Saúde bucal e condições sistêmicas em idosos da Baixada Fluminense: coorte retrospectivo / Oral health and systemic conditions in elderly people from Baixada Fluminense: retrospective cohort

O equilíbrio sistêmico e a saúde bucal são condições clínicas que estabelecem entre si uma relação multidimensional capaz de exercer grande impacto sobre o bem-estar cotidiano do indivíduo. As disfunções metabólicas associadas ao estado nutricional e a perda da capacidade muscular geram uma maior necessidade de cuidados em pessoas idosas. Sob o ponto de vista odontológico a presença de dentes naturais bem como o grau de doença periodontal, estão associados a competência mastigatória e, desta forma, são fatores determinantes na saúde da população acima dos 60 anos de idade. O presente estudo teve como objetivo avaliar, através da análise retrospectiva dos últimos 05 anos, a relação entre a saúde bucal e as condições sistêmicas de indivíduos acima de 60 anos residentes na Baixada Fluminense (Rio de Janeiro/Brasil) com evidente crescimento demográfico populacional. Para isso foram analisados 11.390 prontuários de pacientes usuários da Clínica Odontológica da Universidade Iguaçu/RJ sendo selecionados 1.125 que atendiam aos critérios de inclusão. Os resultados destacam a presença de doença periodontal em cerca de 56% dos indivíduos diabéticos, além de 43% com quadro hipertensivo no momento do atendimento apontando para uma importante relação entre a atenção com a saúde bucal da população assistida nessa região e suas condições sistêmicas.

Systemic balance and oral health are clinical conditions that establish a multidimensional relationship capable of having a great impact on the individual's daily well-being. Metabolic dysfunctions associated with nutritional status and loss of muscle capacity generate a greater need for care in the elderly. From the dental point of view, the presence of natural teeth, as well as the degree of periodontal disease, are associated with masticatory competence and, thus, are determining factors in the health of the population over 60 years of age. The present study aimed to describe descriptively, through the retrospective analysis of the last 05 years, the relationship between oral health and the systemic conditions of individuals over 60 years old living in the Baixada Fluminense (Rio de Janeiro / Brazil) with evident population demographic growth. For that purpose, 11,390 medical records of patients who were users of the Clínica Odontológica of Universidade Iguaçu / RJ were analyzed, 1,125 who met the inclusion criteria were selected. The results highlight the presence of periodontal disease in about 56% of diabetic individuals, in addition to 43% with the hypertensive condition at the time of care, pointing to an important relationship between the attention to the oral health of the assisted population in this region and their systemic conditions.

Autopercepção da saúde bucal e fatores associados em pessoas idosas quilombolas: um estudo de base populacional / Self-perception of oral health and associated factors in quilombola older people: a population-based study

Resumo Objetivo investigar a autopercepção das condições bucais e fatores associados em idosos quilombolas rurais do norte de Minas Gerais, Brasil. Método Trata-se de um estudo analítico e transversal de base populacional, no qual utilizou-se uma amostragem por conglomerados com probabilidade proporcional ao tamanho (n=406). A coleta de dados envolveu a realização de entrevistas e exames clínicos odontológicos. A autopercepção das condições bucais foi avaliada por meio do GOHAI (Índice de Determinação da Saúde Bucal Geriátrica). Resultados A maioria dos idosos autopercebeu a saúde bucal como ótima (46,3%) ou regular (30,2%). Os pesquisados revelaram ainda precária saúde bucal e acesso restrito aos serviços odontológicos. Verificaram-se, na análise múltipla, associações significantes (p˂0,05) entre GOHAI regular e variáveis relativas ao local da última consulta e uso de prótese, bem como entre GOHAI ruim e variáveis atinentes ao estado conjugal, religião, motivo da última consulta, índice CPO-D e uso de prótese. Conclusão Parcela expressiva dos idosos quilombolas manifestou uma autoavaliação mais positiva da saúde bucal, divergente do quadro odontológico constatado profissionalmente. Constatou-se ainda que o relato de percepção ruim das condições bucais esteve fortemente associado a uma saúde bucal mais precária entre os investigados.

Abstract Objective to investigate self-perception of oral conditions and associated factors in rural quilombola older people in northern Minas Gerais, Brazil. Method This is an analytical and cross-sectional population-based study, in which cluster sampling with probability proportional to size (n=406) was used. Data collection involved conducting interviews and clinical dental examinations. Self-perception of oral conditions was assessed using the GOHAI (Geriatric Oral Health Determination Index). Results Most older people self-perceived oral health as excellent (46.3%) or regular (30.2%). Those surveyed also revealed precarious oral health and restricted access to dental services. In the multiple analysis, significant associations (p˂0.05) were found between regular GOHAI and variables related to the location of the last consultation and use of prosthesis, as well as between poor GOHAI and variables related to marital status, religion, reason for last consultation, CPO-D index and use of prosthesis. Conclusion A significant portion of the quilombola older people showed a more positive self-assessment of oral health, which differs from the professionally verified dental condition. It was also found that the report of poor perception of oral conditions was strongly associated with poorer oral health among those investigated.

Xerostomia and dysgeusia in the elderly: prevalence of and association with polypharmacy

Xerostomia is defined as the perception of dry mouth, and dysgeusia, as a change in taste. Both are common complaints in the elderly, especially among those making use of polypharmacy drug combinations. Aim: This study aimed to determine the prevalence of xerostomia and dysgeusia and to investigate their association with polypharmacy in the elderly. Methods: older people under follow-up at the Multidisciplinary Elderly Center of the University Hospital of Brasília were interviewed and asked about health problems, medications used, presence of xerostomia and dysgeusia. Descriptive statistics were used to determine the prevalence of the symptoms surveyed. The chi-square test was used to investigate the relationship between xerostomia and dysgeusia and polypharmacy. Secondary associations were performed using binomial logistic regression. Results: Ninety-six older people were evaluated and of these, 62.5% had xerostomia and 21.1%, had dysgeusia. The average number of medications used was 4±3 medications per individual. Polypharmacy was associated with xerostomia but not dysgeusia. It was possible to associate xerostomia with the use of antihypertensive drugs. Conclusion: Xerostomia was a frequent complaint among elderly people making use of polypharmacy, especially those using antihypertensives. Antihypertensives and antidepressants were used most drugs by the elderly and exhibited interactions with drugs most prescribed in Dentistry. Two contraindications were found between fluconazole and mirtazapine; and between erythromycin and simvastatin

