Prolonged use of old dentures: A qualitative study with Brazilian older adults.

OBJECTIVE: To explore older adults' perceptions, motivations and reasons for using and not replacing old and worn complete dentures over prolonged periods. MATERIALS AND METHODS: In-depth, semi-structured interviews were conducted with Brazilian edentulous older adults who were wearing complete dentures which were at least 20 years old. A purposive sampling method was used to recruit participants from an existing waiting list of those referred to a hospital clinic for new dentures. The interviews were video-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Sixty-two individuals were assessed and nine were included in the study, aged from 61 to 77 years (mean = 65.4), with seven (77.8%) of them women. The reported time using their current dentures ranged from 22 to 45 years (mean = 28). Content analysis revealed three main themes: the perception of the current dentures' condition after prolonged use; reasons for the prolonged use and non-replacement; and unsuccessful attempts to replace the dentures. Overall, participants acknowledged the poor condition of their dentures and did recognise the need for replacement. Several factors had prompted them to delay or temporarily forego replacement, with financial constraints being the main barrier. Some reported failed attempts to replace the dentures in the past years or months; however, challenging adaptation to the new prostheses led to them reverting back to their old dentures as a fallback solution. CONCLUSION: Factors influencing prolonged denture use in older adults include a complex interplay of financial aspects, treatment awareness, access and personal factors. Dental professionals can play a pivotal role in promoting timely denture adjustment or replacement by addressing these factors through patient education and personalised care.

Ageism in dental students - a multicentric study in southern Brazil.

OBJECTIVES: Gerontological education and intergenerational contact are proven strategies for effectively combating ageism. In this context, this study investigates the association between gerontological education, intergenerational contact, and ageism among dental students. METHODS: Gerontological education from students' perspective, intergenerational contact, and ageism were assessed using a questionnaire containing sociodemographical aspects and an ageism scale (ASDS-Braz). The sample included students enrolled in the final year of dental programs at three public universities in southern Brazil. A multilevel Poisson regression was conducted to assess factors associated with ASDS-Braz scores. RESULTS: A modest correlation was identified between dental schools in terms of reducing ageism, and a weak correlation was found between self-reported race and ageism. Notably, statistically significant findings were observed across family relationship with older individuals: students who reported having a poor relationship with older adults in their families presented 45% higher ageism scores than did those with an excellent relationship. CONCLUSION: The results suggested that while some gerontological education was reported by the participants, it may not be sufficient to prepare dental students to provide effective oral healthcare to older adults and to reduce ageism among them. Additionally, reinforcing positive aspects of intergenerational relationships may be an additional strategy in combating ageism within this population.

Edentulism and Individual Factors of Active Aging Framework in Colombia.

BACKGROUND: While edentulism remains a serious public health problem for older adults in Colombia, few analyses have been conducted from the framework of active aging as a part of the positive discourse of aging. This study analyzed complete edentulism and its relationship with determinants including personal, behavioral, and health systems and social services. METHODS: This study included a total of 19,004 older adults. We used univariate, bivariate, and multivariate logistic regression type scores to investigate the relationships between the variables. The personal determinants included basic (Barthel scale) and instrumental activities of daily living (Lawton scale), public transportation, functional limitations, self-perceived health, and health problems. The behavioral factors included alcohol and tobacco use, mini nutritional tests, and physical activity. The last determinant was the healthcare system, while social services access included dental services. The analysis also included sociodemographic variables. RESULTS: The results revealed significant associations for the variables of the three determinants, including the risk of malnutrition (odds ratio [OR]=1.15), functional limitation (OR=1.15), moderate physical activity (OR=1.08), and access to dental services (OR=2.31). Sex, years of education, and race were also risk factors, among other variables. Personal determinants, behavior, and use and access to health services were related to edentulism in older adults. CONCLUSION: These findings support the need to include different analyses of edentulism from multicausality and to understand the oral cavity and the living conditions of aging adults.

