Gerodontology最新文献

Background: Xerostomia, or the subjective sensation of dry mouth, is highly prevalent among older adults, particularly those living in long-term care facilities (LTCFs). This condition can impair essential oral functions such as chewing, swallowing and speaking, and has been consistently associated with reduced oral health-related quality of life (OHRQoL). Despite its clinical relevance, no previous studies have evaluated the impact of xerostomia on OHRQoL in Chilean older adults living in LTCFs-a population characterized by high levels of frailty, polypharmacy and poor oral health.

Objective: To describe the association between xerostomia and oral health-related quality of life among older adults living in LTCFs in Chile.

Materials and methods: We conducted a cross-sectional study in 11 LTCFs in Santiago, Chile, including 102 adults aged 60 and over. Xerostomia was assessed using the Spanish version of the Xerostomia Inventory (XI) and OHRQoL was measured using the validated OHIP-14Sp questionnaire. Clinical oral health status was evaluated following WHO criteria, including DMFT index, prosthesis use and occlusal support (Eichner Index). Linear regression and negative binomial models were used to assess the association between xerostomia and OHRQoL, adjusting for potential confounders.

Results: Xerostomia was reported by 55.9% of participants and was significantly more common in women than in men (70% vs. 38%, p = 0.043). Participants with xerostomia had higher OHIP-14 scores (median: 9 vs. 2; p < 0.0001), and a strong positive correlation was observed between XI and OHIP-14 scores (slope = 0.44; R² = 0.327). In adjusted negative binomial regression models, greater xerostomia severity was associated with worse oral health-related quality of life, with higher Xerostomia Inventory scores associated with increased OHIP-14 scores (IRR = 1.05; 95% CI: 1.03-1.08).

Conclusion: Xerostomia was highly prevalent among older adults living in urban LTCFs and associated with impaired OHRQoL. These findings underscore the need for systematic screening, prevention and management strategies for xerostomia in LTCFs to improve the well-being of this vulnerable population.

Objective: To examine the association between oral frailty (OF) and social frailty (SF) among independent community-dwelling older adults in Japan.

Methods: A cross-sectional study was conducted using data from the 2022 wave of the Japan Gerontological Evaluation Study (JAGES) including 19,319 functionally independent older adults aged ≥ 65 years. Oral frailty was used as an exposure variable in four ways: (1) a categorical variable (robust = 0, pre-frail = 1, frail ≥ 2), (2) count score (sum of 5 OF components), (3) individual OF components and (4) a combined variable for the four oral functions. SF was measured using the 5-item index (SF-5; robust = 0, pre-frail = 1, frail ≥ 2). Missing data were handled via multiple imputation. Ordered logistic regression models were used after adjusting for sociodemographic and health-related covariates.

Results: Participants were 48.4% males and aged 65-104 years. SF prevalence was 28.3% (n = 5466). In the adjusted models, oral frail individuals had higher odds of being socially frail (OR 1.35; 95% CI 1.26-1.45) than the robust group and the highest oral frailty score (score 5) showed the highest odds (OR 2.53; 95% CI 1.50-4.27) for SF. In addition, among OF components, dry mouth had the strongest association (OR 1.29; 95% CI 1.20-1.38), and those with four diminished oral functions were more likely to be socially frail (OR 2.42; 95% CI 1.53-3.82). Overall, a clear gradient-like pattern was observed with more oral frailty linked to higher odds of social frailty.

Conclusion: OF and its components were associated with SF among older adults in Japan. These findings might suggest the need for integrated screening and preventive strategies to mitigate social vulnerability linked to oral functional decline.

Objective: To explore the in-depth experiences of individuals who have lived with edentulism and have long-term experience with conventional complete dentures.

Background: With the global rise in ageing populations, complete tooth loss (edentulism) and the subsequent use of dental prostheses have become increasingly common. Understanding the lived experiences of edentulous patients treated with conventional dentures is essential for dental professionals to provide personalised and empathetic care.

Methods: This qualitative study employed an interpretive phenomenological analysis (IPA) approach. Completely edentulous participants with long-term experience of using conventional complete dentures were recruited. Data were collected through semi-structured, face-to-face interviews that were audio-recorded and transcribed verbatim. Thematic analysis was used to identify key patterns and meanings across the participants' narratives.

Results: Twelve participants expressed varied emotional and functional responses to edentulism. Some attributed their tooth loss to dental professionals, whereas others held themselves or their families responsible. Edentulism significantly affected oral function and social engagement. While several participants developed coping strategies to address the discomfort and limitations of conventional dentures, others perceived the dentures as beneficial, citing enhanced self-image and improved chewing ability. Two main themes emerged: the long experience of tooth loss and experience of conventional complete dentures.