Conhecimento, necessidade e preferência acerca da odontologia domiciliar e condições de saúde bucal de idosos domiciliados: um estudo transversal / Knowledge, needs and preferences regarding home dentistry and oral health conditions of homebound elderly people: a cross-sectional study

O trabalho visa compreender o conhecimento, preferência e necessidade de atendimento odontológico domiciliar, além de identificar a condição de saúde bucal dos idosos domiciliados e seus fatores associados. Trata-se de dois web surveys, sendo o primeiro com a população adulta escolarizada e o segundo com a população idosa. Além disso, também foi realizado um estudo com dados secundários de prontuários de idosos que utilizaram algum serviço de atendimento odontológico domiciliar para identificar a condição de saúde bucal destes. Nos três estudos foram realizadas análise descritiva, teste do qui-quadrado e regressão robusta de Poisson com um nível de significância de 5%, tendo sido usado no último estudo a análise de Cluster de dois passos, previamente à regressão, para identificar grupos de pessoas idosas em relação à condição dentária e de reabilitação. No primeiro estudo, 443 respondentes participaram, cuja predominância foi de mulheres (67,9%) e na faixa etária de 31 a 40 anos (38,8%). A maioria dos participantes (69,5%) não conhecem o que é atendimento odontológico domiciliar. No segundo estudo, 203 idosos participaram, sendo 67% mulheres, na faixa de idade de 60 a 69 anos. A maioria dessa população não conhece a odontologia domiciliar (79,8%), nunca fez uso desse tipo de serviço (95,6%) e preferem ser atendidos em consultório odontológico (68,5%). Houve associação significativa entre conhecer a Odontologia domiciliar e ter plano de saúde médico. Foi observado ainda que aqueles idosos que não têm plano de saúde e com nível de escolaridade mais baixo preferem ser atendidos em casa em relação ao consultório tradicional. No terceiro estudo, 207 prontuários de idosos foram avaliados, cujo sexo predominante foi o feminino (58,5%), com faixa de idade 80 a 89 anos e parcialmente dependentes para atividades básicas de vida diária. Em relação à condição de saúde bucal, o CPOD médio foi de 23,5, com 3,35 pares em oclusão, sendo 75,8% edêntulos funcionais. Nos prontuários, 53,6% das pessoas idosas possuíam sangramento à sondagem em algum sextante e cerca de 20% apresentavam lesão em tecido mole. Os pacientes com mais lesões foram os idosos mais jovens, diabéticos e que foram ao dentista há mais tempo. Em relação à questão periodontal, moradores de residência individual possuem mais sangramento à sondagem. Em relação à condição dentária e de reabilitação, dois clusters foram produzidos, sendo o primeiro com idosos edêntulos e pouco reabilitados e o segundo com idosos mais dentados e reabilitados. Idosos negros e que não possuem plano de saúde estiveram mais presentes no primeiro cluster. A população em geral e idosa pouco conhece e percebe que necessitam da atenção odontológica domiciliar. Como consequência, a população idosa mais independente ainda prefere ser atendida em consultório. Ademais, a condição de saúde bucal de pacientes que utilizam atendimento odontológico domiciliar ainda é precária, fruto de uma assistência odontológica mutiladora, caracterizando o cenário desigualdade social entre as pessoas idosas domiciliadas (AU).

The study is to understand the knowledge, preference and need for dental home care addition to identifying the oral health condition of the elderly living in residence and its associated factors. Two studies are web surveys, the first with the educated adult population and the second with the elderly population. The last study was a study with secondary data from medical records of elderly people who used a home dental care service to identify their oral health condition. In three was used studies, descriptive analysis, chi-square test and robust Poisson regression were performed with a significance level of 5%, and in the last study the two-step Cluster analysis , prior to the regression, to identify groups of people elderly in relation to dental and rehabilitation status. In study number one 443 respondents participated, whose predominance was women (67.9%) and aged between 31 and 40 years (38.8%). Most participants (69.5%) don't know about home dental care. At the study number two, 203 elderly people participated, 67% of whom were women, aged between 60 and 69 years. Most of the population doesn't know about home dentistry (79.8%), has never used this type of service (95.6%) and prefers to go to the dental office (68.5%). There is a significant association between knowing about home dentistry and having a medical health plan. And those elderly people who do not have health insurance and have little education prefer to be cared for at home compared to the traditional dental office. In study three, 207 medical records of the elderly were evaluated, whose predominant sex was female (58.5%), aged 80-89 years and partially dependent for basic activities of daily living. In terms of oral health status, the mean CPOD was 23.5, with 3.35 pairs in occlusion, 75.8% of whom were functional edentulous. In the medical records, 53.6% of the elderly had bleeding on probing in some sextant and about 20% had a soft tissue lesion. Patients with more injuries were the younger elderly, diabetics and those who had been to the dentist for a longer period of time. With bleeding the probing were residents of individual residences. Two clusters were produced, the first with edentulous and poorly rehabilitated elderly and the second with more dentate and rehabilitated elderly. Black elderly people who don't have health insurance were more present in the first cluster. The population and elderly don't know and realizes that they need home dental care. As a result, the more independent elderly population still prefers to be seen in the office. Furthermore, the oral health condition of patients who use home dental care is still precarious, as a result of mutilating dental care, characterizing the scenario of social inequality among elderly people living in domicile (AU).

