatriation General Hospital The University of Sydney Concord NSW Australia
| | - Louise M. Waite
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Robert G. Cumming
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- School of Public Health Sydney Medical School The University of Sydney Sydney NSW Australia
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Bakker MH, Vissink A, Meijer HJA, Raghoebar GM, Visser A. Mandibular implant-supported overdentures in (frail) elderly: A prospective study with 20-year follow-up. Clin Implant Dent Relat Res 2019; 21:586-592. [PMID: 30993810 PMCID: PMC6767521 DOI: 10.1111/cid.12772] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/24/2019] [Accepted: 03/26/2019] [Indexed: 01/09/2023]
Abstract
Purpose To prospectively assess long‐term (20 year) clinical, radiographic, and patient‐reported outcomes of an elderly population provided with mandibular implant‐supported overdentures. Materials and Methods A total of 53 elderly (aged ≥60 years at the time of treatment) were provided with two endosseous implants supporting a mandibular overdenture and a conventional maxillary denture. Outcome parameters—including implant loss, plaque index, gingival index, bleeding index, presence of calculus, probing depth, and satisfaction with implant‐supported overdenture—were scored 1, 5, 10, and 20 years after prosthetic treatment. Radiographic analysis was performed to assess peri‐implant bone changes. At the 20‐year evaluation, frailty (Groningen Frailty Index) and quality of life (EuroQol 5D) were additionally assessed. Results A total of 15 patients completed the 20‐year follow‐up. The 20‐year implant survival rate was 92.5%. Plaque index, bleeding index, and probing depth increased slightly over time, while gingival index and presence of calculus remained unchanged. Radiographic analysis revealed minor marginal bone loss during the first 10 years and no further loss thereafter. Participants were very satisfied with their prosthesis and reported a good quality of life. At the 20‐year evaluation, 64.3% of the patients were classified as frail. Conclusions The long‐term survival of implants supporting a mandibular overdenture is high. Although most elderly in the study became frail over time, peri‐implant health and marginal bone level remained at a satisfactory level.
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Affiliation(s)
- Mieke H Bakker
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anita Visser
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Shwe PS, Ward SA, Thein PM, Junckerstorff R. Frailty, oral health and nutrition in geriatrics inpatients: A cross-sectional study. Gerodontology 2019; 36:223-228. [PMID: 30861197 DOI: 10.1111/ger.12397] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 01/17/2019] [Accepted: 02/02/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Poor nutritional status is a risk factor for the development of frailty. Likewise, oral health is independently associated with nutrition. The potential association between oral health and frailty in hospitalised elderly adults has, however, not previously been investigated. OBJECTIVE To investigate the relationship between oral health and frailty in hospitalised elderly adults and to identify the predictors of frailty. METHOD A cross-sectional study of 168 geriatric inpatients >65 years old was performed from August to December 2016. Patients of non-English speaking background, with impaired cognition (MMSE <24), severe hearing or visual impairment or active delirium were excluded. Oral health, nutrition and frailty were assessed using previously validated tools, namely the Geriatric Oral Health Assessment Index (GOHAI), Mini Nutrition Assessment (MNA) and Reported Edmonton Frailty Scale (REFS). Other data collected included demographics, co-morbidities, level of education and smoking/alcohol history. RESULTS On univariate analysis, the REFS score decreased with better nutritional status/higher MNA (P < 0.001) and better self-reported oral health/higher GOHAI (P = 0.023). Nutritional status accounted for 17% of variability in frailty assessment. On multivariate analysis, co-morbidities (P < 0.001), MNA (P < 0.001) and living in residential care (P < 0.001) were independent predictors of frailty. After adjusting for nutrition and co-morbidities, self-reported oral health was found to have an independent negative association with frailty (P = 0.019). CONCLUSION Poor self-reported oral health was found to be independently associated with frailty. Further research should be directed at whether interventions to maintain good oral health can prevent or slow the progression of frailty.
