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Effect of oral health status and oral function on malnutrition in community-dwelling older adult dental patients: A two-year prospective cohort study 社区老年牙科患者口腔健康状况和口腔功能对营养不良的影响:一项为期两年的前瞻性队列研究。
IF 2 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-10-17 DOI: 10.1111/ger.12718
Nanami Sawada, Noriko Takeuchi, Daisuke Ekuni, Manabu Morita

Objectives

To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment.

Background

Malnutrition is common in older adults and increases the risk of frailty, sarcopenia, and mortality. However, few longitudinal studies have been performed to investigate the causal effect of oral status on malnutrition in detail, and the information reported in those longitudinal studies has been limited to dentition status and swallowing ability.

Materials and Methods

The participants in this prospective cohort study were patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2021. The number of teeth, periodontal condition, oral function (oral diadochokinesis, masticatory ability, number of bacteria in tongue coating, occlusal force, oral moisture, tongue pressure, swallowing function), nutritional status, the number of comorbidities, and mental health status were examined. These variables were analysed using structural equation modelling (SEM).

Results

The final analysis included 141 participants (40 males and 101 females; mean age, 73.5 ± 6.3 years; follow-up rate: 79.7%). The results of the SEM revealed that oral status (number of teeth present and swallowing function) was positively associated with nutritional status 2 years later. In addition, age was negatively associated with oral status.

Conclusion

In community-dwelling older adult dental patients (age ≥60 years), oral function at baseline was associated with nutritional status two years later.

目的:详细调查口腔状况,并阐明迷你营养评估评估中与营养状况相关的因素。背景:营养不良在老年人中很常见,会增加虚弱、少肌症和死亡率的风险。然而,很少进行纵向研究来详细调查口腔状况对营养不良的因果影响,这些纵向研究中报告的信息仅限于牙列状况和吞咽能力。材料和方法:这项前瞻性队列研究的参与者是2017年11月至2021年1月访问冈山大学医院预防牙科诊所的患者。检查了牙齿数量、牙周状况、口腔功能(口腔假牙、咀嚼能力、舌苔细菌数量、咬合力、口腔水分、舌压、吞咽功能)、营养状况、合并症数量和心理健康状况。使用结构方程模型(SEM)对这些变量进行了分析。结果:最终分析包括141名参与者(40名男性和101名女性;平均年龄73.5 ± 6.3 年;随访率:79.7%)。SEM结果显示,口腔状况(牙齿数量和吞咽功能)与营养状况2呈正相关 几年后。此外,年龄与口腔状况呈负相关。结论:居住在社区的老年牙科患者(年龄≥60岁) 年),基线时的口腔功能与两年后的营养状况相关。
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引用次数: 0
Outreach dental care programme for older adults using long-term care services in Hong Kong: A qualitative study 香港使用长期护理服务的老年人拓展牙科护理计划:一项定性研究。
IF 2 3区 医学 Q1 Dentistry Pub Date : 2023-10-04 DOI: 10.1111/ger.12717
Stella X. Yang, Edward C. M. Lo, Katherine C. M. Leung

Objectives

To explore the effects and improvement needs of an outreach dental care programme (ODCP) for older adults using residential care or daycare services from the perspectives of the caregivers, the dentists and administrative staff involved in the implementation of the ODCP.

Methods

A qualitative study was conducted through semi-structured interviews with three stakeholders, long-term care (LTC) facility caregivers, administrative staff and dentists working for the ODCP. Combined maximum variation and snowball sampling strategies were adopted, and 22, 9 and 7 participants were interviewed from each stakeholder, respectively. The interviews were conducted via telephone, which were audio-recorded and transcribed verbatim for analysis. NVivo software was used for storing and analysing the data. Data analysis was conducted continuously during the study.

Results

Most participants opined that the ODCP benefited older adults by raising their oral health conditions and awareness. However, they complained of the complicated administrative procedures, unmet dental treatment needs, inefficient coordination, unclear work guidelines and shortage of dental manpower. More advanced dental treatment options, better coordination among different parties, simpler administrative processes and better incentives for dentists were proposed to further improve the programme.

Conclusions

According to the stakeholders, ODCP seems beneficial to older adults using LTC services. Further improvements in the scope of dental treatments, cooperation between the outreach dental teams and caregivers, and streamlining of the administrative process are needed for the provision of effective outreach dental care to satisfy the unmet treatment needs of older adults who use LTC services. Better incentives are needed to attract and retain dentists.