Tego: a new concept of teledentistry for the elderly through a web platform and mobile app in the context of the covid-19 pandemic / Tego: un nuevo concepto de teleodontología para adultos mayores a través de una plataforma web y aplicación móvil en el contexto de la pandemia del covid-19

Objective: To develop a new concept of teledentistry for the elderly through a web platform and associated mobile application in the context of the COVID-19 pandemic. Material and Methods: A new concept for attention via teledentistry of the elderly supported by the web platform/app TEGO (Acronym for Tele-platform of Geriatric and Dental Specialties in Spanish) was developed. Priority and urgent dental care for elderly patients in the context of the COVID-19 pandemic was provided onboard a mobile dental clinic equipped with all the necessary conventional dental care facilities as well as state-of-the-art digital technology. Dental care was carried out in five cities of Chile. For the study, 135 elderly patients were treated. The tele-dental care model includes visit-appointment and remote interconsultation with a staff of specialists. To evaluate patient satisfaction aspects, regarding the service / care provided, a user satisfaction survey was applied. Results: A total of 68 questionnaires were completed by patients. The results showed high levels of patients' satisfaction after the priority or urgent dental care, which reached above 75% in all dimensions of the questionnaire (Access to dental care, user treatment, platform, recommendation). Conclusion: The generation of a technological ecosystem for teledentistry can provide a series of important advantages in the attention of elderly patients, by optimizing the dental care coverage by different specialists who can provide attention to a population that has limited or no access to them.

Objetivo: Desarrollar un nuevo concepto de teleodon-tología para adultos mayores a través de una plataforma web y aplicación móvil asociada en el contexto de la pandemia de COVID-19. Material y Métodos: Se desarrolló un nuevo concepto de atención vía teleodontología del adulto mayor apoyado en la plataforma/app web TEGO (Teleplataforma de Especialidades Geriatricas y Odontológicas). La atención dental prioritaria y urgente para pacientes de edad avanzada en el contexto de la pandemia de COVID-19 se brindó a bordo de una clínica dental móvil equipada con todas las instalaciones de atención dental convencional necesarias, así como con tecnología digital de última generación. La atención odontológica se realizó en cinco ciudades de Chile. Para el estudio, 135 pacientes de edad avanzada fueron atendidos. El modelo de atención teledental incluye visita-cita e inter-consulta remota con un staff de especialistas. Para evaluar los aspectos de satisfacción del paciente, respecto al servicio/atención brindada, se aplicó una encuesta de satisfacción del usuario. Resultados: Los pacientes completaron un total de 68 cuestionarios. Los resultados mostraron altos niveles de satisfacción de los pacientes tras la atención odontológica prioritaria o urgente, que superó el 75% en todas las dimensiones del cuestionario (Acceso a la atención odontológica, trato al usuario, plataforma, recomendación). Conclusión: La generación de un ecosistema tecnológico para la teleodontología puede brindar una serie de ventajas importantes en la atención de pacientes adultos mayores, al optimizar la cobertura de atención odontológica por parte de diferentes especialistas que pueden brindar atención a una población que tiene acceso limitado o nulo.

Salud bucal en ancianos del Hogar Provincial de Sancti Spíritus / Oral health in the elderly of the Provincial Home of Sancti Spíritus

RESUMEN Fundamento: Las personas de edad avanzada requieren atención estomatológica ajustada a su salud bucal. Objetivo: Describir la salud bucal de los ancianos pertenecientes al Hogar Provincial de Sancti Spíritus. Metodología: Se realizó un estudio observacional descriptivo transversal en el Hogar de ancianos provincial de Sancti Spíritus, entre diciembre de 2019 y agosto 2020. Se seleccionaron 72 ancianos, según criterios de inclusión. Se utilizaron métodos del nivel teórico, empírico y estadístico para estudiar las variables: Enfermedades bucales, factores de riesgo, higiene bucal, nivel de conocimientos sobre salud bucal y autopercepción de salud bucal. Resultados: En los ancianos predominó la enfermedad periodontal (29.4 %) y la disfunción masticatoria (28.6 %); los factores de riesgo que se observaron fueron la alimentación azucarada (12.8 %) y la diabetes mellitus (12.5 %), la higiene bucal deficiente (58.3 %), el nivel de conocimientos malo (51.4 %) y la autopercepción de salud bucal baja (54.2 %). Conclusiones: La salud bucal de los ancianos estudiados se caracterizó por presentar enfermedad periodontal y disfunción masticatoria en casi la tercera parte, con predominio de la alimentación azucarada y la diabetes mellitus como factores de riesgo y más de la mitad presentó higiene bucal deficiente, nivel de conocimientos malo y baja autopercepción de salud bucal.

ABSTRACT Background: Elderly people require dental care adjusted to their oral health. Objective: To describe the oral health of the elderly belonging to the Provincial Home of Sancti Spíritus. Methodology: A cross-sectional descriptive observational study was carried out in the Provincial Nursing Home of Sancti Spíritus, between December 2019 and August 2020. 72 elderly were selected, according to inclusion criteria. Theoretical, empirical and statistical level methods were used to study the variables: oral diseases, risk factors, oral hygiene, level of knowledge about oral health and self-perception of oral health. Results: In the elderly, periodontal disease (29.4 %) and masticatory dysfunction (28.6 %) predominated; the risk factors that were observed were sugary diet (12.8 %) and diabetes mellitus (12.5 %), poor oral hygiene (58.3%), poor level of knowledge (51.4 %) and low self-perception of oral health (54.2 %). Conclusion: The oral health of the elderly studied was characterized by presenting periodontal disease and masticatory dysfunction in almost a third of them, with a predominance of sugary diets and diabetes mellitus as risk factors, and more than half presented poor oral hygiene, level of poor knowledge and low self-perception of oral health.

Relationship between tooth loss, nutritional status and consumption of macro and micronutrients in elderly people from southern Brazil

Maintaining a functional natural dentition plays an important role in keeping a satisfactory nutritional status. The aim of this study was to evaluate the relationship between oral health conditions determined by the presence of edentulism and the number of missing teeth, nutritional status and consumption of nutrients by the elderly. This cross-sectional study comprised 494 independent elderly of both genders, over 60 years of age, registered at the Brazilian public health service in Londrina, southern Brazil. The data collection included: oral examinations; anthropometric measurements by calculating the Body Mass Index (BMI); analysis of food consumption based on a multiple pass 24-hour dietary recall and a food intake frequency questionnaire; and structured interviews to obtain sociodemographic information. Multiple linear regression, the Fisher's Exact test, chi-square and Mann-Whitney tests, were applied at a 5% significance level. The prevalence of edentulism was 47.3%; this predominated in females, age group from 65 to 74 years, low education level and low/medium economic classification. A larger numberof underweight and fewer number of overweight elderly were recorded among the edentulous versus dentate participants (< 0.0001). Significantly lower consumption of several nutrients, as well as fruit, was recorded among the edentulous group. In particular, carbohydrates, vitamins (B1, B9 and C), and the majority of the minerals studied were associated with a larger number of missing teeth. In conclusion, tooth loss was associated with the food consumption pattern of some macro-and micronutrients and the nutritional status of the Brazilian elderly.

