Gerodontology最新文献

Objective: This study investigated the associations between baseline n-6 and n-3 polyunsaturated fatty acid levels and the number of teeth lost subsequently over 5 years.

Background: The relationship between n-3 and n-6 polyunsaturated fatty acids and tooth loss remains unclear. Previous studies have been limited to older individuals aged 70 and above, and no research has been conducted that takes into account a broader age range.

Material and methods: Participants (n = 1534) attended both the baseline survey and the follow-up survey conducted 5 years later. Poisson regression analyses were conducted after converting the number of teeth present at baseline into an adjustment variable. The dependent variable was the number of lost teeth over a five-year period. The exposure variables were each quintile of self-reported n-3 and n-6 polyunsaturated fatty acid intake levels (g/1000 kcal) and the ratio of self-reported n-6 to n-3 polyunsaturated fatty acid intake levels (n-6:n-3 ratio) adjusted by age, sex, smoking, use of dental floss or interdental brush and history of diabetes mellitus.

Results: Higher n-3 fatty acid intake (5th quintile, incidence rate ratio (IRR): 0.21, p < 0.001) and a lower dietary n-6:n-3 ratio (≤ 4.0) significantly lower tooth loss risk. Conversely, higher n-6 intake (5th quintile, IRR: 1.32, p = 0.006) was associated with the likelihood of tooth loss. Younger age, flossing and adequate chewing ability were associated with better dental outcomes.

Conclusion: Balanced dietary intake, particularly higher n-3 fatty acids and a lower n-6:n-3 ratio, helps preserve dental health by reducing tooth loss risk.

Objective: To examine each Kihon Checklist (KCL) oral function item, physical function, and the number of medications and describe associations between KCL oral function, frailty, sarcopenia, and polypharmacy.

Methods: Participants were 318 community-dwelling older adults (78.6 ± 6.9 years). The number of medications, KCL, the Japanese version of the Cardiovascular Health Study (J-CHS), grip strength, gait speed, and skeletal muscle index were measured. Analyses used cross-tabulation. Logistic regression modelled the presence of low oral function.

Results: Of the three oral function questions on the KCL, 34.9% of participants answered "yes" to Q13 on mastication, 24.8% answered "yes" to Q14 on swallowing, and 31.4% answered "yes" to Q15 on dry mouth. A total of 25.2% of the participants had low oral function according to the KCL. More of those with low oral function had polypharmacy. Oral function was not associated with sarcopenia. Physical frailty was associated with low oral function. Logistic regression analysis with oral function as the dependent variable and age, sex, polypharmacy, physical frailty, and sarcopenia status as the independent variables showed that physical frailty was associated with it.

Conclusion: Older people who are physically frail and taking multiple medications are likely also to have oral frailty.

Background: The newly announced Canadian Dental Care Plan (CDCP) particularly aims to reduce financial barriers to dental care for individuals living below a family income threshold. The Canadian government has also launched an "Oral Health Access Fund" to support projects aiming to address financial barriers to dental care for older adults, those with disabilities and other groups. Evidence from programs implemented elsewhere in the world could inform policy decisions and address such non-financial barriers for older Canadians and those with disabilities.

Aim: To identify dental programs and policies in OECD countries focusing on people with disabilities and older people, and to outline how they might be applied to the Canadian context.

Methods: The strategy for this narrative literature review comprised a combination of Medical Subject Headings (MeSh) or their equivalent, title/abstract keywords, truncations, and Boolean operators. Medline (Ovid), Embase (Ovid), CINAHL and Scopus were used. The searches were limited to English language publications involving programs and policies in all OECD countries. All searches ran from inception to January 25, 2023, with no restrictions on publication time.

Results: The search identified 129 articles eligible for review. Findings were categorized as (1) interventions at the institutional-level (subdivided into patient-, professional- and community-focused programs) and (2) interventions at the governmental-level (subdivided into universal, population-specific, and community-based programs). Evidence suggests that targeted, integrated coaching or education programs for oral health care are beneficial, especially when programs are constantly evaluated and improved. Programs with a unified network system that integrates various relevant organizational and health domains have demonstrated to be most effective in the improvement of oral health care and overall health. Dental and medical healthcare workers play a crucial role in improving oral health outcomes and need motivation and fair compensation when caring for older people.

Conclusions: There is limited quality evidence supporting approaches to improving oral health care and oral health for older people and those with disabilities. It is important for policymakers and stakeholders to consider programmes from other countries when expanding the CDCP.

Objectives: To evaluate the accuracy and reliability of intraoral 3D scans for assessing the oral health of older patients living in nursing homes.

