Gerodontology最新文献

Objectives: This study explored the attitudes of New Zealand (NZ) general dental practitioners (GDPs) towards older adults living within the community and the barriers and difficulties caring for their oral health needs.

Background: Adults are living longer and retaining teeth. Their dentitions are complex and alongside their dental needs, older adults often experience age-related systemic disease or decline. Ageism and stereotypical views of older adults impedes access to dental care. While there is some understanding of older adults and ageism from the perspective of dental students, there is a paucity of knowledge about dentists' management of this patient demographic.

Materials and methods: A mixed-methods survey questionnaire collected quantitative and qualitative data. Quantitative data were analysed descriptively followed by bivariate analysis. Qualitative data responses to open-ended questions were analysed thematically.

Results: A total of 382 GDPs participated (response rate of 24%) and demonstrated positive attitudes and low levels of ageism towards older adults who they enjoyed treating. Confidence was positively related to clinical experience, and most dentists had engaged in gerodontology updates. Barriers to care for older adults were perceived to be beyond their control and mostly related to cost, chronic disease or age-related change. Consent processes could create difficulty and so collaboration with family or caregivers was important.

Conclusion: The GDPs displayed positive attitudes and confidence towards older adults who are a rewarding patient cohort. Gerodontology education during training and following graduation is critical to enhance oral health outcomes for older patients.

Objectives: Limited access to oral health services contributes to poor oral health in institutionalised older adults. The objective of this study was to map and analyse the distribution of residential age-care facilities (RACFs) in relation to dental practices across Australia.

Methods: Age-care data were sourced from the Australian Institute of Health and Welfare. The data were categorised according to the Australian Bureau of Statistics remoteness index in each state and territory, defined by a geographic coordinate system. The structure of remoteness area data was integrated into RACF data using a geographic information system. Buffer analysis in QGIS was employed to calculate the buffer distance surrounding RACFs by identifying dental practices relative to a measuring distance.

Results: In total, Australia had 2718 RACFs and 7379 dental practices (both private 95.5% and public 4.5%). In all States, more than a third of metropolitan RACFs were within accessible reach of a private practice (ranging from 37% of RACFs in NSW to 55% in WA). However, proximity to public clinics was low, ranging from only 4% (WA) to 9% (QLD). More than one-fifth of metropolitan RACFs in NSW, QLD, WA and ACT (ranging from 20% to 24%) were not within accessible proximity of either a public or private dental clinic/practice. While more than 70% of RACFs in regional and remote Australia are reasonably close to dental practices, areas with inadequate access exist, with the highest percentage recorded in WA (6%).

Conclusion: Ensuring an equitable distribution of dental practices relative to RACFs is crucial in bridging the service access gap in underserved areas.

Objective: The purpose of this study was to investigate the effect of coronectomy on postoperative quality of life in older adults.

Background: Coronectomy is an alternative to complete surgical removal of a mandibular third molar that lies close to the inferior alveolar nerve.

Materials and methods: This prospective study included patients >60 years old who had an indication for coronectomy of a mandibular third molar. Patients were asked to complete the Dutch version of the Oral Health Impact Profile-14 (OHIP-14) daily during the first postoperative week. Postoperative pain, swelling, limited mouth opening, chewing ability and infection were also recorded. Furthermore, the effect of the impaction pattern, state of eruption, presence of preoperative pathology, patient health status according to the American Society of Anaesthesiologists score, gender, smoking on the postoperative OHIP-14 and pain scores were investigated.

Results: Thirty patients (16 males, 14 females) with a mean age of 71.2 (SD 8.3, range 60-91) years were included in the study. OHIP-14 and pain scores were highest on the first postoperative day and gradually declined during the first postoperative week. Patients who underwent coronectomy of a fully impacted mandibular third molar had significantly higher OHIP-14 scores on the first postoperative day than those who underwent coronectomy on a (partially) erupted mandibular third molar. We did not observe any postoperative complications up to 1 year after the surgery.

Conclusion: Mandibular third molar coronectomy seems to present a valid treatment option in older adults.