Impacto del tratamiento de adultos mayores con ISRS y su relación con los tratamientos odontológicos / The impact of treating older adults with SSRI and its relationship with dental treatments

La población mayor de 60 años es el grupo etario de mayor crecimiento en el mundo. Debido a que la depresión es una patología frecuente en la persona adulta mayor y anciana, los inhibidores de la recap- tación de la serotonina (ISRS) son el tratamiento de primera línea de elección. Este trabajo referencia la asociación del consumo de estos fármacos con la disminución de la densidad ósea mineral (DMO), el riesgo de fracturas y su repercusión en la atención odontológica. Además, incluye una breve descripción de la homeostasis ósea y la relación depresión-carga alostática. El trabajo interdisciplinario y una correcta anamnesis pueden detectar posibles complicaciones y riesgos vinculados con este tipo de medicamen- tos. Ello facilitaría un mejor manejo, más aún en el adulto mayor, donde una pequeña variable puede repercutir en su integridad (AU)

The population over 60 is the fastest growing age group in the world. Depression is a frequent pathology in the elderly and the elderly, with serotonin reuptake inhibitors (SSRI) being the 1st line treatment of choice. The association of the consumption of this drug with a decrease in bone mineral density (BMD), risk of fractures and its impact on dental care are referenced in this work. In addition, it includes a brief description of bone homeostasis and the depression-allostatic load relationship. Interdisciplinary work and a correct anamnesis can detect possible complications and risks linked to this type of medication, facilitating better management and even more so in the elderly, where a small variable can affect their integrity (AU)

Confiabilidade intra e interobservador de enfermeiro e cirurgião-dentista na avaliação e triagem das condições bucais de idosos institucionalizados / Intra- and interobserver reliability of nurses and dentists in the assessment and screening of oral conditions of institutionalized older adults

Introduction: older persons in Long-Term Care (LTC) facilities have functional impairments and a higher disease prevalence. Nurses' comprehensive assessment of older persons' health is highlighted, including using tools for screening dental treatment needs. Objective: to report the intra- and inter-observer reliability of older adults' oral health assessment in LTC facilities by video. Material and method: descriptive study, in three LTC facilities, in the Florianópolis region, Southern Brazil. Data were collected according to Oral Health Assessment Tool (OHAT), which presents 8 categories ("lips, tongue, gums/tissues, saliva, natural teeth, dentures, dental hygiene, and toothache"), and the scores 0=healthy, 1=presence of changes (could be a need for care), 2=unhealthy (need for dental service); final score from 0 to 16. In each LTC facility, a Nurse assessed oral conditions and made a video of each older adult using a smartphone. The dentist performed the oral health assessment through the videos. Estimated Kappa test, p<0.05. Result: the sample was 34 older adults, 71% were female. Interobserver reliability between Nurses 1 and 2 and Dentist for "lips" and "natural teeth" was classified as poor and excellent/very good for toothache and denture conditions. The nurse's intraobserver reliability was classified as weak for the "natural teeth" was classified as poor and excellent/very good for toothache and denture conditions. The nurse's intraobserver reliability was classified as weak for the "natural teeth" assessment. Conclusion: the OHAT showed reliability for assessing denture conditions and pain. However, nurses' training for recognizing oral conditions that require dental care is suggested, as well as the management of this action by the dentist and LTC facilities

Introdução: idosos em Instituições de Longa Permanência (ILPIs) possuem comprometimento da capacidade funcional e maior prevalência de agravos bucais. Destaca-se o papel do profissional enfermeiro na avaliação integral do idoso inclusive com instrumentos para identificação e encaminhamento para tratamento odontológico. Objetivo: descrever a confiabilidade intra e interobservador, na avaliação da saúde bucal de idosos em ILPIs por vídeo. Material e método: estudo metodológico, em três ILPIs da Grande Florianópolis, Sul do Brasil. Foi utilizado o instrumento Avaliação da Saúde Bucal para Triagem Odontológica (ASBTO), que possui oito categorias ("lábios", "língua", "gengivas/tecidos", "saliva", "dentes naturais", "dentadura", "higiene" e "dor de dente"), segundo escores 0=saudável, 1=presença de alterações (podendo haver necessidade de atendimento), 2=não saudável (necessidade de atendimento) e escore final de 0 a 16. Um Enfermeiro, em cada ILPI, avaliou as condições bucais presencialmente e realizou vídeo com smartphone de cada idoso. Um cirurgião-dentista avaliou as condições bucais à partir desses vídeos. Foi estimado o teste de Kappa, p<0,05. Resultado: amostra de 34 idosos, 71% do sexo feminino. Confiabilidade interobservador entre os enfermeiros 1 e 2 e cirurgião-dentista para "lábios" e "dentes naturais" foi classificada como fraca e excelente/muito boa para dor de dente e condição das dentaduras segundo dois enfermeiros. Confiabilidade intraobservador dos enfermeiros foi classificada como fraca para avaliação dos "dentes naturais". Conclusão:o ASBTO mostrou-se confiável na avaliação das condições de prótese e dor, entretanto sugerese maior capacitação dos Enfermeiros para o reconhecimento de condições bucais que requerem atendimento odontológico, assim como, a gestão deste processo pelo cirurgião-dentista e ILPIs

Tooth Loss, Sociodemographic Conditions and Oral Health-Related Quality of Life in the Elderly