Materials and methods: One examiner recorded missing teeth, restorations, caries lesions and oral hygiene (Geriatric-Debris-Index Simplified [GDI-S] ≥ 1.9) in nursing home residents using visual-tactile diagnostics (reference test) and afterwards obtained intraoral scans with an intraoral scanner (TRIOS 4, 3Shape). Two other independent investigators and the clinical examiner assessed only the scans to delineate the same diagnostic outcomes. For these outcomes, we assessed accuracy, sensitivity, specificity and the Area-under-the-Receiver-Operating-Characteristics Curve (AUROC). Kappa values (κ) were calculated to evaluate inter-examiner and intra-examiner reliability after re-examination by all examiners after a minimum interval of 3 weeks.

Results: Forty-three partially dentate patients (65-95 years of age) in need of care living in four nursing homes with a total of 486 teeth (mean [SD]: 11 [9] teeth per patient) were examined. Scans were perfectly accurate for detecting missing teeth (AUROC [sensitivity/specificity]: 1 [1/1]) and showed high accuracy for detecting restorations (0.96 [0.93/0.98]), too. Accuracy was lower to detect caries (0.77 [0.58/0.97]) and insufficient for oral hygiene (0.76 [0.54/0.99]). Agreement between examiners was perfect for missing teeth (κ: 1), very good for the detection of restorations (0.94), and good for caries or insufficient oral hygiene (0.73 and 0.72, respectively).

Conclusions: Scans were suitable for basic diagnostic evaluations but showed considerable shortcomings in detecting caries and poor oral hygiene. Assessing scans was relatively reliable.

Clinical relevance: Using scans may allow telemedical assessments of nursing home residents, but users should be aware of the differential accuracy for different diagnostic targets.

Objective: This study aimed to evaluate the effect of an individually tailored oral health intervention on the oral hygiene and health of family caregivers and their care recipients aged 60 years and older.

Background: Older adults are retaining their natural teeth longer. The compromised condition of teeth and oral health increases the risk of the deterioration of functional ability. Focused early intervention plays a significant role in preventing oral health problems in the future.

Materials and methods: This study was a six-months intervention study with a six-month follow-up and was part of the LENTO (Lifestyle, Nutrition and Oral health of caregivers) study. The sample consisted of family caregivers and their care recipients living in Eastern Finland. At baseline, the total sample comprised 239 (124 family caregivers and 115 care recipients) who were randomly allocated to either an intervention or a control group. In the intervention group, family caregivers received a tailored oral health intervention.

Results: The number of teeth with plaque decreased among family caregivers (β = -2.1, CI -4.0-(-1.2), p = 0.015) and their care recipients (β = -0.6, CI -0.0-(-2.1), p = 0.050). The number of teeth with caries decreased among family caregivers who participated in the intervention (β = -0.6, CI -1.1-(-0.1), p = 0.015), but not among their care recipients.

Conclusion: Our study shows that tailored information effectively promotes oral cleanliness among older adults. Furthermore, the number of teeth with caries decreased among family caregivers. It can therefore be recommended that such information and education on oral hygiene be implemented in healthcare systems in general. Furthermore, an interprofessional approach is necessary to promote better oral health in this vulnerable group of older adults.

Trial registration: ClinicalTrials.gov NCT04003493. Registered on June 28, 2019.

Objective: To date, no studies have directly investigated the association between oral health management (OHM) and food forms. Therefore, this study aimed to investigate the association between OHM by dental hygienists and food forms in older adults admitted to long-term care facilities (LTCFs).

Background: OHM involves oral health maintenance by dental hygienists and may prevent weight loss and pneumonia in older adults admitted to LTCFs.

Materials and methods: Older adults in LTCFs in Japan (n = 273) who participated in baseline (2018) and follow-up (2019) surveys were evaluated. Basic characteristics, medical history, OHM status, oral maintenance management status, food forms, and oral conditions were investigated at baseline. After 1 year, a follow-up survey was conducted only on food items. Furthermore, factors associated with the maintenance or improvement in food forms after 1 year were examined using binomial logistic regression analysis.

Results: Overall, 273 (69.2%) older adults in LTCFs required OHM by dental hygienists during the follow-up year, of whom 142 (52.0%) received OHM and 88 maintained or improved their regular diet. The analyses revealed that the maintenance or improvement in food forms after 1 year was significantly associated with OHM implementation (odds ratio: 2.01, 95% confidence interval: 1.03-3.90).

Conclusion: OHM in older adults in Japanese LTCFs was associated with the maintenance or improvement in food forms, emphasising the importance of OHM for these individuals. OHM may also maintain or improve eating and swallowing functions, improving nutritional status.