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Affiliation(s)
- Phu Sabei Shwe
- Monash Ageing Research Centre (MONARC), Monash Health, Melbourne, Victoria, Australia
| | - Stephanie A Ward
- Monash Ageing Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, School of Preventive Medicine and Public Health, Monash University, Melbourne, Victoria, Australia
| | - Paul M Thein
- Department of General Medicine, Monash Health, Melbourne, Victoria, Australia
| | - Ralph Junckerstorff
- Department of General Medicine, Monash Health, Melbourne, Victoria, Australia
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40
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Woo J, Tong C, Yu R. Chewing Difficulty Should be Included as a Geriatric Syndrome. Nutrients 2018; 10:E1997. [PMID: 30562922 PMCID: PMC6315631 DOI: 10.3390/nu10121997] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/07/2018] [Accepted: 12/13/2018] [Indexed: 12/14/2022] Open
Abstract
Recent studies have noted an association between chewing difficulties and frailty. In a pilot survey of primary care needs of older people living in the community using automated methods, we examined the prevalence of chewing difficulties and the cross-sectional association with other geriatric syndromes, chronic diseases, and the use of hospital services. A brief multi-domain geriatric assessment was administered to 2259 men and women using a mobile device, the data uploaded to the cloud and analyzed. A total of 37.8% had chewing difficulties, which were associated with older age, poor vision, frailty, sarcopenia, memory complaints, low subjective well-being, incontinence, and stroke. The results suggest that chewing difficulties should be included as a geriatric syndrome and should be included in primary care screening of geriatric syndromes as well as chronic diseases.
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Affiliation(s)
- Jean Woo
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Cecilia Tong
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Ruby Yu
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China.
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41
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Bakker MH, Vissink A, Spoorenberg SLW, Jager-Wittenaar H, Wynia K, Visser A. Are Edentulousness, Oral Health Problems and Poor Health-Related Quality of Life Associated with Malnutrition in Community-Dwelling Elderly (Aged 75 Years and Over)? A Cross-Sectional Study. Nutrients 2018; 10:nu10121965. [PMID: 30545100 PMCID: PMC6315642 DOI: 10.3390/nu10121965] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/03/2018] [Accepted: 12/10/2018] [Indexed: 12/12/2022] Open
Abstract
As the population ages, the risk of becoming malnourished increases. Research has shown that poor oral health can be a risk factor for malnutrition in institutionalized elderly. However, it remains unclear whether oral health problems, edentulousness and health-related quality of life also pose a risk for malnutrition in community-dwelling older adults. In this cross-sectional observational study, 1325 community-living elderly (≥75 years) were asked to complete questionnaires regarding nutritional status, oral status (edentulous, remaining teeth, or implant-supported overdentures), oral health problems, health-related quality of life (HRQoL), frailty, activities of daily living (ADL) and complexity of care needs. Univariate and multivariate logistic regression analyses were performed with nutritional status as dependent variable. Of the respondents, 51% (n = 521) were edentulous, 38.8% (n = 397) had remaining teeth and 10.2% (n = 104) had an implant-supported overdenture. Elderly with complex care needs were malnourished most frequently, followed by frail and robust elderly (10%, 4.5% and 2.9%, respectively). Malnourished elderly reported more frequent problems with chewing and speech when compared with well-nourished elderly (univariate analysis). However, multivariate analysis did not show an association between malnutrition and oral health problems and edentulousness, although HRQoL was associated with malnutrition (odds ratio (OR) 0.972, confidence interval (CI) 0.951–0.955). Based on the results of this cross-sectional study, it can be concluded that poor HRQoL is significantly associated with malnutrition; however, edentulousness and oral health problems are not.
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Affiliation(s)
- Mieke H Bakker
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
| | - Sophie L W Spoorenberg
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
| | - Harriët Jager-Wittenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands.