目的:从参与实施外展牙科护理计划的护理人员、牙医和行政人员的角度,探讨针对使用住宿护理或日托服务的老年人的外展牙科护理方案(ODCP)的效果和改进需求,长期护理机构的护理人员、行政人员和为ODCP工作的牙医。采用最大方差和滚雪球抽样相结合的策略,分别采访了来自每个利益相关者的22名、9名和7名参与者。访谈是通过电话进行的,录音并逐字转录以供分析。NVivo软件用于存储和分析数据。研究期间持续进行数据分析。结果:大多数参与者认为,ODCP通过提高老年人的口腔健康状况和意识使他们受益。然而,他们抱怨行政程序复杂,牙科治疗需求未得到满足,协调效率低下,工作指南不明确,牙科人力短缺。为了进一步改进该方案,建议采用更先进的牙科治疗方案、更好地协调各方、更简单的行政程序和更好地激励牙医。结论:根据利益相关者的说法,ODCP似乎对使用LTC服务的老年人有益。需要进一步改善牙科治疗的范围、外展牙科团队和护理人员之间的合作以及简化行政程序,以提供有效的外展牙科护理,满足使用长期护理服务的老年人未满足的治疗需求。需要更好的激励措施来吸引和留住牙医。
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引用次数: 0
Current status of geriatric dentistry education in selected dental schools in Latin America and the Caribbean 拉丁美洲和加勒比选定牙科学校的老年牙科教育现状。
IF 2 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-10-04 DOI: 10.1111/ger.12714
Soraya León, Rodrigo A. Giacaman, Francisca Araya-Bustos, Sardi Venegas, Nicole Saavedra, Fernando Neves Hugo, Renato J. De Marchi, María-Fernanda Muñoz, Claudia Salazar, Roberto C. Castrejón-Pérez, Lorena Bustillos, Adriana Fortanete, Aracelly Cedeño de López, Jorge E. Aredes, Dairo Marín-Zuluaga, Augusto Elias-Boneta

Objective

Latin American and Carribean (LAC) are currently experiencing a rapid aging of their population, coupled with a significant burden of oral diseases. Despites this, there is a scarcity of evidence regarding the manner in wich geriatric dentistry is being taught in dental schools across LAC. So, the objective of this study is to investigate the current status of geriatric dentistry education at undergraduate and postgraduate levels in selected LAC dental schools.

Methods

An electronic questionnaire was developed and emailed to all 539 dental schools in 19 LAC countries. The questionnaire recorded activity levels, contents and methodology of geriatric dentistry education as part of dental degree programmes. Reminders by email and telephone calls were used to encourage non-responders to complete the questionnaire.

Results

In total, 317 schools from 17 countries responded to the questionnaire (response rate: 58.8%). Geriatric dentistry was taught in 54.6% of the schools at the undergraduate level and in 6.9% at the postgraduate level. Thirty two percent of the schools had a programme director trained in geriatric dentistry. Geriatric dentistry was taught as an independent course in 14.5% of the schools. Dry mouth, periodontal disease, denture-related conditions and prosthodontic management, oral mucosal disease and age-related changes of the orofacial complex were the most frequently covered topics. Clinical teaching of geriatric dentistry was reported by 26.5% of the schools, with 38.0% providing clinical training in outreach facilities.

Conclusions

Geriatric dentistry education remains incipient in LAC, with only one in every four dental school offering it as a standalone course. There is an urgent need to further develop geriatric dentistry education in the continent, including further research to develop a minimum geriatric dentistry curriculum.