Stomatological profile of elderly patients who received dental care at a reference Hospital of Belo Horizonte, Minas Gerais - Brazil: a cross-sectional study

Aim: The aim of this study was to draw a stomatological profile of elderly patients treated at the Stomatology Service of a referral hospital in the city of Belo Horizonte, Minas Gerais ­ Brazil.Methods: Information was collected on the diagnostic hypotheses and definitive diagnoses of the elderly (aged 60 to 98 years) treated at the service, from September 2014 to December 2017. Results: Medical records of 1388 patients were evaluated, and 281 different diagnostic hypotheses were found. For males, there was a higher prevalence in both diagnostic and definitive diagnoses for benign and malignant epithelial neoplasms; In females, there was a higher prevalence, also in the hypotheses and diagnostic definitions, of inflammatory fibrous hyperplasia, related to the use of removable prostheses. Conclusion: Thus, this study evidenced the importance of knowledge about the main alterations that affect the oral cavity of elderly patients, which allows better attention to this population, besides being a pioneering stomatological study in hospital units.

Nivel de conocimientos sobre lesiones premalignas bucales en pacientes geriátricos

Fundamento: El nivel de conocimiento sobre lesiones premalignas en la población geriátrica es un factor significativo que incide en la prevención, evitando la progresión a un cáncer bucal. Objetivo: Identificar el nivel de conocimiento de los pacientes geriátricos sobre las lesiones premalignas bucales. Metodología: Entre septiembre de 2019 y junio de 2021 se realizó un estudio observacional descriptivo transversal en el Consultorio Médico de la Familia # 12 del municipio Cabaiguán, provincia Sancti Spíritus. La población estuvo constituida por 158 pacientes geriátricos y mediante un muestreo probabilístico aleatorio simple la muestra quedó conformada por 80. Se aplicaron métodos del nivel teórico, empírico, estadístico y matemático. Las variables utilizadas fueron edad, sexo, escolaridad, nivel de conocimiento sobre factores de riesgo y signos clínicos, conocimientos sobre el autoexamen bucal y la conducta a seguir. Resultados: Se constató que el nivel de conocimientos sobre factores de riesgo fue regular y sobre signos clínicos y forma y frecuencia del autoexamen bucal fue mal. La mayoría de la muestra en estudio conocía donde acudir y afirmó haber recibido información al respecto. Conclusiones: En su mayoría el nivel de conocimientos sobre lesiones premalignas se observó entre regular y mal con un descenso significativo del nivel de conocimientos en los pacientes de edades más avanzadas.

Background: The knowledge level about premalignant lesions in the geriatric population is a significant factor that influences on prevention, avoiding progression into mouth neoplasms. Objective: To diagnose the knowledge level in geriatric patients about buccal premalignant lesions. Methodology: A cross-sectional descriptive observational study was conducted between September 2019 and June 2021 at the Family Medical Office # 12 of Cabaiguán municipality, Sancti Spíritus province. The population was constituted by 158 geriatric patients and by means of a simple random probabilistic sampling, the sample was made up by 80. Theoretical, empirical, statistical and mathematical methods were applied. The used variables were age, sex, schooling, risk factors and clinical signs knowledge, knowledge of buccal self-examination and conduct to be followed. Results: The knowledge level about risk factors was found to be regular and on clinical signs and form and frequency of buccal self-examination was bad. The majority of the sample under study knew where to go and affirmed that they had received information about it. Conclusions: Mostly the knowledge level of premalignant lesions was observed to be regular to bad with a significant decrease in the knowledge level in more elderly patients.

Current status of geriatric dentistry education in selected dental schools in Latin America and the Caribbean.

OBJECTIVE: Latin American and Carribean (LAC) are currently experiencing a rapid aging of their population, coupled with a significant burden of oral diseases. Despites this, there is a scarcity of evidence regarding the manner in wich geriatric dentistry is being taught in dental schools across LAC. So, the objective of this study is to investigate the current status of geriatric dentistry education at undergraduate and postgraduate levels in selected LAC dental schools. METHODS: An electronic questionnaire was developed and emailed to all 539 dental schools in 19 LAC countries. The questionnaire recorded activity levels, contents and methodology of geriatric dentistry education as part of dental degree programmes. Reminders by email and telephone calls were used to encourage non-responders to complete the questionnaire. RESULTS: In total, 317 schools from 17 countries responded to the questionnaire (response rate: 58.8%). Geriatric dentistry was taught in 54.6% of the schools at the undergraduate level and in 6.9% at the postgraduate level. Thirty two percent of the schools had a programme director trained in geriatric dentistry. Geriatric dentistry was taught as an independent course in 14.5% of the schools. Dry mouth, periodontal disease, denture-related conditions and prosthodontic management, oral mucosal disease and age-related changes of the orofacial complex were the most frequently covered topics. Clinical teaching of geriatric dentistry was reported by 26.5% of the schools, with 38.0% providing clinical training in outreach facilities. CONCLUSIONS: Geriatric dentistry education remains incipient in LAC, with only one in every four dental school offering it as a standalone course. There is an urgent need to further develop geriatric dentistry education in the continent, including further research to develop a minimum geriatric dentistry curriculum.