Background: The increasing geriatric population in India needs special attention from the oral health workforce. This study explores dental teachers' perceptions of the status of geriatric dentistry in the dental curriculum and the challenges of implementing geriatric dentistry curriculum in the present dental training sector in India from the trainers' (teachers) perspective.

Methods: We utilised a qualitative approach, and four focus group discussions were conducted with/among various levels of academic teachers-Heads of Departments (n = 8), Board of Study members (n = 7), Deans (n = 5), Lecturers and Associate professors (n = 8). All discussions were audio-taped and transcribed. Data was analysed thematically, and coding was done using an inductive approach. Consensus on themes was achieved through deliberations.

Results: Three themes were identified-Unique challenges in managing geriatric patients (bordering on Dental care, Attitude, Awareness, Social issues and dependency on family); Current issues with provision of geriatric care (Curricular concerns-Teachers' training, Students' training, Instructional content, timing of delivery; Students' and trainers' attitudes; Infrastructural issues) and Strategies for advancement (Sensitisation of policymakers, Collaboration with other agencies, Modification in course design, Improved educational strategies and Shift in patient care delivery).

Conclusion: Trainers perceived a strong need to develop geriatric competencies among dental students. A geriatric dentistry curriculum based on local needs could ensure the success and sustenance of change. Introducing specialisation in geriatric dentistry would ensure quality oral care for the rising geriatric population. Innovative teaching strategies, interdisciplinary training and the use of newer technologies could aid in improved teaching of geriatric dentistry.

Objectives: Evaluate oral health care access and utilisation, while identifying the specific oral health needs of the Native American Elders within the Wampanoag Tribe of Gay Head (WTGH) on Martha's Vineyard Island.

Background: Elders, particularly the WTGH face notable issues in obtaining oral health care. This study addressed the oral health gaps within the WTGH Elders through a comprehensive community needs assessment.

Methods: Employing a mixed-methods approach, qualitative concept mapping interviews with stakeholders and tribe members, a quantitative survey was conducted, and deidentified billing codes were analysed.

Results: Concept mapping revealed limited availability of services, accessibility and transportation, insurance challenges, lack of a centralised database, tribal/national policy and health-related self-sufficiency. Quantitative data indicated that 65% of Elders faced challenges in accessing oral health care, and 48% reported experiencing an oral health issue in the last 12 months. Additionally, 23% did not receive oral health care during this period, with a significant portion having previously utilised services at the Martha's Vineyard Hospital Oral Health Clinic.

Conclusion: Establishing a formal relationship between the WTGH and an academic institution for creating a portable oral health clinic supervised by faculty and developing a structured referral system is essential. This initiative aims to dismantle barriers to oral health care, improve access, and meet the oral health needs among Elders while offering valuable educational experiences for students regarding diverse patient populations and access-to-care factors.

Objective: To explore older adults' perceptions, motivations and reasons for using and not replacing old and worn complete dentures over prolonged periods.

Materials and methods: In-depth, semi-structured interviews were conducted with Brazilian edentulous older adults who were wearing complete dentures which were at least 20 years old. A purposive sampling method was used to recruit participants from an existing waiting list of those referred to a hospital clinic for new dentures. The interviews were video-recorded, transcribed verbatim and analysed using thematic analysis.

Results: Sixty-two individuals were assessed and nine were included in the study, aged from 61 to 77 years (mean = 65.4), with seven (77.8%) of them women. The reported time using their current dentures ranged from 22 to 45 years (mean = 28). Content analysis revealed three main themes: the perception of the current dentures' condition after prolonged use; reasons for the prolonged use and non-replacement; and unsuccessful attempts to replace the dentures. Overall, participants acknowledged the poor condition of their dentures and did recognise the need for replacement. Several factors had prompted them to delay or temporarily forego replacement, with financial constraints being the main barrier. Some reported failed attempts to replace the dentures in the past years or months; however, challenging adaptation to the new prostheses led to them reverting back to their old dentures as a fallback solution.

Conclusion: Factors influencing prolonged denture use in older adults include a complex interplay of financial aspects, treatment awareness, access and personal factors. Dental professionals can play a pivotal role in promoting timely denture adjustment or replacement by addressing these factors through patient education and personalised care.