目标:拉丁美洲和加勒比(LAC)目前正经历人口的快速老龄化,再加上口腔疾病的严重负担。尽管如此,关于拉丁美洲和加勒比地区牙科学校教授老年牙科的方式,却缺乏证据。因此,本研究的目的是调查拉丁美洲和加勒比地区牙科学校本科生和研究生阶段老年牙科教育的现状。方法:编制一份电子问卷,并通过电子邮件发送给19个拉丁美洲和加勒比国家的539所牙科学校。问卷记录了作为牙科学位课程一部分的老年牙科教育的活动水平、内容和方法。通过电子邮件和电话提醒被用来鼓励未回答者填写问卷。结果:共有来自17个国家的317所学校对问卷进行了回复(回复率:58.8%)。54.6%的学校在本科阶段教授老年牙科,6.9%的学校在研究生阶段教授老年牙医。32%的学校有一名接受过老年牙科培训的项目主任。14.5%的学校将老年牙科作为一门独立课程进行教学。口腔干燥、牙周病、义齿相关条件和修复管理、口腔粘膜疾病和与年龄相关的口腔面部复合体变化是最常见的话题。26.5%的学校报告了老年牙科的临床教学,38.0%的学校在外展设施中提供临床培训。结论:拉丁美洲和加勒比地区的老年牙科教育仍处于起步阶段,只有四分之一的牙科学校将其作为独立课程提供。非洲大陆迫切需要进一步发展老年牙科教育,包括进一步研究制定最低限度的老年牙科课程。
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引用次数: 0
Association between frailty and oral health services use in Brazilian older adults 巴西老年人虚弱与口腔保健服务使用之间的关系。
IF 2 3区 医学 Q1 Dentistry Pub Date : 2023-09-26 DOI: 10.1111/ger.12716
Natália Boessio Tex de Vasconcellos, Maria Laura Braccini Fagundes, Gabriele Rissotto Menegazzo, Orlando Luiz do Amaral Júnior, Juliana Balbinot Hilgert, Jessye Melgarejo do Amaral Giordani

Objectives

To assess the association between frailty and oral health services use in Brazilian older adults.

Methods

This cross-sectional study analysed the baseline data from the Longitudinal Study on Brazilian Ageing (ELSI-Brazil) representative of Brazilians aged 50 or over. The outcome was oral health services used in the year prior to the interview. The main exposure variable was Frailty defined by the frailty phenotype. Age, skin colour, wealth, sex, education, type of service, health insurance, number of teeth and self-perceived oral health were included as covariates. Prevalence ratios (PR) with their respective 95% confidence intervals (CI) were estimated using Poisson regression with robust variance.

Results

8405 individuals were included in this study. The prevalence of frailty was 7.5%. Regarding frailty status, the prevalence of dental service use was 47.0%, 48.5% and 4.5% for robust, pre-frail and frail individuals, respectively. Frail individuals had a 7% higher prevalence of not using dental (PR: 1.07; 95% CI: 1.01–1.13) than robust individuals. Frailty was independently associated with not using oral health services.

Conclusion

Given the complexity of the determinants of dental service use, frailty adds another dimension to be examined in older adults. Public health strategies considering a common risk factor approach should be endorsed.

目的:评估巴西老年人虚弱与口腔健康服务使用之间的关系。方法:这项横断面研究分析了巴西老龄化纵向研究(ELSI Brazil)代表50岁或以上巴西人的基线数据。结果是访谈前一年使用的口腔健康服务。主要暴露变量是由虚弱表型定义的虚弱。年龄、肤色、财富、性别、教育、服务类型、健康保险、牙齿数量和自我感知的口腔健康被纳入协变量。使用具有稳健方差的泊松回归来估计患病率(PR)及其各自的95%置信区间(CI)。结果:8405人被纳入本研究。虚弱的患病率为7.5%。关于虚弱状况,强壮、前期虚弱和虚弱个体使用牙科服务的患病率分别为47.0%、48.5%和4.5%。虚弱个体不使用牙科的患病率比强壮个体高7%(PR:1.07;95%CI:1.01-1.13)。虚弱与不使用口腔健康服务独立相关。结论:考虑到牙科服务使用的决定因素的复杂性,虚弱增加了老年人需要检查的另一个维度。应认可考虑共同风险因素方法的公共卫生战略。
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引用次数: 0
Electrolysed oxidising water as a multi-purpose biocide in dental healthcare—A scoping review 电解氧化水在口腔保健中的多用途杀菌剂——综述。
IF 2 3区 医学 Q1 Dentistry Pub Date : 2023-09-11 DOI: 10.1111/ger.12712
Chitra S. Krishnan, Geoffrey R. Tompkins, Karl M. Lyons, Richard D. Cannon

Objectives

The objective of this scoping review was to map evidence of electrolysed oxidising water (EOW) as a biocide for dental applications of relevance to older people and identify research gaps.

Background

EOW is an emerging, “green,” and cost-effective biocide. There are no reviews on the landscape of EOW research as either an antiseptic or disinfectant in dental healthcare or its suitability for the oral healthcare of older people.