Abstract Objective: To verify the association between impacts produced by tooth loss and sociodemographic variables in the oral health-related quality of life (OHRQoL) in the elderly. Material and Methods: This is an analytical cross-sectional study carried out in the municipality of Vitória/ES, Brazil, which sample was composed of 402 older adults. The Oral Health Impact Profile (OHIP-14) was used to measure the individuals' OHRQoL. For data analysis, descriptive and bivariate analyses were performed using the Fisher's exact test and the Mantel-Haenzsel test to assess the effects of combined dimensions. The significance level adopted was 5%. To assess the strength of association between independent variables and dimensions, Odds-Ratio (OR) with 95% confidence interval (CI) was calculated. Results: The prevalence of negative impact on OHRQoL in the elderly was 32.6%. The greatest impact perception was found in individuals with up to 10 years of schooling (p=0.021 and OR=1.602), with need for removable partial dentures (p=0.000 and OR=2.873) and those who did not accept the loss of dental elements (p=0.000 and OR=3.064). Conclusion: Older female adults with socioeconomic class C/D-E, with up to 10 years of schooling, who lost 11 or more teeth, who declared the need for removable partial dentures, suffered greater impacts caused by tooth loss on OHRQoL.

Caracterización del estado de salud bucal de la población geriátrica / Characterization of oral health status in an older population

RESUMEN La vejez, si no es un divino tesoro, resulta un preciado don que en la actualidad disfrutan más de 600 millones de personas mayores de 60 años. El objetivo de esta investigación fue determinar el estado de salud bucal de la población geriátrica correspondiente al consultorio 21-21 del municipio Santa Clara. Se realizó un estudio observacional, descriptivo y de corte transversal en el consultorio 21-21 perteneciente al Policlínico Universitario «XX Aniversario» del municipio Santa Clara, entre enero 2017 - septiembre 2018. En la población de estudio predominó el sexo femenino y el grupo de edad de 70-74 años. La enfermedad sistémica encontrada con mayor frecuencia fue la hipertensión arterial y el principal problema bucal fue la dificultad masticatoria. El nivel de conocimiento de la población se clasificó como regular. Los ancianos presentaban gran variedad de enfermedades sistémicas y bucales, lo que se corresponde con el deterioro propio de la edad.

ABSTRACT Old age, if not a divine treasure, is a precious gift that is currently enjoyed by more than 600 million people over 60 years old. The objective of this research was to determine the oral health status in an older population belonging to the 21-21 doctor's office from Santa Clara municipality. A cross-sectional, descriptive and observational study was carried out in the 21-21 doctor's office belonging to "XX Aniversario" University Polyclinic from Santa Clara municipality, between January 2017 and September 2018. The study population was predominantly female and aged 70-74 years. Hypertension was the most common systemic disease found and masticatory difficulty was the main oral problem. The level of knowledge of the population was classified as fair. The elderly had a wide variety of systemic and oral diseases, which corresponds to age-related deterioration.

Autopercepción y condición de salud bucal en el anciano / Self-perception of oral health in the elderly and oral health condition

Introducción: Debido al aumento en la esperanza de vida y, en consecuencia, al aumento en el número de personas mayores, la asociación entre los estados de salud se vuelve relevante en términos de salud pública, ya que además de los años vividos, la calidad de vida de estos pacientes es importante. Objetivo: Evaluar la autopercepción y el estado de salud bucal en personas mayores. Métodos: Estudio observacional, de corte transversal (enero-julio del 2019) en el que se realizaron cuestionarios GOHAI (índice de evaluación de la salud oral geriátrica) y el cuestionario sobre el tipo, el tiempo de uso y la limpieza de las prótesis dentales, el cáncer oral y los datos socioeconómicos. La presencia de posibles lesiones orales también se evaluó mediante examen clínico. Los sujetos incluidos en la muestra eran ancianos (60 años o más) que asistían a las unidades de salud de Aracaju. Resultados: Participaron 55 mujeres y ocho hombres. Al evaluar el índice de evaluación de la salud oral geriátrica, se verificó que el 47,6 por ciento de la muestra tenía una mala percepción de la salud oral. Se encontraron asociaciones entre el índice de evaluación de la salud oral geriátrica entre la última visita al dentista, la adaptación de la prótesis dental y las heridas bucales (p < 0,05). Las lesiones orales más prevalentes fueron mucosa rojiza o irritada (35,7 por ciento) y eritroplasia (14,2 por ciento) y se detectó que el 76 por ciento de las prótesis tenían grietas o suciedad. El 77,7 por ciento de los participantes en el estudio solo utilizaban dentífrico como material de limpieza de la prótesis. Conclusión: La salud bucal autopercibida y las condiciones de salud bucal de los ancianos evaluados se consideraron deficientes, se observa la presencia de prótesis mal adaptadas y agrietadas, además de mucositis(AU)

Introduction: due to the increase in life expectancy and, consequently, to the increase in the number of elderly people, the association between health states becomes relevant in terms of public health, since in addition to the lived years the quality of life of these patients is important. Objective: evaluate the self-perception of oral health and check the oral health condition of the elderly. Methods: observational cross-sectional study (January to July / 2019) in which questionnaires were the GOHAI (Geriatric Oral Health Assessment Index) questionnaire and questionnaire about type, time of use and cleaning of dental prostheses, oral cancer and socioeconomic data. The presence of possible oral lesions was also assessed by clinical examination. The subjects included in the sample were elderly (60 years or older) attending the Aracaju Health Units. Results: fifty-five were female and eight male. When evaluating the Geriatric Oral Health Assessment Index, it is verified that 47.6 percent of the sample has poor self-perception of oral health. Associations were found between GOHAI Index for last visit to the dentist, dental prosthesis adaptation and mouth wound (p < 0.05). The most prevalent oral lesions were reddish or irritated mucosa (35.7 percent), followed by erythroplakia (14.2 percent), 76 percent of the prostheses had cracks or dirt. About the cleaning of the protests, 77.7 percent use only dentifrice as cleaning material. Conclusion: self-perceived oral health and oral health conditions of the elderly evaluated were considered poor, in the presence of poorly adapted and cracked prostheses, in addition to mucositis(AU)

Obesity is associated with lack of access to dental care and physical activity among older adults: a cross-sectional study / Obesidade está associada com falta de acesso a serviços odontológicos e atividade física em idosos: um estudo transversal