Influencia de la salud oral en la calidad de vida de los adultos mayores: una revisión sistemática / Influence of oral health on the quality of life of older adults: a systematic review

Objetivo: analizar cómo interfieren las diversas dimensiones de la salud oral en la calidad de vida de las personas mayores. Método: se realizó una revisión sistemática en las bases bibliográficas Medline, LILACS, SciELO y EBSCO Dentistry & Oral Sciences, para ello se utilizó la estrategia de búsqueda: aged OR aging AND "oral health" OR dentistry OR "geriatric dentistry" OR "dental care" OR "dental care for aged" OR "mouth diseases" OR "tooth diseases" OR "tooth loss" OR "facial pain" OR "oral hygiene" AND "quality of life" OR "health status" OR "self concept" OR "health services needs and demand" OR "personal satisfaction" OR "attitude to health" OR "risk factors" OR "age factors" OR "health status indicators" AND "sickness impact profile" OR "health surveys" OR "need essessment" OR "surveys and questionnaires" OR "reproducibility of results". Resultados: De los 1.356 registros identificados 14 artículos fueron incluidos para el análisis. Se evidenció, mediante la evaluación bucal clínica y las encuestas de autopercepción de la salud oral, que existe una asociación entre la salud oral y la calidad de vida de las personas mayores. Conclusiones: el deterioro de la calidad de vida de las personas mayores es causado, principalmente, por la pérdida de dientes.

Objective: To analyze how the various dimensions of oral health interfere with the quality of life of older adults. Method: a systematic review was carried out in the bibliographic databases Medline, LILACS, SciELO and EBSCO Dentistry & Oral Sciences using the search strategy: aged OR aging AND "oral health" OR dentistry OR "geriatric dentistry" OR "dental care" OR "dental care for aged" OR "mouth diseases" OR "tooth diseases" OR "tooth loss" OR "facial pain" OR "oral hygiene" AND "quality of life" OR "health status" OR "self concept" OR "health services needs and demand" OR "personal satisfaction" OR "attitude to health" OR "risk factors" OR "age factors" OR "health status indicators" AND "sickness impact profile" OR "health surveys" OR "need assessment" OR "surveys and questionnaires" OR "reproducibility of results". Results: Of the 1,356 records identified, 14 articles were included for the analysis. Clinical oral evaluation and oral health self-perception surveys demonstrated the association between oral health and quality of life in older adults. Conclusions: the deterioration of the quality of life of older adults is mainly caused by the loss of teeth.

Odontogeriatría y función cognitiva I: Generalidades y conducta clínica en demencias / Geriatric dentistry and cognitive function I: Generalities and clinical behavior in dementias

Introducción: Este trabajo hace una revisión de los estudios más recientes sobre la demencia, enfocándose en cómo se están abordando las necesidades de cuidado oral que presentan los pacientes afectados en las diferentes etapas de este trastorno. Se destaca la necesidad de dar a la odontología un mayor rol en las decisiones clínicas sobre pacientes con demencia. Revisión: La demencia es un deterioro progresivo de diversas facultades mentales; posee características degenerativas, no tiene tratamiento conocido y sus síntomas empeoran con el tiempo. Cada etapa del deterioro cognitivo requiere cuidados odontológicos con abordajes terapéuticos específicos, según el compromiso clínico del propio paciente. Discusión: Las personas con demencia desarrollan necesidades diferentes de cuidado oral, incluso en etapas tempranas. Los estudios han demostrado que la masticación puede considerarse como una medida que desacelera el deterioro cognitivo, siendo importante realizar acciones de prevención oral mediante tratamientos tempranos. Conclusión: Los pacientes con demencia se benefician de medidas preventivas en su cuidado oral, especialmente en las primeras etapas de este trastorno degenerativo.