Materials and Methods

The review follows the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Database searches (Google Scholar, PubMed, Web of Science, Ovid, Scopus and Science Direct) were undertaken using MESH terms and Boolean operators with no date restrictions, to identify full-text, original reports published in English-language peer-reviewed journals.

Results

The search yielded 114 papers that met the inclusion/exclusion criteria. Dental applications of EOW include its use as an endodontic irrigant (39%); mouth rinse/surgical irrigant (21%); disinfectant for dental unit water lines (19%) and dental biomaterials (17%); and for antimicrobial efficacy, effects on oral tissues and on dental material properties. Most studies (83%) evaluated a single EOW formulation (acidic, moderately acidic or neutral) that was either generated at ‘point-of-use’ (POU; 72%), bottled (‘ready-to-use’, RTU; 24%) or from unspecified (3%) sources. Six reports evaluated storage-related parameters and 25 evaluated clinical applications; 89 were in vitro studies and one investigated the cost-effectiveness of POU EOW.

Conclusions

Neutral-pH, EOW is effective as an antimicrobial agent without deleterious effects on oral tissues. However, research on the impact of storage conditions, anti-Candida biofilm efficacy and mechanism of action against yeasts, long-term effects on denture materials and cost-effectiveness is required to establish the suitability of EOW as a multipurpose biocide for dental healthcare, including infection-control requirements relating to older people.

目的:本综述的目的是绘制电解氧化水(EOW)作为与老年人牙科应用相关的杀菌剂的证据,并确定研究空白。背景:EOW是一种新兴的“绿色”、高性价比的杀菌剂。目前还没有关于EOW作为牙科保健中的防腐剂或消毒剂或其对老年人口腔保健的适用性的研究综述。材料和方法:审查遵循PRISMA范围审查扩展(PRISMA- scr)指南。数据库检索(b谷歌Scholar, PubMed, Web of Science, Ovid, Scopus和Science Direct)使用MESH术语和布尔运算符进行,没有日期限制,以识别发表在英文同行评审期刊上的全文原创报告。结果:检索出114篇符合纳入/排除标准的论文。EOW的牙科应用包括用作牙髓冲洗剂(39%);漱口水/手术冲洗液(21%);牙科单位水管消毒剂(19%)和牙科生物材料消毒剂(17%);对于抗菌效果,对口腔组织和牙科材料性能的影响。大多数研究(83%)评估了单一EOW制剂(酸性、中酸性或中性),这些制剂要么在“使用点”(POU)产生;72%),瓶装(“即食”,RTU;24%)或来源不明(3%)。6份报告评估了储存相关参数,25份报告评估了临床应用;89项是体外研究,一项是研究POU - EOW的成本效益。结论:EOW为中性ph,是一种有效的抗菌药物,对口腔组织无不良影响。然而,需要对储存条件的影响、抗念珠菌生物膜的功效和对酵母的作用机制、对义齿材料的长期影响和成本效益进行研究,以确定EOW作为牙科保健的多用途杀菌剂的适用性,包括与老年人有关的感染控制要求。
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引用次数: 0
Orofacial dysfunction after stroke—A multidisciplinary approach 中风后口面部功能障碍--多学科方法。
IF 2 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-09-11 DOI: 10.1111/ger.12713
Pia Skott, Elisabet Åkesson, Kerstin Johansson, Jesper Dalum, Emmelie Persson, Åsa Karlsson, Åke Seiger, Anita McAllister, Gunilla Sandborgh-Englund

Objective

This paper describes the study protocol in an ongoing clinical trial evaluating oral screen training as part of a post-stroke rehabilitation programme. Baseline data were related to four domains: dysphagia, lip function, masticatory performance and patient-related outcome measures (PROM).

Background

Stroke is one of the most common causes of disability-adjusted life years, and dysphagia is a common remaining problem after stroke. Rehabilitation using oral screen training has been suggested to improve swallowing, but evidence is still insufficient.

Materials and Methods

Patients diagnosed with stroke with persisting objective and/or subjective swallowing dysfunction after primary rehabilitation were assessed for eligibility. In total, 25 patients were included. Objective function was assessed by swallowing capacity test (SCT), lip force and masticatory performance, subjective function by EAT-10 and NOT-S and PROM by LiSat-11 and ESAS.

