Gerodontology最新文献

Objective: To systematically review the impact of periodontitis on clinical oral health outcomes and oral health-related quality of life (OHRQoL) in older adults (≥ 60 years).

Background: Global evidence shows that severe periodontitis prevalence peaks in the 60s, yet how periodontitis relates specifically to oral health outcomes in older adults has not been comprehensively synthesised. Prior reviews in mixed-age populations demonstrate strong links with tooth loss but less consistent associations with OHRQoL.

Methods: This systematic review followed PRISMA guidelines and was registered on PROSPERO (CRD420251010568). Searches of PubMed, MEDLINE, Embase, Scopus, and Cochrane Library (to May 2025) identified studies of adults ≥ 60 years with periodontitis reporting oral health outcomes or OHRQoL. Two reviewers independently screened studies, extracted data, and assessed risk of bias.

Results: Forty-three studies met inclusion criteria: 18 longitudinal studies on clinical outcomes and 25 cross-sectional studies on OHRQoL. Clinical studies consistently demonstrated that deeper baseline periodontal pockets, greater clinical attachment loss, and higher CPI/CPITN scores predicted adverse outcomes over 18 months to 12 years follow-up, including tooth loss, further attachment loss, and functional decline. OHRQoL studies showed inconsistent findings, with roughly equal numbers reporting significant associations versus no relationship.

Conclusions: In adults ≥ 60 years, periodontitis consistently predicts tooth loss and continued periodontal breakdown, whereas OHRQoL associations are inconsistent and appear mediated primarily through downstream consequences such as tooth loss and functional impairment, though direct effects may occur in advanced disease. These findings emphasise the importance of periodontal prevention and management in older adults.

Background: Salivary dysfunction, including xerostomia and drooling, is common in Parkinson's disease and further impairs oral health and quality of life, which are already compromised in this population. Their effective management demands deeper insight into the complexity of salivary dysfunction.

Objective: To examine the occurrence and associations of xerostomia and drooling complaints in individuals with Parkinson's disease.

Methods: 111 individuals with Parkinson's disease (69.9 ± 7.7 years; 46.8% female) participated in an online survey. The questionnaire used validated scales (e.g., Xerostomia Inventory) and original questions. After descriptive analyses, multiple linear regression analyses identified factors (e.g., severity of motor impairment) associated with severity of xerostomia and drooling.

Results: Xerostomia (64.9%) and drooling (27.0%) were common, with 18.0% of the individuals experiencing both concurrently. Xerostomia was associated with the presence of jaw symptoms (B = 4.63; 95% CI 1.86-7.40), chewing gum usage (B = 1.27; 95% CI 0.52-2.02), swallowing difficulties (B = 0.41; 95% CI 0.04-0.78) and taste alterations (B = 0.15; 95% CI 0.00-0.30). Drooling was associated with the severity of motor impairment (B = 0.40; 95% CI 0.18-0.60) and with swallowing difficulties (B = 0.64; 95% CI 0.14-1.15).

Conclusions: Xerostomia and drooling complaints frequently co-occur in individuals with Parkinson's disease. To prevent further deterioration of the oral health-related quality of life, a comprehensive evaluation of the underlying aetiology of salivary issues in people with Parkinson's disease is crucial to assist in determining suitable treatment.

Background: As populations age globally, effective geriatric oral health interventions require a workforce equipped with the necessary knowledge, attitudes and skills. In Malaysia, geriatric dentistry is not yet a recognised speciality and training opportunities remain limited within undergraduate curricula and continuing professional development.

Objectives: To assess the knowledge, attitudes, practices (KAP) and perceived barriers of dental practitioners in providing care for older adults, as baseline evidence for developing educational interventions.

Methods: A cross-sectional survey was conducted among 260 dental practitioners from the Ministry of Health in Selangor, Malaysia. A validated self-administered questionnaire assessed knowledge, attitudes, practices and barriers across domains such as treatment complexity, polypharmacy, functional status and time demands. Preparedness was defined as the combined score of the KAP domains. Descriptive and inferential analyses, including modified Poisson regression, were conducted.