OBJECTIVE: This study evaluated the prevalence of obesity and associated factors among older adults. METHODS: This was a household-based cross-sectional study involving 282 individuals aged ≥ 60 years recruited in the city of Veranópolis, Brazil, using random probabilistic sampling. Participants underwent a clinical oral examination and completed a structured questionnaire. Obesitywas determined based on body mass index (BMI). Individuals were divided into two groups based on the presence (BMI ≥ 30 kg/m2) or absence of obesity (BMI < 30 kg/m2). Uni- and multivariate analyses were performed using Poisson regression with robust variance. RESULTS: The prevalence of obesity was 34% (n = 96). Each 1-year increase in age resulted in a 3.09% decrease in the likelihood of being classified as having obesity (prevalence ratio [PR] = 0.969; 95% confidence interval [95%CI] 0.949 ­ 0.989). Older adults that reported walking < 5 or ≥ 5 times per week were 39.65 and 37.20% less likely to be classified as obese. The PRs of obesity in former and non-smokers were 4.40 and 5 times higher, respectively, than in current smokers (p < 0.05). Older adults with no access to dental care were 51.72% (p = 0.013) more likely to present with obesity. CONCLUSIONS: There was a high prevalence of obesity among older adults. Obesity was associated with lower age, smoking status, no access to dental care, and a lack of physical activity

OBJETIVO: O presente estudo avaliou a prevalência de obesidade e fatores associados em idosos. METODOLOGIA: Um estudo transversal domiciliar, com amostragem probabilística, foi realizado com 282 indivíduos de idade ≥60 anos de Veranópolis, Brasil. Um exame clínico de saúde bucal foi realizado e um questionário estruturado foi aplicado. A obesidade foi determinada pelo Índice de Massa Corporal (IMC). Os indivíduos foram categorizados com obesidade (IMC ≥ 30kg/m2) e sem obesidade (IMC < 30kg/m2). Análises uni e multivariadas foram feitas por meio de regressão de Poisson com variância robusta. RESULTADOS: A prevalência de obesidade foi de 34% (n = 96). Cada ano de aumento na idade resultou em uma diminuição de 3,09% (razão de prevalência [RP] = 0,969; intervalo de confiança de 95% [IC95%] = 0,949 ­ 0,989) na RP de ser do grupo de obesos. Idosos que reportaram caminhar < cinco ou ≥ cinco vezes por semana apresentaram menor RP para obesidade, 39,65 e 37,20%, respectivamente. Ex-fumantes e não fumantes obtiveram, respectivamente, 4,40 e 5 vezes maior RP de serem do grupo de obesos quando comparados aos fumantes (p < 0,05). Idosos sem acesso a serviços odontológicos demonstraram 51,72% (p = 0,013) maior RP de serem do grupo com obesidade. CONCLUSÕES: Houve uma alta prevalência de obesidade em idosos, que foi associada com menor idade, estado de fumo e ausência de acesso ao dentista e atividade física.

Salud oral integral para adultos de 60 años: un análisis territorial de su cobertura a 12 años de su implementación / Comprehensive oral health for adults 60 years of age: a territorial analysis of its coverage 12 years after its implementation

INTRODUCCIÓN. Las personas mayores en Chile tienen alta carga de morbilidad oral y de déficit funcional que afecta directamente su calidad de vida. El programa universal GES Salud Oral Integral del adulto de 60 años, implementado desde el 2007, permite a las personas de 60 años acceder a tratamiento odontológico integral, aunque a la fecha se tiene pocos antecedentes de sus resultados. El objetivo de este estudio es estimar la cobertura del programa GES 60 para el año 2019 de los beneficiarios FONASA y su variabilidad territorial desagregada por Servicio de Salud (SS), sexo y tipo de prestador (público o compra de servicios). MATERIALES Y MÉTODOS. Se realizó un estudio observacional ecológico, utilizando fuentes de datos secundarios de uso público (DEIS, FONASA). Se estimó la cobertura nacional total y por sexo, estratificada para cada SS. RESULTADOS. La cobertura del programa en el sector público de salud fue de un 22,8% el año 2019. La menor cobertura se observó en el SS Arica (5,3%) y la mayor en el SS Arauco (37,9%). La cobertura nacional fue significativamente mayor (valor p=0,001) en mujeres (27,1%) que en hombres (17,9%). La compra de servicios a proveedores externos totalizó el 12,2% de las altas dentales, siendo esta proporción heterogénea entre SS con relación inversa entre Compra de servicios y Cobertura. DISCUSIÓN. La cobertura para el año evaluado fue baja, siendo insuficiente para poder resolver la alta carga de morbilidad de las personas mayores chilenas. Existe una amplia variabilidad territorial de la cobertura, presentando diferencias por sexo y en la compra de servicios.

INTRODUCTION. Elderly people in Chile have a high burden of oral morbidity and functional deficits that directly affect their quality of life. The universal GES program: "Comprehensive Oral Health for the 60-year-old adult", implemented since 2007, allows 60-year-olds to access comprehensive dental treatment, however there is limited evidence of its results to date.The aim of this study is to estimate the coverage of the program for the year 2019 of the public health insurance FONASA beneficiaries and their territorial variability disaggregated by Health Service (HS), sex and type of provider (public or purchase of services). MATERIALS AND METHODS. An observational ecological study was carried out, using secondary data from public sources (DEIS, FONASA). Total national coverage and by sex was estimated, stratified for each SS. Results. The coverage of the program in the public health sector was 22.8% in 2019. The lowest coverage was observed in Arica HS (5.3%) and the highest in Arauco HS (37.9%). National coverage was significantly higher (p-value = 0.001) in women (27.1%) than in men (17.9%). Purchase of services from external providers totaled 12.2% of the dental discharges, this pro-portion being heterogeneous between SS with an inverse relationship between "Purchase of services" and "Coverage". DISCUSSION. The coverage for the evaluated year was low, being insufficient to be able to solve the high burden of morbidity of Chilean elderly. There is a wide territorial variability of coverage, presenting differences by sex and in the purchase of services.

