Merel C. Verhoeff, Karina E. Pigeaud, Danisha M. Tholen, Miranda Rezk, Frank Lobbezoo
Background
Parkinson's disease patients have poorer oral health than their healthy peers. Insight into their own experiences is vital for improving dental care.
Objective
To better understand the experiences of Parkinson's disease patients' with their oral health and dental care.
Materials and Methods
Eleven semistructured interviews with Parkinson's disease patients from the Netherlands were conducted. Data were analysed using thematic analysis to identify recurring themes and patterns.
Results
Participants' narratives revealed challenges in accessing dental treatment, primarily due to motor and communication difficulties. They also highlighted organisational barriers, such as appointment scheduling and awareness of care practitioners about Parkinson's disease patients' oral health. Furthermore, they expressed the urgent need for Parkinson's disease-specific dental education to (dental) care practitioners and research initiatives that focus on Parkinson's disease patients' oral health and dental care.
Conclusion
Parkinson's disease patients' experiences highlight the need for tailored care interventions and improvements in dental care systems.
{"title":"Oral Health and Dental Health Care Experiences of Patients From the Netherlands With Parkinson's Disease: A Qualitative Study","authors":"Merel C. Verhoeff, Karina E. Pigeaud, Danisha M. Tholen, Miranda Rezk, Frank Lobbezoo","doi":"10.1111/ger.12822","DOIUrl":"10.1111/ger.12822","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parkinson's disease patients have poorer oral health than their healthy peers. Insight into their own experiences is vital for improving dental care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To better understand the experiences of Parkinson's disease patients' with their oral health and dental care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Eleven semistructured interviews with Parkinson's disease patients from the Netherlands were conducted. Data were analysed using thematic analysis to identify recurring themes and patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants' narratives revealed challenges in accessing dental treatment, primarily due to motor and communication difficulties. They also highlighted organisational barriers, such as appointment scheduling and awareness of care practitioners about Parkinson's disease patients' oral health. Furthermore, they expressed the urgent need for Parkinson's disease-specific dental education to (dental) care practitioners and research initiatives that focus on Parkinson's disease patients' oral health and dental care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Parkinson's disease patients' experiences highlight the need for tailored care interventions and improvements in dental care systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 4","pages":"529-535"},"PeriodicalIF":1.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ger.12822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To provide policy-relevant evidence to reduce oral health disparities and improve dental care accessibility by considering characteristics of urban and rural areas.
Background
Individual and regional factors influence dental care access. Regional poverty and limited dental resources among older adults may contribute to unmet dental care needs due to cost.
Materials and Methods
A multilevel logistic regression analysis was conducted to examine the association between regional factors (regional deprivation, number of dentists per 10,000 and number of dental offices per 100,000) and unmet dental care needs due to cost. The analysis was adjusted for individual factors, such as sex, education, marital status, household income, subjective health status, chewing difficulty and limited daily activities, as determined by the 2021 Korean Community Health Survey (KCHS; n = 47,802).
Results
The prevalence of unmet dental care needs due to cost was 4.94% in urban and 4.80% in rural older adults. Individuals who lived in higher regional deprivation (poorer regions) were less likely to experience unmet dental care needs due to cost (OR = 0.66, 95% CI = 0.47–0.94) only in rural areas. Individuals residing in areas with a higher number of dentists per 10,000 were more likely to experience unmet dental care needs due to cost in urban (OR = 2.19, 95% CI = 1.01–4.73) and rural (OR = 1.97; 95% CI = 1.16–3.34). Household income and oral health status were the strongest predictors of unmet dental care needs due to cost.
Conclusions
The influence of regional poverty, dentist distribution and individual factors should be considered in developing policies to reduce the unmet dental care needs of older Koreans.