Results: Respondents were mainly female (91.2%) and over half were aged 32 or older (51.9%). Most practitioners demonstrated good knowledge (96.2%), while attitudes were moderate (68.1%). The mean barrier score was 3.8 (±0.4), with the most frequently reported obstacles being disease complexity, polypharmacy and functional limitations of older adults. Modified Poisson regression revealed that higher knowledge (PR = 3.68, p < 0.05) was significantly associated with greater recognition of barriers, suggesting heightened awareness but not necessarily preparedness.

Conclusion: Despite strong knowledge levels, moderate attitudes and recognition of significant barriers, this highlights the urgent need for structured educational interventions in geriatric dentistry. Integrating geriatric-focused modules into undergraduate curricula, expanding continuing professional development and fostering interprofessional learning are critical to preparing a competent workforce for ageing populations.

Introduction: Burning mouth syndrome (BMS) is occasionally accompanied by denture intolerance.

Case presentation: An 80-year-old woman with complaints of residual and relapsed intraoral pain and denture intolerance due to BMS was improved by olanzapine without severe adverse events, and her eating ability was successfully restored.

Conclusion: This case suggests that olanzapine may be an optional treatment for denture intolerance as well as BMS pain in older adult patients.

Background: The final remaining tooth in an otherwise edentulous mouth embodies a unique intersection of biology, psychology, and identity. Beyond its limited functional role, it serves as a powerful symbol of continuity and selfhood, making its extraction an emotionally charged event for many patients.

Objective: This narrative review explores the concept of 'Romanticising the Last Tooth', emphasising its psychosocial and clinical significance within geriatric and prosthodontic practice.

Methods: The discussion integrates evidence on emotional attachment, bone preservation, proprioception, and overdenture strategies to illustrate how the final tooth can influence both treatment planning and patient adaptation.

Results: Ethical dilemmas surrounding tooth retention and patient autonomy are examined, highlighting the need for empathy driven, shared decision making to guide clinicians. Recent literature emphasises advances in implant-supported rehabilitation, digital workflows, and biomaterials in full-arch prosthetic management, which can influence decisions regarding the last tooth.

Conclusions: The R.O.M.A.N.T.I.C. framework (Retain Or Move Ahead: Navigating the Tooth In Context) is introduced, offering structured parameters for deciding whether to preserve or extract the last tooth. This approach underscores a broader vision of prosthodontics one that harmonises technical precision with human understanding to restore not only function but dignity and confidence in the ageing patient.

Objective: This study aimed to construct a knowledge map of oral frailty research to visualise current research status and hotspots, thereby facilitating further advances and innovations in this field.

Methods: We retrieved relevant literature published between January 1, 2010 and January 1, 2025, from the China National Knowledge Infrastructure (CNKI) and Web of Science (WOS) databases. Bibliometric analysis was conducted using CiteSpace software to examine publication trends, geographical distribution, journal sources, keyword co-occurrence and citation patterns.

Results: The analysis included 83 Chinese and 596 English publications. The annual publication count exhibited a fluctuating upward trend, with Japan producing the highest number of studies, followed by China. International research primarily focused on the association between older oral health and systemic health outcomes, whereas Chinese studies emphasised oral health issues and their determinants in ageing populations. The research paradigm transitioned from conceptual frameworks to clinical applications and multidimensional intervention strategies.

Conclusion: This study systematically outlined current progress in oral frailty research, highlighting its connections with frailty syndrome and malnutrition. Future research should prioritise in-depth needs assessment, integrate international best practices, promote interdisciplinary collaboration and develop personalised oral health interventions to improve geriatric oral health outcomes.

Objective: To explore informal caregivers' perspectives concerning support in oral care for frail home-dwelling older persons (FHOPs), while identifying their needs and barriers at the IC-FHOP as well as the IC-healthcare professional level.

Background: FHOPs' oral health is a global concern. Health determinants ranging from the individual up to the public policy level shape oral health. Informal caregivers' perspectives on these topics are underexamined for oral health, despite their key role in supporting FHOPs and connecting them to professional care.