Conclusion: This study contributes important insights for completely edentulous patients, conventional denture wearers and oral health practitioners into the complex emotional and functional dimensions of edentulism and denture use. The findings emphasise the value of patient-centred care approaches that account for individual coping strategies, personal narratives and long-term experiences with prosthetic rehabilitation.

Background: Dental caries remains highly prevalent in older adults and represents a growing public health concern due to increased tooth retention, polypharmacy, hyposalivation and functional limitations. Silver diamine fluoride (SDF) is widely used for caries arrest in this population but causes undesirable tooth staining. Nano Silver Fluoride (NSF) has emerged as a potential alternative, combining antimicrobial and remineralizing properties with improved aesthetics. However, its applicability in geriatric dentistry remains unclear.

Objective: This scoping review aimed to identify and map existing evidence on the use of Nano Silver Fluoride for the prevention or management of dental caries in older adults.

Methods: The review followed the PRISMA-ScR guidelines framework. A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and SciELO for articles published between January 2020 and December 2024. Studies were eligible if they involved human participants aged ≥ 60 years, evaluated NSF for caries prevention or treatment and were published in English, Spanish or Portuguese. In vitro studies, animal models, case reports, reviews, and studies on children or young adults only were excluded.

Results: A total of 157 records were identified; 14 full-text articles were assessed. None met the inclusion criteria, as all clinical studies involving NSF were conducted in paediatric or young adult populations, lacked older adult participants, or were laboratory-based. No clinical trials, observational studies, or reviews evaluating NSF in older adults were found.

Discussion: This scoping review reveals a complete absence of clinical evidence regarding the use of Nano Silver Fluoride in adults aged 60 years or older. Although NSF has shown promising results in younger populations and is chemically related to SDF, its effectiveness and safety in geriatric dentistry remain unknown. High-quality clinical studies in older adults are urgently needed.

Background: Patient groups and policymakers are calling for the implementation of relationship-centred, co-ordinated care for vulnerable older people. Relationship-centred care highlights the significance of strong, quality relationships among residents, their families and the broader healthcare team. The present work performed a qualitative evidence synthesis to explore issues relating to the provision of relationship-centred dental care for older people living in care homes, as perceived by care home staff, dental professionals, family and residents. This builds on the existing evidence base and outlines areas for improvement of dental care provision within residential care homes.

Methods: A 'best fit' framework synthesis of primary research was used to understand how and why current dental care might or might not be relationship-centred. A palliative healthcare-focused conceptual framework for relationship-centred care was used as the basis for the synthesis. The review focuses on qualitative primary research studies exploring dental care for care-home residents.

Results: Of 235 unique citations, fifteen qualitative primary research papers were included. The synthesis identified supporting evidence for all five of the broad a priori themes from the relationship-centred care coding framework: Relationship-centred care, Integration within the wider health and social care systems, Digital inclusion, Workforce support and Parity of esteem. Relationships between themes were articulated.

Conclusions: This 'best-fit' framework synthesis found that care home staff identified numerous barriers to providing relationship-centred dental care for older residents. Dentists, families and residents were underrepresented, highlighting the need for further research into their perspectives. By acknowledging the complexity of dental care and addressing issues such as integration, workforce support, digital services and parity of esteem, the synthesis suggests that applying organisational change research may help improve oral health outcomes in care homes.

Background: Unmet dental care is a key indicator of oral health inequality and is associated with oral functional decline and frailty in later life. Because oral function may influence dental care utilisation across age groups, age-stratified evaluation is warranted. This study examined age-specific factors associated with unmet dental care among Korean adults.

Methods: This cross-sectional study analysed pooled data from the 2022 and 2024 Korean Community Health Surveys (n = 463,513). Participants aged ≥ 40 years were stratified into ≤ 64 and ≥ 65 age groups. Unmet dental care was defined as self-reported inability to receive needed dental treatment in the past year. Survey-weighted Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs).

Results: The prevalence of unmet dental care was 16.1% (95% CI: 15.8-16.4) among adults aged ≤ 64 years and 14.6% (95% CI: 14.1-15.1) among those aged ≥ 65 years. Following these prevalence estimates, age-specific associations were identified. Among adults aged ≤ 64 years, higher education and economic activity were associated with a higher prevalence of unmet dental care, whereas physical activity and toothbrushing after lunch were associated with a lower prevalence. Among adults aged ≥ 65 years, female sex and toothbrushing after lunch were associated with a lower prevalence, while living with a spouse was associated with a higher prevalence. Poor subjective oral health and chewing difficulty were associated with unmet dental care in both age groups. A significant interaction between subjective oral health status and chewing difficulty was observed only in the ≤ 64 age group.

Conclusion: Determinants of unmet dental care differ by age group, underscoring the need for age-tailored oral health strategies that incorporate oral functional assessment into community-based care.

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.