Attitudes of dental students towards treating elderly patients. Dental students' attitudes on geriatric patients

The purpose of this questionnaire-based survey was to evaluate the attitudes of the undergraduate dental students towards elders. The 14-item Geriatric attitudes scale (GAS) questionnaire, along with a 9-item questionnaire with specific questions on the current geriatric dental curriculum, confidence, and preference in treating the elderly patients were administered to the undergraduate dental students (3rd bachelor, 1st master, and 2nd master) in the four Swiss university dental schools. Mean GAS scores were calculated and inter- and intra-group differences were analyzed with ANOVA and post hoc tests (level of significance set at α=0.05). Responses to the 9-item questionnaire were reported descriptively. Further analyses were performed to evaluate the effect of demographic factors on the GAS scores. 305 students (meanage: 25.8±4.0y) participated in this study. The mean overall GAS score of the students was 3.5±0.4. There were no significant differences in the GAS scores between the centers [F(3, 300)=2.266, p=0.081] or between the year of training [F(2, 301)=1.884, p=0.154]. Demographic factors did not influence the GAS scores. Students considered geriatric dentistry as an important part of their dental undergraduate education. The current geriatric curriculum was perceived to be on an adequate level. Hands-on experience in treating geriatric patients in the undergraduate curriculum was positively opinionated, and mobile dental services for elders with limited access to care was considered a good solution. In conclusion, the attitudes of the Swiss undergraduate dental students towards an elderly patient seem acceptable but could still be improved.

Digital Oral Medicine for the Elderly.

Sustainable oral care of the elderly requires a holistic view of aging, which must extend far beyond the narrow field of dental expertise to help reduce the effects of sociobiological changes on oral health in good time. Digital technologies now extend into all aspects of daily life. This review summarizes the diverse digital opportunities that may help address the complex challenges in Gerodontology. Systemic patient management is at the center of these descriptions, while the application of digital tools for purely dental treatment protocols is deliberately avoided.

The elderly patient: no reason to worry!?

In December 2013, the Organisation for Economic Co-operation and Development (OECD) has placed Switzerland for the first time at the top of the list of countries’ general population life ex- pectancy. The augmenting life expectancy and demographic changes are leading to an increase in the number of older people who are dependent on care (Höpflinger & Hugentobler 2003, Höpflinger et al. 2011). Multimorbidity and the resulting polypharmacy have inevitable consequences for the oral health and present a challenge for dentists (Fried et al. 2001). As dental treatment for multimorbid and bedridden adults can be quite complex, it seems necessary also from a dental perspective to detect age-related defi- ciencies as early as possible. If depression, dementia or malnutrition is suspected, an immediate referral to a specialist physician is recommended for an in-depth assessment and treatment. For older adults in particular, dental measures alone do not necessarily lead to an improvement in well-being and nutritional state.

Paradigmawechsel zugunsten einer besseren oralen Gesundheit im Alter.

Gerodontology is still understanding itself as a special field that is caring for elderly persons in the 4th stage of life needing nursing and generally living in an institution. In spite of all efforts that have been made, oral health of this population has not really improved. The reason for this lies in the fact that the causes of oral diseases which we face in institutions occur much earlier, in the so-called 3rd stage of life, in which the elderly are living at home and care for their daily life more or less independently. Oral problems arising in this stage of life are closely related to the increase of chronic diseases. The latter and the following social consequences significantly affect dental care ability. Excluding these health risks in the 3rd age e. g. through a systematic medical and social screening of the elderly in the dental office, it will be unlikely to succeed in improving oral health of elderly persons living at home and thus of those in institutions.

The effect of tooth loss on gait stability of community-dwelling older adults.

OBJECTIVE: To investigate the effects of tooth loss on gait stability in a healthy elderly population. METHODS: A case-control study was conducted among healthy and prosthetically well-restored seniors over the age of 65 years. The test group comprised 24 edentulous participants who were restored with complete dentures in the upper jaw and an overdenture fixed on two implants in the lower jaw. The control group comprised 25 dentate participants who either still had their natural teeth or were restored with conventional fixed partial dentures. Gait stability was evaluated by measuring the parameters 'gait velocity' and 'cycle-time variability' during self-selected normal walking speed and under dual-task performance conditions. Measurements were conducted using the GAITRite(®) electronic walkway system. RESULTS: Dentated and fixed restored participants (the control group) had a significantly higher gait velocity compared with denture wearers (the test group) under both normal walking (p = 0.03) and dual-task performance conditions (p = 0.01). In each test condition, among edentulous participants, gait velocity did not significantly differ according to whether the participant wore their dentures. CONCLUSION: The present results suggest that tooth loss in healthy seniors is associated with lower gait velocity and therefore may have a negative impact on gait stability.

[Medical and psycho-social screening of ageing patients in dental office]. / Medizinisch-psychosoziales Screening des alternden Menschen in der zahnärztlichen Praxis.

The demographic changes cause an increasing number of ageing persons laying claim to medical and dental care. They are trying to maintain their habit of regular dental controls. Therefore, the dental care team should be able to recognize early medical and psycho-social deficiencies relevant for oral health. In this way, health status and ressources of elderly persons could be estimated better and failures in oral diagnosis as well as in treatment due to monodisciplinary case analysis could be avoided. This paper presents a systematic medical and psychosocial screening concept for oral care of elderly patients.

[Malnutrition in the elderly--a interdisciplinary problem for the dentist]. / Malnutrition im Alter--Eine interdisziplinäre Problemstellung auch für den Zahnarzt.

Success in dental treatment and long-term care of elderly persons requires an interdisciplinary consideration of aging. Medical knowledge, which is far beyond specific dental expertise, is assumed. A typical example is that of malnutrition, which in spite of its high frequency in the elderly, has not yet been considered to be important in dentistry. Missing diagnosis and therapy of malnutrition lead to increasing morbidity and mortality. Clarifying the nutritional conditions of aging persons therefore should also become a part of dental diagnosis to guarantee early medical diagnosis and therapy as well as to avoid oral complications.

Three-dimensional treatment planning for prosthetic rehabilitation.

All prosthetic rehabilitations require healthy, stable oral conditions. The biologic response to the preliminary treatment provides important criteria for planning the final reconstruction and permits testing of the desired prosthetic treatment goals within the unique patient-specific biologic conditions before final restoration. This study used long-term provisional restorations that corresponded in both form and function to the anticipated restorations. Intraoral testing of the diagnostic waxup is an outstanding basis for discussing the provisional as well as final restoration. As required, changes necessary to teeth form and position can be simply accomplished.