Results

Baseline data presented a heterogeneous pattern with no significant association between objective and subjective dysfunction. Most of the participants (20/25) showed impaired swallowing capacity in SCT, and 23/24 revealed orofacial dysfunction according to NOT-S. The most common subjective item reported was chewing and swallowing problems (19/24).

Conclusion

The heterogenous findings in the included tests and the lack of correlations emphasise the importance of multidisciplinary approaches to identify objective and subjective orofacial post-stroke dysfunction in clinical practice to be able to offer evidence-based individualised care. The included participants were representative of stroke patients with dysphagia, which supports proceeding with the planned intervention.

目的本文介绍了一项正在进行的临床试验的研究方案,该试验评估了作为中风后康复计划一部分的口腔筛查训练。基线数据涉及四个方面:吞咽困难、唇功能、咀嚼功能和患者相关结果测量(PROM):背景:中风是导致残疾调整寿命的最常见原因之一,而吞咽困难是中风后常见的遗留问题。背景:脑卒中是导致残疾调整寿命的最常见原因之一,而吞咽困难是脑卒中后常见的遗留问题。有人建议通过口腔筛查训练进行康复治疗来改善吞咽功能,但目前证据仍不充分:评估被诊断为中风且在初级康复后仍存在客观和/或主观吞咽功能障碍的患者的资格。共纳入 25 名患者。客观功能通过吞咽能力测试(SCT)、唇力和咀嚼功能进行评估,主观功能通过EAT-10和NOT-S进行评估,PROM通过LiSat-11和ESAS进行评估:结果:基线数据呈现出不同的模式,客观和主观功能障碍之间无明显关联。大多数参与者(20/25)在 SCT 中显示吞咽能力受损,23/24 在 NOT-S 中显示口面部功能障碍。最常见的主观项目是咀嚼和吞咽困难(19/24):结论:所纳入的测试结果各不相同,且缺乏相关性,这强调了在临床实践中采用多学科方法识别客观和主观卒中后口面部功能障碍的重要性,以便能够提供以证据为基础的个性化护理。所纳入的参与者在有吞咽困难的中风患者中具有代表性,这为继续进行计划中的干预提供了支持。
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引用次数: 0
Evaluation of a protocol to assess a novel artificial biofilm equivalent for dentures—A prospective clinical pilot study 评估用于假牙的新型人工生物膜等效物的方案--前瞻性临床试点研究。
IF 2 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-09-04 DOI: 10.1111/ger.12715
Katarzyna Kresse-Walczak, Heike Meissner, René Mauer, Evelyn Trips, Klaus Boening

Objectives

This pilot study aimed to carry out preliminary tests of the removability of an artificial biofilm equivalent (ABE) and to verify the reproducibility of the ABE testing protocol for a planned main study.

Background

There is a lack of data to develop suitable artificial biofilm substitutes, which may be helpful to perform denture hygiene education and to carry out in vitro examinations of oral hygiene products.

Materials and Methods

This single-group, prospective, longitudinal, interventional pilot study was conducted in Dresden (Germany) from February until December 2020. Participants were recruited who wore fully functional upper complete dentures. Denture biofilm was grown on acrylic specimens by wearing dentures for 12 h and 36 h using intraoral appliances. Acrylic specimens were coated with ABEs of three compositions: chitosan (ChS) 0.3 g, methylcellulose (MC) 1.7 g; ChS 0.2 g, MC 1.8 g; ChS 0.1 g, MC 1.9 g (labelled 1.7MC, 1.8MC and 1.9MC, respectively). All specimens underwent standardised mechanical brushing. The percentages of remaining biofilm (POB) were measured.

Results

Thirty-one participants were prescreened, and eight (26%) were included. The appliances were well tolerated, and biofilm was collected. ABE was prepared and brushed as planned. Three and six brushing strokes were needed to remove 12-h and 36-h natural denture biofilm, respectively. Correspondingly, three brushing strokes were needed to remove 1.9MC ABE and six brushing strokes to remove 1.8MC and 1.7MC ABE. A reproducibility of ABE removal was indicated.

Conclusion

The removability of ABE and the ABE testing protocol were feasible and reproducible for conducting the future main study.