目的：结合城乡特点，为缩小口腔健康差距，提高口腔保健可及性提供政策依据。背景：个体和区域因素影响牙科保健的可及性。地区贫困和老年人有限的牙科资源可能会导致牙科保健需求未得到满足。材料与方法：采用多水平logistic回归分析，检验区域因素（区域贫困、每万名牙医数量和每10万名牙科诊所数量）与成本导致的未满足的牙科保健需求之间的关系。根据2021年韩国社区健康调查（KCHS）确定的个人因素，如性别、教育程度、婚姻状况、家庭收入、主观健康状况、咀嚼困难和有限的日常活动，对分析进行了调整；n = 47,802)。结果：城镇老年人因费用原因未满足牙科保健需求的比例为4.94%，农村老年人为4.80%。生活在较高地区贫困地区（较贫困地区）的个人由于成本原因（OR = 0.66, 95% CI = 0.47-0.94），仅在农村地区就不太可能经历未满足的牙科保健需求。由于城市（OR = 2.19, 95% CI = 1.01-4.73）和农村（OR = 1.97）的成本，居住在每万名牙医数量较高地区的个人更有可能经历未满足的牙科保健需求；95% ci = 1.16-3.34)。由于成本原因，家庭收入和口腔健康状况是未满足牙科保健需求的最强预测因子。结论：在制定政策时应考虑地区贫困、牙医分布和个人因素的影响，以减少韩国老年人未满足的牙科保健需求。
{"title":"Effect of Regional Deprivation and Dental Care Resources on the Unmet Dental Care Needs due to Cost of Older Individuals in South Korea","authors":"Ji-Yeon Lim, Ju-Mi Lee, Hae-Sung Nam","doi":"10.1111/ger.12823","DOIUrl":"10.1111/ger.12823","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To provide policy-relevant evidence to reduce oral health disparities and improve dental care accessibility by considering characteristics of urban and rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Individual and regional factors influence dental care access. Regional poverty and limited dental resources among older adults may contribute to unmet dental care needs due to cost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A multilevel logistic regression analysis was conducted to examine the association between regional factors (regional deprivation, number of dentists per 10,000 and number of dental offices per 100,000) and unmet dental care needs due to cost. The analysis was adjusted for individual factors, such as sex, education, marital status, household income, subjective health status, chewing difficulty and limited daily activities, as determined by the 2021 Korean Community Health Survey (KCHS; <i>n</i> = 47,802).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of unmet dental care needs due to cost was 4.94% in urban and 4.80% in rural older adults. Individuals who lived in higher regional deprivation (poorer regions) were less likely to experience unmet dental care needs due to cost (OR = 0.66, 95% CI = 0.47–0.94) only in rural areas. Individuals residing in areas with a higher number of dentists per 10,000 were more likely to experience unmet dental care needs due to cost in urban (OR = 2.19, 95% CI = 1.01–4.73) and rural (OR = 1.97; 95% CI = 1.16–3.34). Household income and oral health status were the strongest predictors of unmet dental care needs due to cost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The influence of regional poverty, dentist distribution and individual factors should be considered in developing policies to reduce the unmet dental care needs of older Koreans.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 4","pages":"536-544"},"PeriodicalIF":1.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ger.12823","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Dietary n-6 and n-3 Polyunsaturated Fatty Acids and Tooth Loss in Community-Dwelling Older Japanese People","authors":"Akihiro Yoshihara, Masanori Iwasaki, Kana Suwama, Ayuko Odajima, Keiko Kabasawa, Yumi Ito, Junta Tanaka","doi":"10.1111/ger.12819","DOIUrl":"10.1111/ger.12819","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher n-3 fatty acid intake (5th quintile, incidence rate ratio (IRR): 0.21, <i>p</i> < 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, <i>p</i> = 0.006) was associated with the likelihood of tooth loss. Younger age, flossing and adequate chewing ability were associated with better dental outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 4","pages":"521-528"},"PeriodicalIF":1.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779753","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}
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.