Materials and methods: Semi-structured interviews were conducted with informal caregivers of older adults from urban and rural areas in Flanders (Belgium), with a Groningen Frailty Index equal to or greater than 4. Interviews were recorded, transcribed, and analysed using a reflexive thematic approach.

Results: The sample comprised 19 informal caregivers (ICs) aged 53-87 years. Four themes were identified: (1) When words matter: the (un)spoken role of oral care in informal caregiving, (2) Balancing care and independence: the role of ICs in FHOPs' daily oral care, (3) Between necessity and accessibility: the role of ICs in FHOPs' dental visits, and (4) Ensuring oral health together: the collaboration with professionals. ICs' oral care involvement varied, influenced by knowledge, confidence, and support.

Conclusion: This study emphasises the vital role of ICs in supporting FHOPs' oral care, yet they often lack role clarity, confidence, and guidance. Enhancing education and support for both ICs and healthcare professionals is essential to promote person-centred oral care and collaboration.

Introduction: Care approaches to oral health are shaped by the perspectives of both aged care and dental care professionals. This study provides a new and comprehensive understanding of how these two professional groups conceptualise and address oral care for care-dependent older adults.

Material and methods: Researchers conducted 13 focus group discussions with 4-6 participants each in two Danish municipalities within the Lifelong Oral Health research project: nine with aged care staff and four with managers from aged care and dental care. Two semi-structured interviews were conducted with dental care staff. The research was guided by a qualitative methodological framework using inductive thematic analysis to explore participants' experiences and perspectives.

Results: Aged care and dental care staff held varying perspectives on four distinct care approaches: (1) knowledge of oral health; (2) prioritisation of oral health; (3) care practice in relation to oral health; (4) handling refusal of oral care. In contrast to dental care staff, aged care staff had rudimentary oral health knowledge and prioritised other care tasks over oral care. Aged care staff took a rehabilitative approach to oral care, whereas dental care staff favoured a compensatory approach. Aged care staff stated that the right to self-determination overruled the duty of care presented by dental care staff when patients refused oral care. These differences affected daily oral care practices and collaboration between both staff groups, who both endorsed better collaboration.

Conclusion: Divergent care approaches to oral care between aged care and dental care staff can hinder good oral health in care-dependent older adults. To enhance oral health in older adults, this article identifies four divergent approaches and explores how they challenge inter-professional collaboration.

Objective: To explore the perceptions and practices of women in peri/menopause towards oral healthcare in Australia.

Background: Hormonal changes associated with peri/menopause create a period where women may be more prone to developing oral health problems, which can significantly impact their quality of life. While healthcare providers are capable of addressing women's oral health needs across various life stages, limited evidence exists on the management of oral health by women in peri/menopause and the role of non-dental healthcare providers in promoting oral health.

Materials and methods: Seventeen semi-structured interviews were conducted with Australian women in peri/menopause using maximum variation and snowball sampling. A hybrid thematic analysis was used to construct themes and subthemes.

Results: Women who self-identified as being in peri/menopause with an age range of 43-59 years and residing across different Australian states participated in the study. Dry mouth was the most commonly reported oral health issue by participants, followed by tooth sensitivity, tooth decay, gum problems, and bad breath. Participants reported that these oral health problems impacted their mental health, lifestyle, and dietary choices. Barriers such as cost, lack of awareness of the impact of peri/menopause on oral health, systemic illness, carer responsibilities, and limited support from healthcare providers, including dentists, restricted participants in accessing oral healthcare. Women suggested that raising awareness, providing cost-effective dental services, and oral health promotion through their health care providers are needed to overcome the oral health challenges women face in peri/menopause.

Conclusion: Women undergoing peri/menopause may experience greater susceptibility to oral health problems and encounter a range of challenges in managing their oral healthcare. These findings underscore the need for clinically informed, patient-centred strategies, including proactive screening, tailored preventive guidance, and improved access to care to support oral health during this transitional stage.