| | - Klaske Wynia
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
| | - Anita Visser
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
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Vissink A, Spijkervet FKL, Raghoebar GM. The medically compromised patient: Are dental implants a feasible option? Oral Dis 2018; 24:253-260. [DOI: 10.1111/odi.12762] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 08/09/2017] [Accepted: 08/09/2017] [Indexed: 12/17/2022]
Affiliation(s)
- A Vissink
- Department of Oral and Maxillofacial Surgery; University of Groningen and University Medical Center Groningen; Groningen The Netherlands
| | - FKL Spijkervet
- Department of Oral and Maxillofacial Surgery; University of Groningen and University Medical Center Groningen; Groningen The Netherlands
| | - GM Raghoebar
- Department of Oral and Maxillofacial Surgery; University of Groningen and University Medical Center Groningen; Groningen The Netherlands
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Hoeksema AR, Peters LL, Raghoebar GM, Meijer HJA, Vissink A, Visser A. Health and quality of life differ between community living older people with and without remaining teeth who recently received formal home care: a cross sectional study. Clin Oral Investig 2018; 22:2615-2622. [PMID: 29450736 PMCID: PMC6097036 DOI: 10.1007/s00784-018-2360-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 01/23/2018] [Indexed: 12/31/2022]
Abstract
Objective To assess oral health, health, and quality of life (QoL) of care-dependent community-living older people with and without remaining teeth who recently received formal home care. Materials and methods For this cross-sectional observational study, community-living older people (≥ 65 years), who recently (< 6 months) received formal home care, were interviewed with validated questionnaires and underwent an oral examination. Oral health, general health, medicines usage, frailty (Groningen Frailty Indicator), cognition (Minimal Mental State Examination), QoL (RAND 36), and oral health-related QoL (Oral Health Impact Profile-14) were assessed. Results One hundred three out of 275 consecutive eligible older people (median age 79 [IQR (Inter Quartile Range) 72–85 years] participated in the study. Thirty-nine patients had remaining teeth and 64 were edentulous. Compared with edentulous older people, older people with remaining teeth scored significantly better on frailty, QoL, physical functioning, and general health. No significant differences were seen in cognition. Dental and periodontal problems were seen in more than half of the patients with remaining teeth. Two third of the edentulous patients did not visit their dentist regularly or at all. Conclusions Care-dependent home-dwelling older people with remaining teeth generally were less frail, scored better on physical functioning and general health and had better QoL than edentulous older people. Dental and periodontal problems were seen in approximately 50% of the elderly. Clinical relevance Notwithstanding their common dental problems, frailty, health, and QoL are better in home-dwelling older people with remaining teeth. To maintain this status, we advise not only dentists, but also health care workers and governments, to encourage people to maintain good oral health.
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Affiliation(s)
- A R Hoeksema
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
| | - L L Peters
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
| | - G M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
| | - H J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, and Department of Fixed and Removable Prosthodontics, Dental School, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
| | - A Visser
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands.
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44
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Affiliation(s)
- Carol W. Bassim
- Department of Health Research Methods, Evidence, and Impact; McMaster University; Hamilton Canada
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45
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Husain FA, Tatengkeng F. Oral Health-Related Quality of Life Appraised by OHIP-14 Between Urban and Rural Areas in Kutai Kartanegara Regency, Indonesia: Pilot Pathfinder Survey. Open Dent J 2017; 11:557-564. [PMID: 29238416 PMCID: PMC5712656 DOI: 10.2174/1874210601711010557] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/14/2017] [Accepted: 09/15/2017] [Indexed: 12/16/2022] Open
Abstract
Background: Health-Related Quality of Life (HRQoL) periphrastically has a significant impact on oral health. A recent study has shown the significant facts of the oral health-related quality of life based on many factors such as individual, social status, household management, daily habits, and local factors. The differences in the oral health status possibly occur in between countries, different regions, and topographical areas frequently and indirectly contributing to oral health status. Objective: The objective is to evaluate the difference of Oral Health-Related Quality of Life (OHRQoL) and to assess the main affected dimension between rural and urban areas in Kutai Kartanegara Regency. Methods: This study uses pilot pathfinder design. The respondents comprised of 214 adults who were elder than 18 years and were randomly selected from urban and rural areas in Kutai Kartanegara Regency, Indonesia. The data were collected by 103 samples from the rural area and 111 respondents from the urban area. Oral Health Impacts Profile (OHIP-14) has been translated to Bahasa (Indonesia version). OHIP-14 was used to assess the subjects’ oral health-related impact. Shapiro-Wilk and Mann Whitney tests were used to analyze the data, and p-value was set at P < 0.05. Results: The mean OHIP scores in the urban and the rural areas were 25.4 and 28.8, respectively. The overall OHIP-14 score showed a significant statistical difference P= 0,009 (P < 0.05) between rural and urban area. Conclusion: This study illustrates that oral health-related quality of life in the urban area is better than in the rural area. Physical pain components of the OHRQoL are the major oral problems associated with both the areas.
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Affiliation(s)
- Fuad Akbar Husain
- Department of Dental Public Health, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
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