Saúde bucal de idosos internados na perspectiva de pacientes, acompanhantes e profissionais / Oral health for hospitalized elderly patients: perspective of patients, family members, and professionals

Objetivo:Analisar a percepção sobre a saúde bucal de idosos durante o período de internamento hospitalar na perspectiva de usuários, acompanhantes hospitalares e técnicos de enfermagem. Métodos: Trata-se de um estudo qualitativo realizado no Hospital Universitário Regional dos Campos Gerais, Ponta Grossa, Paraná, Brasil, entre os anos de 2018 e 2019. A seleção dos participantes foi realizada por meio de análise da Escala de Coma de Glasgow, com o auxílio do prontuário eletrônico do paciente, e da aplicação do Mini Exame do Estado Mental (MEEM) em pacientes e acompanhantes. Indivíduos considerados aptos e que concordaram com a pesquisa foram entrevistados individualmente por dois pesquisadores apoiados por roteiro-guia. As entrevistas foram gravadas e o método de saturação utilizado para o encerramento da coleta de dados. A equipe técnica de enfermagem foi considerada em sua totalidade. Resultados:Foram entrevistados sete pacientes, cinco acompanhantes e quatorze técnicos de enfermagem. Emergiram da análise três categorias: valor atribuído à higiene bucal durante a internação; relação entre higiene bucal deficiente e saúde geral e sugestão de melhoria em saúde bucal durante a internação. Destas categorias, oito subcategorias também foram observadas. Os resultados apontaram percepções comuns e isoladas dos entrevistados, sendo a importância da manutenção de hábitos de higiene bucal durante o período de internação e a existência de desdobramentos negativos da higiene bucal deficiente sobre o bem-estar e a qualidade de vida do paciente, percepções apontadas por todas as categorias. Conclusão:O estudo evidenciou a necessidade de ampliação das ações do cirurgião-dentista nos espaços hospitalares.

Aim: This study sought to analyze the perception of elderly patients' oral health during their hospital stay from the perspective of patients, family members accompanying them, and nursing technicians Methods: This is a qualitative study conducted at the Regional University Hospital of Campos Gerais, Ponta Grossa, Paraná, Brazil, between 2018 and 2019. The selection of participants was performed by analyzing the Glasgow Coma Scale, with the aid of the patient's electronic medical record, and the application of the Mini-Mental State Examination (MMSE) to patients and family members. The technical nursing team was considered in its entirety. Individuals considered fit and who agreed with the terms of the study were interviewed individually by two researchers, following due guidelines. The interviews were recorded, and the saturation method was used to complete the data collection. Results: Seven patients, five family members, and fourteen nursing technicians were interviewed. Three categories emerged from the analysis: value attributed to oral hygiene during hospitalization, relationship between poor oral hygiene and general health, and suggestions for improvement in oral health during hospitalization. Of these categories, eight subcategories were also observed. The results showed common and isolated perceptions of the interviewees, with the importance of maintaining oral hygiene habits during the hospitalization period and the existence of negative consequences of poor oral hygiene on the patient's well-being and quality of life, perceptions pointed out in all categories. Conclusion: This study illustrated the need to expand the actions of dentists within hospital spaces.

Experiencia del programa de educación en salud bucal dirigido a personas mayores. Universidad CES, Medellín - Colombia 2019 / Experience of the oral health education program aimed at the elderly. Universidad CES, Medellín - Colombia 2019

Objetivo: describir la experiencia de educación en promoción y prevención en salud bucal desarrollada con un grupo de adultos mayores que participan en el programa "Vecinos Saludables", del Hospital Pablo Tobón Uribe de la ciudad de Medellín. Métodos: se implementaron tres etapas, la primera para definir los temas, la segunda para la ejecución y la última, para evaluar la percepción de los participantes. Resultados: 30 adultos mayores asistieron a 6 talleres participativos en salud bucal. El 40% del grupo usaba, al menos, una prótesis total y el 65% algún tipo de prótesis parcial. El 77% había sentido alguno de los síntomas que podrían asociarse con disminución de cantidad de saliva en la boca y el 56,6% mencionó que con frecuencia tenía dificultades para masticar o al tragar. La percepción del programa realizado por parte de los adultos mayores fue muy positiva; en términos generales, comprendieron que el envejecimiento no implicaba desinterés en el cuidado del cuerpo y la boca. Conclusiones: la implementación de actividades lúdicas educativas con adultos mayores favorece su empoderamiento con la salud bucal y el interés por mantenerse sanos, lo cual repercute de forma positiva en su calidad de vida.

Objective: To describe the experience of education in promotion and prevention in oral health developed with a group of older adults who participate in the "Healthy Neighbors" program at the Pablo Tobón Uribe Hospital in the city of Medellín. Methods: There were implemented three stages. The first to define the topics. The second for the execution, and the last one to evaluate the participants' perceptions. Results: 30 older adults attended six participatory workshops on oral health. 40% of the group used at least one total prosthesis and 65% some partial prosthesis types. 77% had felt any of the symptoms could be associated with a decrease in the saliva amount, and 56.6% mentioned that they frequently had difficulty chewing or swallowing. The perception of the program carried out by the elderly was very positive; in general terms, they understood that aging did not imply neglecting the care of the body and mouth. Conclusions: The implementation of educational and recreational activities with older adults favors their empowerment with oral health and interest in staying healthy has a positive impact on their quality of life.