目的:本试验研究旨在对人工生物膜等效物(ABE)的可去除性进行初步测试,并为计划中的主要研究验证 ABE 测试方案的可重复性:本试验研究旨在对人工生物膜等效物(ABE)的可去除性进行初步测试,并为计划中的主要研究验证人工生物膜等效物测试方案的可重复性:背景:目前缺乏开发合适的人工生物膜替代物的数据,而人工生物膜替代物可能有助于开展义齿卫生教育和对口腔卫生产品进行体外检查:这项单组、前瞻性、纵向、干预性试验研究于 2020 年 2 月至 12 月在德累斯顿(德国)进行。参与者均佩戴功能齐全的上部全口义齿。通过佩戴假牙 12 小时和使用口内装置 36 小时,在丙烯酸试样上培养假牙生物膜。丙烯酸试样涂有三种成分的 ABE:壳聚糖 (ChS) 0.3 克,甲基纤维素 (MC) 1.7 克;壳聚糖 (ChS) 0.2 克,甲基纤维素 (MC) 1.8 克;壳聚糖 (ChS) 0.1 克,甲基纤维素 (MC) 1.9 克(分别标为 1.7MC、1.8MC 和 1.9MC)。所有标本均经过标准化机械刷洗。结果:预选了 31 名参与者,其中 8 人(26%)接受了治疗。他们对矫治器的耐受性良好,并收集了生物膜。按照计划准备和刷洗 ABE。分别需要三次和六次刷牙才能清除 12 小时和 36 小时的天然义齿生物膜。相应地,三次刷牙可清除 1.9MC ABE,六次刷牙可清除 1.8MC 和 1.7MC ABE。这表明 ABE 的去除具有可重复性:结论:ABE 的可去除性和 ABE 测试方案是可行和可重复的,可用于今后的主要研究。
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引用次数: 0
Binge drinking and oral health-related quality of life in older adults: Socioeconomic position matters 老年人酗酒和口腔健康相关生活质量:社会经济地位的影响
IF 2 3区 医学 Q1 Dentistry Pub Date : 2023-08-27 DOI: 10.1111/ger.12711
Leandro Machado Oliveira, Thayná Regina Pelissari, Flávio Fernando Demarco, Fabrício Batistin Zanatta

Objective

The objective of the study was to investigate whether the association between binge drinking and oral health-related quality of life (OHRQoL) differs by socioeconomic position (SEP) in Brazilian older adults.

Background

The adverse health effects of alcohol consumption disproportionately affect socioeconomically disadvantaged and older individuals. Moreover, measures of binge drinking may capture different domains of the association between alcohol misuse and health that might be independent of the traditional markers of volume or frequency of consumption. Evidence of the association between alcohol use and oral health outcomes has failed to consider binge drinking and possible effect modification by SEP.

Methods

We conducted a secondary cross-sectional analysis using the baseline data from The Brazilian Longitudinal Study of Ageing (2015-2016). Effect Measure Modification analyses using multivariable Poisson regression models tested whether the association between past-month binge drinking and higher scores of the Oral Impacts on Daily Performance (OIDP) questionnaire differed in magnitude by level of household wealth and educational attainment, assessed using Relative Excess Risk due to Interaction (RERI) and simple slope test.

Results

The analytical sample comprised 8857 individuals. Participants who were from low-wealth households or with lower education and reported past-month binge drinking had 27% (95% CI: 1.16 to 1.39) and 28% (95% CI: 1.18 to 1.40) higher OIDP scores, respectively, than those not binge drinkers from higher SEP, and super-additive associations were detected (RERI for household wealth: 0.12; RERI for educational attainment: 0.14).

Conclusion

Binge drinkers from low SEP have poorer OHRQoL. Public oral health initiatives aiming to combat binge drinking are likely to disproportionately benefit vulnerable groups.