{"title":"Subjectively Low Oral Function Is Associated With Physical Frailty and Polypharmacy in Community-Dwelling Older Adults","authors":"Aya Hirata, Masahiro Ishizaka, Akihiro Yakabi, Kaoru Kobayashi, Akihiro Ito, Tsuyoshi Hara, Tomohiko Urano","doi":"10.1111/ger.12818","DOIUrl":"10.1111/ger.12818","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Older people who are physically frail and taking multiple medications are likely also to have oral frailty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 4","pages":"514-520"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752197","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}
<div> <section> <h3> Background</h3> <p>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.</p> </section> <section> <h3> Aim</h3> <p>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.</p> </section> <section> <h3> Methods</h3> <p>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.</p> </section> <section> <h3> Results</h3> <p>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.</p> </section> <section> <h3> Conclusions</h3> <p>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 c
{"title":"Policy Options to Complement the New Canadian Dental Program Enabling High Quality Care for People With Disabilities and Older Adults","authors":"Logan D. Davari, Martin Morris, Paul J. Allison","doi":"10.1111/ger.12813","DOIUrl":"10.1111/ger.12813","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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 c","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 3","pages":"307-320"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ger.12813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Basel Kharbot, Maike Riegel, Falk Schwendicke, Sebastian Paris, Gerd Göstemeyer
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.
{"title":"Accuracy and Reliability of Intraoral 3D Scans for Diagnostic Evaluations in Nursing Home Residents","authors":"Basel Kharbot, Maike Riegel, Falk Schwendicke, Sebastian Paris, Gerd Göstemeyer","doi":"10.1111/ger.12817","DOIUrl":"10.1111/ger.12817","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the accuracy and reliability of intraoral 3D scans for assessing the oral health of older patients living in nursing homes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>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 (<i>κ</i>) were calculated to evaluate inter-examiner and intra-examiner reliability after re-examination by all examiners after a minimum interval of 3 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>κ</i>: 1), very good for the detection of restorations (0.94), and good for caries or insufficient oral hygiene (0.73 and 0.72, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Scans were suitable for basic diagnostic evaluations but showed considerable shortcomings in detecting caries and poor oral hygiene. Assessing scans was relatively reliable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>Using scans may allow telemedical assessments of nursing home residents, but users should be aware of the differential accuracy for different diagnostic targets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 4","pages":"507-513"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ger.12817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Salmi Annina, Nykänen Irma, Välimäki Tarja, Koponen Sohvi, Savela Roosa-Maria, Schwab Ursula, Suominen Anna Liisa
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
目的：本研究旨在评估个体化口腔健康干预对60岁及以上家庭照顾者及其受照顾者口腔卫生和健康的影响。背景：老年人保留天然牙齿的时间更长。牙齿和口腔健康的受损状况增加了功能能力恶化的风险。有针对性的早期干预对今后预防口腔健康问题起着重要作用。材料和方法：本研究是一项为期6个月的干预研究和6个月的随访，是LENTO（照顾者的生活方式、营养和口腔健康）研究的一部分。样本包括生活在芬兰东部的家庭照顾者和他们的照顾对象。在基线时，总样本包括239人（124名家庭照顾者和115名接受照顾者），他们被随机分配到干预组或对照组。在干预组中，家庭照顾者接受了量身定制的口腔健康干预。结果：家庭照顾者（β = -2.1, CI -4.0-(-1.2), p = 0.015）和受照顾者（β = -0.6, CI -0.0-(-2.1), p = 0.050）的牙菌斑数量减少。参与干预的家庭照顾者的龋齿数量减少（β = -0.6, CI -1.1-(-0.1), p = 0.015），但接受护理者的龋齿数量没有减少。结论：我们的研究表明，量身定制的信息有效地促进了老年人的口腔清洁。此外，在家庭照顾者中，龋齿的数量减少了。因此，可以建议在一般的卫生保健系统中实施这些关于口腔卫生的信息和教育。此外，有必要采取跨专业的方法来促进老年人这一弱势群体的口腔健康。试验注册：ClinicalTrials.gov NCT04003493。2019年6月28日注册。
{"title":"The Effect of an Individually Tailored Oral Health Intervention on Dental Plaque and Caries Among Family Caregivers and Their Care Recipients","authors":"Salmi Annina, Nykänen Irma, Välimäki Tarja, Koponen Sohvi, Savela Roosa-Maria, Schwab Ursula, Suominen Anna Liisa","doi":"10.1111/ger.12814","DOIUrl":"10.1111/ger.12814","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The number of teeth with plaque decreased among family caregivers (<i>β</i> = −2.1, CI −4.0–(−1.2), <i>p</i> = 0.015) and their care recipients (<i>β</i> = −0.6, CI −0.0–(−2.1), <i>p</i> = 0.050). The number of teeth with caries decreased among family caregivers who participated in the intervention (<i>β</i> = −0.6, CI −1.1–(−0.1), <i>p</i> = 0.015), but not among their care recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov NCT04003493. Registered on June 28, 2019</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 4","pages":"495-506"},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700261","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}
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.
