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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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de Albuquerque LS, de Queiroz RG, Abanto J, Strazzeri Bönecker MJ, Soares Forte FD, Sampaio FC. Dental Caries, Tooth Loss and Quality of Life of Individuals Exposed to Social Risk Factors in Northeast Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6661. [PMID: 37681801 PMCID: PMC10487409 DOI: 10.3390/ijerph20176661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/11/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
This study aimed to investigate the impact of dental caries and tooth loss on oral health-related quality of life (OHRQoL) in socioeconomically disadvantaged people. A population-based, cross-sectional survey was conducted in 28 cities at social risk in Northeast Brazil. All permanent residents aged 12, 15-19, 35-44, and 65-74 years were eligible, and 3063 were included. Participants answered a questionnaire on socioeconomic status, beliefs, and behaviors. Trained local dentists performed oral clinical examinations during home visits. Caries and tooth loss were evaluated using the decayed, missing, and filled teeth (DMFT) index and OHRQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14). Poisson regression analysis was performed to assess the relationship between individual domains, OHIP-14 scores, dental caries, tooth loss, and socioeconomic/demographic characteristics. Mean DMFT (standard deviation) scores were 2.68 (4.01), 4.84 (4.30), 15.35 (7.26), and 26.72 (8.03) for groups aged 12, 15-19, 35-44, and 65-74 years, respectively. Most participants (70%) were partially edentulous and 13% were completely edentulous. Caries and tooth loss significantly increased with age and impacted OHRQoL. Physical pain (5.8%) and psychological discomfort (5.8%) were the most commonly reported on the OHIP-14. Untreated caries (prevalence ratio (PR), 1.54; 95% confidence interval (CI), 1.37-1.72) and edentulism (PR, 1.29; 95% CI, 1.08-1.53) had a significant negative impact on OHRQoL. Income, level of education, sex, age, and oral hygiene habits were also related to OHRQoL. There was a high prevalence of dental caries and edentulism in all age groups except 12-year-olds. OHRQoL was negatively impacted by these oral conditions across the lifespan, with a trend towards more negative scores and higher impact in older adults.
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Affiliation(s)
- Luísa Simões de Albuquerque
- Department of Clinical and Community Dentistry, Health Science Center, Federal University of Paraíba, João Pessoa 58051-900, PB, Brazil; (L.S.d.A.); (R.G.d.Q.); (F.D.S.F.)
| | - Raiana Gurgel de Queiroz
- Department of Clinical and Community Dentistry, Health Science Center, Federal University of Paraíba, João Pessoa 58051-900, PB, Brazil; (L.S.d.A.); (R.G.d.Q.); (F.D.S.F.)
| | - Jenny Abanto
- Internacional University of Catalunya, Catalunya, 08017 Barcelona, Spain;
| | | | - Franklin Delano Soares Forte
- Department of Clinical and Community Dentistry, Health Science Center, Federal University of Paraíba, João Pessoa 58051-900, PB, Brazil; (L.S.d.A.); (R.G.d.Q.); (F.D.S.F.)
| | - Fábio Correia Sampaio
- Department of Clinical and Community Dentistry, Health Science Center, Federal University of Paraíba, João Pessoa 58051-900, PB, Brazil; (L.S.d.A.); (R.G.d.Q.); (F.D.S.F.)
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Melo L, Blum IR, Foxton RM. Should new operating procedures arising from COVID-19 make us re-think our management of deep caries? Prim Dent J 2022; 11:72-74. [PMID: 35383500 DOI: 10.1177/20501684221085872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
COVID-19 has impacted heavily on the delivery of dental services within the UK, particularly in regards to aerosol generating procedures (AGPs). However, it has created an opportunity to reflect on how operative dental procedures, such as the management of dental caries, are undertaken. In light of recent evidence in favour of speed increasing contra-angle handpieces in combination with an electric micromotor to eliminate the generation of aerosols at certain speeds while still allowing the cutting of hard tooth tissue, albeit at a slower rate than the traditional air-turbine, this article explores the evidence for partial caries removal using the electric micromotor system. Aspects of maintaing the health of the pulpal tissue using this system and adopting a logical approach to placing adhesive direct resin composites to faciliate an optimum outcome for the patient are also explored.
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Affiliation(s)
- Luciana Melo
- Senior Specialist Clinical Teacher, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Igor R Blum
- Clinical Professor of Primary Care Dentistry & Advanced General Dental Practice, Lead for Dental Outreach, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Clinical Lead, Consultant & Specialist in Restorative Dentistry, Head, Restorative Dentistry & Primary Dental Care, King's College Hospital Dental Institute, London, UK
| | - Richard M Foxton
- Senior Clinical Lecturer in Dental Education/Honorary Consultant in Restorative Dentistry, Lead for Simulation, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Maia TS, Lima TD, Vieira WDA, Blumenberg C, Agostini BA, Nascimento GG, Paranhos LR, Menezes MDS. Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review. Braz Oral Res 2021; 35:e130. [PMID: 34878085 DOI: 10.1590/1807-3107bor-2021.vol35.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.
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Affiliation(s)
- Thaís Souza Maia
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Postgraduate Program in Dentistry, Uberlândia, MG, Brazil
| | - Thamires Diogo Lima
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Postgraduate Program in Dentistry, Uberlândia, MG, Brazil
| | - Walbert de Andrade Vieira
- Universidade Estadual de Campinas - Unicamp, School of Dentistry of Piracicaba, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | - Cauane Blumenberg
- Universidade Federal de Pelotas - UFPel, Postgraduate Program in Epidemiology, Pelotas, RS, Brazil
| | | | | | - Luiz Renato Paranhos
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Preventive and Community Dentistry, Uberlândia, MG, Brazil
| | - Murilo de Sousa Menezes
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Restorative Dentistry and Dental Materials, Uberlândia, MG, Brazil
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