目的:本研究的目的是调查巴西老年人酗酒与口腔健康相关生活质量(OHRQoL)之间的关系是否因社会经济地位(SEP)而异。背景:酒精消费对健康的不良影响不成比例地影响社会经济弱势群体和老年人。此外,对酗酒的测量可能会捕捉到酒精滥用与健康之间关联的不同领域,这些领域可能独立于饮酒量或饮酒频率的传统标志。酒精使用与口腔健康结果之间的关联证据没有考虑到酗酒和sep可能改变的影响。方法:我们使用巴西老龄化纵向研究(2015-2016)的基线数据进行了二次横断面分析。效应测量修正分析使用多变量泊松回归模型检验了过去一个月的酗酒与口腔对日常表现的影响(OIDP)问卷得分之间的关联是否因家庭财富水平和受教育程度的不同而有所不同,评估方法是相互作用的相对超额风险(rei)和简单斜率检验。结果:分析样本共8857人。来自低财富家庭或受教育程度较低且报告过去一个月酗酒的参与者,其OIDP得分分别比来自较高SEP的非酗酒者高27% (95% CI: 1.16至1.39)和28% (95% CI: 1.18至1.40),并且检测到超加性关联(家庭财富的rei: 0.12;教育程度的rei为0.14)。结论:低SEP酗酒者的OHRQoL较差。旨在打击酗酒的公共口腔卫生倡议可能会不成比例地惠及弱势群体。
{"title":"Binge drinking and oral health-related quality of life in older adults: Socioeconomic position matters","authors":"Leandro Machado Oliveira,&nbsp;Thayná Regina Pelissari,&nbsp;Flávio Fernando Demarco,&nbsp;Fabrício Batistin Zanatta","doi":"10.1111/ger.12711","DOIUrl":"10.1111/ger.12711","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of the study was to investigate whether the association between binge drinking and oral health-related quality of life (OHRQoL) differs by socioeconomic position (SEP) in Brazilian older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The adverse health effects of alcohol consumption disproportionately affect socioeconomically disadvantaged and older individuals. Moreover, measures of binge drinking may capture different domains of the association between alcohol misuse and health that might be independent of the traditional markers of volume or frequency of consumption. Evidence of the association between alcohol use and oral health outcomes has failed to consider binge drinking and possible effect modification by SEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a secondary cross-sectional analysis using the baseline data from The Brazilian Longitudinal Study of Ageing (2015-2016). Effect Measure Modification analyses using multivariable Poisson regression models tested whether the association between past-month binge drinking and higher scores of the Oral Impacts on Daily Performance (OIDP) questionnaire differed in magnitude by level of household wealth and educational attainment, assessed using Relative Excess Risk due to Interaction (RERI) and simple slope test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analytical sample comprised 8857 individuals. Participants who were from low-wealth households or with lower education and reported past-month binge drinking had 27% (95% CI: 1.16 to 1.39) and 28% (95% CI: 1.18 to 1.40) higher OIDP scores, respectively, than those not binge drinkers from higher SEP, and super-additive associations were detected (RERI for household wealth: 0.12; RERI for educational attainment: 0.14).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Binge drinkers from low SEP have poorer OHRQoL. Public oral health initiatives aiming to combat binge drinking are likely to disproportionately benefit vulnerable groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"40 4","pages":"529-534"},"PeriodicalIF":2.0,"publicationDate":"2023-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10085282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A novel prosthesis presentation test to screen for cognitive and functional decline 用于筛查认知和功能衰退的新型假肢展示测试。
IF 2 3区 医学 Q1 Dentistry Pub Date : 2023-08-16 DOI: 10.1111/ger.12708
Murali Srinivasan, Stephan Duong, Veronique Trombert, Nicole Kalberer, Dina Zekry, François R. Herrmann, Joris Delavy, Gabriel Gold, Frauke Müller

Objectives and background

To validate a novel screening test for cognitive and functional decline in older patients rehabilitated with complete removable dental prostheses (CRDPs).

Materials and methods

Edentate old in-patients rehabilitated with CRDPs were included in this study. Participants were requested to remove their prostheses before their intraoral examinations. The prostheses were then presented in an inverted orientation. Participants had to correct the orientation of the prostheses and insert them in the appropriate jaws. The test was repeated after the intraoral exam. Appropriate statistical models were used ( = .05) to associate the test results with the participants' mini-mental state examination (MMSE) score, functional independence measure (FIM), age and sex.

Results

Among the 86 participants (mean-age: 85.4 ± 6.4 years; mean MMSE: 19.8 ± 5.5; mean FIM: 77.9 ± 20.8), 21 (24.4%) failed to correctly insert the prosthesis. The prosthesis presentation test (PPT) was associated with the FIM but not the MMSE. Regression models further confirmed an association with age (P = .043), but not sex. Additional analyses revealed the PPT test is associated with the FIM's cognitive sub-sets of memory, problem solving and social interaction.