Comportamiento de los trastornos temporomandibulares en pacientes mayores de 60 años. Amancio, 2018 / Behavior of temporomandibular disorders in patients over 60 years old. Amancio, 2018

El artículo resume los resultados de una investigación observacional descriptiva de corte transversal, realizada en el consultorio No. 19 perteneciente al área de salud de la Clínica Estomatológica del Hospital Docente «Dr. Luis Aldana Palomino¼ Municipio Amancio Rodríguez, Las Tunas, Cuba, en el periodo comprendido entre octubre de 2017 y junio de 2019, cuyo objetivo fue describir el comportamiento de los trastornos temporomandibulares en pacientes mayores de 60 años, con un universo de 120 pacientes diagnosticados y la muestra aleatoria de 90 de ellos. En los resultados se destacó que el rango de edad entre 60 y 65 años y en sexo femenino fue donde más prevalecieron los trastornos temporomandibulares; el que se presentó con más frecuencia fue el muscular grupo I, según la clasificación de Okeson. De los factores etiológicos oclusales encontrados, el bruxismo y la rehabilitación protésica fueron los más representativos. El desgaste dentario fue el parámetro clínico más reportado de forma general presentándose en ambos tipos de trastornos (AU)

The article sums up the results of an observational, descriptive, and transversal study, carried out at the dispensary 19, belonging to the area of health of the Stomatological Clinic in the educational hospital «Dr. Luis Aldana Palomino¼ in the municipality Amancio Rodríguez, Las Tunas, Cuba, in the period between October 2017 and June 2019, whose objective was to describe the development of temporomandibular disorders in 60+ year-old patients, from a universe of 120 patients diagnosed and a random sample of 90 of them. In the results, it is highlighted that the age range between 60 and 65 years and female patients was where most of the temporomandibular disorders occurred, being the most frequent the muscular group I, per the Okeson classification. Of the occlusal etiologic factors found, bruxism and prosthetic rehabilitation were the most representative. Dental wear was the clinical parameter most reported in general, showing up in both types of disorders (AU)

Gerodontología: introducción de un nuevo término en la asignatura Atención integral a la familia II / Gerodontology: introduction of a new term in the subject "Comprehensive family care II"

RESUMEN Introducción: la asignatura Atención integral a la familia II, de la carrera de Estomatología en Cuba, no emplea el término «gerodontología¼, tal y como se utiliza en la literatura científica a nivel mundial; solo se utiliza el término odontogeriatría, que tiene diferente significación, puesto que el primero propicia un enfoque preventivo, acorde a las acciones de salud que debe realizar el estomatólogo. Objetivo: fundamentar la propuesta del empleo del término «gerodontología¼ en el proceso de enseñanza-aprendizaje de la asignatura Atención integral a la familia II, de la carrera de Estomatología, en Cuba. Métodos: se realizó una revisión bibliográfica, se utilizaron las bases de datos Ebsco, Pubmed y Scielo. Se revisó el Plan de Estudio y el Programa de la asignatura Atención integral a la familia II, y se identificó la omisión del término «gerodontología¼ en el subtema: «El paciente geriátrico¼. Conclusiones: la utilización del término «gerodontología¼, contextualizado en el currículo de estudio de la carrera de Estomatología en Cuba, no debe sustituir el concepto de odontogeriatría, pues el empleo de ambos términos es válido. Se fundamentó la importancia del término «gerodontología¼ en el subtema: «El paciente geriátrico¼, perteneciente a la asignatura Atención integral a la familia II, además de la utilización del concepto de odontogeriatría, por tener diferentes acepciones.

ABSTRACT Introduction: the subject "Comprehensive family care II" of the Dentistry career in Cuba does not use the term "Gerodontology", as used in scientific literature worldwide; this one only uses the term "Geriatric Dentistry" which has a different meaning since the first one has a preventive approach according to the health actions to be performed by the dentist. Objective: to base the proposal for the use of the term "Gerodontology" in the teaching-learning process of the subject "Comprehensive family care II" of the Dentistry career in Cuba. Methods: a bibliographic review was carried out using Ebsco, Pubmed and SciELO databases. The Study Programme and the Program of the subject "Comprehensive family care II" were revised, and the omission of the term "Gerodontology" was identified in the subtopic: "The geriatric patient ". Conclusions: the use of the term "Gerodontology", contextualized in the study programme of the Dentistry career in Cuba, should not replace the concept of "Geriatric Dentistry", since the use of both terms is valid. The importance of the term "Gerodontology" was based on the subtopic: "The geriatric patient", belonging to the subject "Comprehensive family care II", in addition to the use of the concept "Geriatric Dentistry", since they have different meanings.

Caries en la tercera edad en una universidad de la ciudad de Puebla 2017-2018 / Caries in the third age in a university of the City of Puebla 2017-2018

La caries es una infección que afecta a cualquier persona sin importar edad, género o clase social. Es importante enfocar la atención odontológica a pacientes de tercera edad ya que tienden a un crecimiento anual de 3.8% de la población mexicana. Actualmente, se han realizado campañas de salud bucal para esta población; a pesar de los múltiples esfuerzos realizados para la prevención y erradicación de dicha enfermedad existe un descuido en los tratamientos para pacientes de la tercera edad, lo cual puede favorecer la pérdida de dientes. El objetivo del estudio fue determinar la prevalencia y severidad de caries en adultos mayores en la clínica de odontología de la Universidad Popular Autónoma del Estado de Puebla (UPAEP). Se realizó un estudio descriptivo, retrospectivo; se revisaron 345 expedientes de pacientes de tercera edad del 2017 al 2018, que asistieron por primera vez a consulta. Se obtiene la prevalencia y severidad a través del índice CPOD (cariados, perdidos y obturados). La prevalencia de dientes cariados fue 79%; se obtuvo un CPOD de 18.63 (alto riesgo). Se concluye el implementar medidas preventivas que impacten en mayor dimensión a la caries, para su disminución o erradicación en pacientes geriátricos (AU)

Caries is an infection that affects anyone regardless of their age, gender or social class. It is, however, important to focus dental care on elderly patients as that part of the Mexican population is growing at 3.8% annually. Currently, oral health campaigns have been carried out for this population, but despite the multiple efforts undertaken for prevention and eradication of the disease, treatment for elderly patients is often overlooked. The consequence of this lack of treatment can be the loss of teeth. The objective of this study is to determine the prevalence and severity of caries in elderly patients at the dental clinic of the Universidad Popular Autónoma del Estado de Puebla (UPAEP). A descriptive, retrospective study was carried out where the records of 345 elderly, first-time patients were reviewed for the 2017-2018 period. The prevalence and severity of caries was determined using the DMFT index (decay, missing, filled). The prevalence of carious teeth was 79% with a DMFT of 18.63 indicating high risk. We conclude that preventive measures should be implemented to impact and decrease caries in geriatric patients (AU)