{"title":"Oral Health Management by Dental Hygienists and Older Adults' Food Forms in Long-Term Care Facilities: A 1-Year Longitudinal Study","authors":"Kaoru Inamoto, Kimiya Ozaki, Yutaka Watanabe, Yutaka Yamazaki, Yuki Ohara, Masanori Iwasaki, Hirohiko Hirano, Midori Tsuneishi, Tsuyoshi Kodama, Mitsuyoshi Yoshida, Shunsuke Minakuchi","doi":"10.1111/ger.12810","DOIUrl":"10.1111/ger.12810","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>OHM involves oral health maintenance by dental hygienists and may prevent weight loss and pneumonia in older adults admitted to LTCFs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Older adults in LTCFs in Japan (<i>n</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 3","pages":"416-428"},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656723","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}
John K. Brooks, Natalie Portillo, Arsalan K. Bhatti, Azin Parsa, John R. Basile
Objective
This report describes an unusual case of a lateral periodontal cyst (LPC) residing between the roots of a mandibular first and second molar.
Background
The LPC is a developmental odontogenic cyst, the majority situated along the lateral roots of the mandibular canines and premolars. The occurrence of an LPC solely confined to the molar region is extremely rare. Limited information regarding the LPC has appeared in the geriatric literature.
Patient Presentation
A unilocular cyst-like lesion was incidentally discovered on extraoral and intraoral radiographic examinations involving a 68-year-old patient. It was initially considered an infected odontogenic keratocyst or unicystic ameloblastoma.
Results
Histologic examination of the excised specimen revealed a thin cuboidal epithelial lining with focal nodular thickenings and underlying fibrovascular connective tissue wall. The lesion was diagnosed as an LPC. At a 6-month follow-up, the patient has remained asymptomatic and exhibited radiographic osseous regeneration.
Conclusions
The LPC should be added to the differential diagnosis of developmental odontogenic cysts found in the inter-molar region. A preoperative cone beam computed tomography scan may be helpful to optimise the surgical approach. Timely removal of any suspected cystic lesion, particularly in the context of infection in an older patient, may reduce postoperative sequelae and rule out malignancy.
{"title":"Lateral periodontal cyst in an interdental molar site: Novel presentation in a geriatric patient","authors":"John K. Brooks, Natalie Portillo, Arsalan K. Bhatti, Azin Parsa, John R. Basile","doi":"10.1111/ger.12759","DOIUrl":"https://doi.org/10.1111/ger.12759","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This report describes an unusual case of a lateral periodontal cyst (LPC) residing between the roots of a mandibular first and second molar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The LPC is a developmental odontogenic cyst, the majority situated along the lateral roots of the mandibular canines and premolars. The occurrence of an LPC solely confined to the molar region is extremely rare. Limited information regarding the LPC has appeared in the geriatric literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient Presentation</h3>\u0000 \u0000 <p>A unilocular cyst-like lesion was incidentally discovered on extraoral and intraoral radiographic examinations involving a 68-year-old patient. It was initially considered an infected odontogenic keratocyst or unicystic ameloblastoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histologic examination of the excised specimen revealed a thin cuboidal epithelial lining with focal nodular thickenings and underlying fibrovascular connective tissue wall. The lesion was diagnosed as an LPC. At a 6-month follow-up, the patient has remained asymptomatic and exhibited radiographic osseous regeneration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The LPC should be added to the differential diagnosis of developmental odontogenic cysts found in the inter-molar region. A preoperative cone beam computed tomography scan may be helpful to optimise the surgical approach. Timely removal of any suspected cystic lesion, particularly in the context of infection in an older patient, may reduce postoperative sequelae and rule out malignancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"42 1","pages":"124-128"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521988","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}
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