Conclusion

The PPT is a novel, simple and quick screening tool that can help detect functional difficulties in older people. It can easily be performed during an oral examination. Future studies are needed to determine whether the PPT can be used to detect deficits in executive function, as a complement to the MMSE and also as a first assessment of a patient's ability to manage dentures independently.

目的和背景:验证一种新型认知和功能衰退筛查测试,用于筛查使用全可摘义齿(CRDP)进行康复治疗的老年患者:研究对象包括使用完全可摘义齿(CRDP)进行康复治疗的老年患者。在口内检查前,要求参与者取下义齿。然后将义齿倒置。参与者必须纠正义齿的方向并将其插入适当的下颌。口腔内检查结束后重复该测试。使用适当的统计模型(⍺ = .05)将测试结果与参与者的小型精神状态检查(MMSE)得分、功能独立性测量(FIM)、年龄和性别联系起来:在 86 名参与者(平均年龄:85.4 ± 6.4 岁;平均 MMSE:19.8 ± 5.5;平均 FIM:77.9 ± 20.8)中,有 21 人(24.4%)未能正确插入假肢。假体置入测试 (PPT) 与 FIM 相关,但与 MMSE 无关。回归模型进一步证实与年龄(P = .043)有关,但与性别无关。其他分析表明,PPT 测试与 FIM 的认知子集(记忆、问题解决和社会交往)相关:PPT 是一种新颖、简单、快速的筛查工具,有助于发现老年人的功能障碍。它可以在口腔检查时轻松进行。今后还需要进行研究,以确定 PPT 是否可用于检测执行功能缺陷,作为 MMSE 的补充,以及作为对患者独立管理假牙能力的首次评估。
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引用次数: 0
Idiopathic bone cavity mimicking a botryoid odontogenic cyst: A rare radiographic presentation in an older adult 模仿骨样囊肿的特发性骨腔:一种罕见的老年成人影像学表现
IF 2 3区 医学 Q1 Dentistry Pub Date : 2023-08-14 DOI: 10.1111/ger.12671
John K. Brooks, Young In Lee, Ali Fahimi, Colin J. Stanhope, Ahmed S. Sultan, Jeffery B. Price

Objectives

This report describes an unusual case of a multilocular idiopathic bone cavity (IBC) that presented as a botryoid odontogenic cyst situated between the mandibular lateral incisor and canine in an older adult.

Background

The IBC represents an intraosseous concavity that appears radiographically as a unilocular or multilocular radiolucent lesion found in various skeletal sites, including the jaw. Atypical cases of gnathic IBC have not been appreciated in the gerodontologic literature.

Materials and methods

The teeth adjacent to the bony lesion had normal pulpal responses to cold. A full-thickness flap was elevated and provided a direct entry into a bony concavity, which was devoid of an epithelial lining and fluid.

Results

The lack of a cystic lining within the empty osseous lesion following surgical entry, concomitant with the vital pulpal status of the proximal teeth, led to a diagnosis of an IBC. The bony walls underwent curettage and copious irrigation prior to primary closure. A 10-month follow-up revealed partial evidence of osseous repair. The patient will continue to be monitored.

Conclusion

Timely surgical intervention of central lesions of the jaws may improve clinical outcomes. Variants of the IBC should be included in the differential diagnosis of multilocular lesions, particularly in the geriatric population.

本报告描述了一个罕见的多室特发性骨腔(IBC)病例,其表现为位于下颌侧切牙和犬齿之间的骨样牙源性囊肿。背景:IBC表现为骨内凹陷,影像学表现为单室或多室的透光病变,可见于骨骼的各个部位,包括颌骨。非典型的gnathic IBC病例在老年病学文献中尚未得到重视。材料与方法邻近骨病变的牙髓对低温反应正常。全层皮瓣被抬高,提供了一个直接进入骨凹的入口,骨凹缺乏上皮衬里和液体。结果手术入路后的空骨病变内缺乏囊性衬里,并伴有近端牙齿的重要牙髓状态,导致IBC的诊断。骨壁在初次闭合前进行刮除和大量冲洗。10个月的随访显示骨修复的部分证据。病人将继续接受观察。结论及时对颌骨中心病变进行手术干预可提高临床疗效。IBC的变异应包括在多房性病变的鉴别诊断中,特别是在老年人群中。
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引用次数: 0
期刊
Gerodontology
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