Introduction: This work provides an overview of the latest progress in the study of dementia, with a focus on how dental care is being approached in patients during the various stages of this disorder. This work highlights the need for dentistry to play a greater role in clinical decisions over affected patients. Review: Dementia is a progressive deterioration of various mental faculties; it has degenerative characteristics, no known treatment and its symptoms worsen over time. Each stage of cognitive dysfunction requires specific dental care and therapeutic approaches, depending on the willingness of the patient. Discussion: People with dementia develop different needs for oral care, even during early stages. Studies have shown that preserving a patient's masticatory function is key to slowing down cognitive dysfunction, underlining the need for a proactive approach and early treatment. Conclusion: Patients with dementia benefit from preventative measures when it comes to their oral care, especially during the first stages of this degenerative disorder.

Is There Still Time to Orthodontics in Elderly Patients? / Ainda há Tempo para a Ortodontia na Melhor Idade?

Life expectancy rate has increased in the past decades and a crescent number of elderly patients are searching for dental treatment aiming for aesthetic and functional rehabilitation. Geriatric Dentistry is a dental specialty which focuses on the elderly population dental care, specially aiming at preventive and healing care of patients with diseases or systemic and chronic conditions, associated to physiological, physical or psychological deficiencies. Other specialties in Dentistry, such as Orthodontics, have become important allies in this new challenge of the Dental profession. This study aimed at analyzing characteristics involved in orthodontic treatment when associated with gerontologic needs, considering relevant factors to an adequate application based on a case report. The treatment was planned integrating Periodontics, Orthodontics, Prosthodontics and Operative Dentistry practice, allowing the reestablishment of function and aesthetics harmonically. Orthodontic treatment represents a feasible procedure in Geriatric Dentistry, as long as applying light forces and respecting both the characteristics and limitations of these areas of treatment.(AU)

Com o aumento considerável da expectativa de vida da população, um crescente número de pacientes idosos tem procurado tratamento odontológico para reabilitação estética e/ou funcional. A Odontogeriatria, é a especialidade odontológica que enfatiza o cuidado bucal da população idosa, especificamente do atendimento preventivo e curativo de pacientes com doenças ou condições de caráter sistêmico e crônico, associadas a problemas fisiológicos, físicos ou psicológicos. Diversas especialidades odontológicas, dentre elas a Ortodontia, vêm se integrando com esta área odontológica. Este trabalho objetiva abordar as características do tratamento ortodôntico associado a uma atuação odontogeriátrica, considerando os fatores relevantes para a execução do tratamento ortodôntico nesses pacientes a partir do relato de um caso clínico. Planejou-se este caso de forma integrada, envolvendo Periodontia, Ortodontia, Prótese e Dentística Restauradora, que foram capazes de devolver à paciente função e estética. O tratamento ortodôntico representa uma intervenção viável na atuação odontogeriátrica, desde que realizado com forças suaves, considerando as limitações e respeitando as características inerentes a esta atuação. (AU)

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.

One-year prospective study on single short (7-mm) implant overdentures in patients with severely resorbed mandibles.

OBJECTIVE: This prospective study aimed to assess the effectiveness of using a single short implant to retain a single-implant mandibular overdenture (SIMO) in participants with severely atrophic edentulous mandibles. MATERIAL AND METHODS: The study sample included 18 edentulous participants with severely resorbed mandibular ridges and limited bone height in the symphyseal region sufficient for the insertion of a 7.0-mm-height implant. First, patients received new conventional dentures or had their dentures relined, followed by the insertion of a 3.75 x 7 mm morse-taper implant, and the incorporation of a stud-type attachment and a nylon retentive insert after a 3-month healing period. Implant stability quotient (ISQ) was measured at baseline and after 3 and 12 months. Patient-reported outcomes (satisfaction with the dentures and oral health-related quality of life) were assessed before implant placement and at the 3-, 6-, and 12-month follow-ups. Clinical-radiographic outcomes and the incidence of prosthodontic events were assessed throughout the follow-up period. RESULTS: The implant survival rate was 100%. ISQ increased from baseline (72.7 ± 6.6) to the 3-month (82.0 ± 3.3) and 1-year (85.4 ± 2.9) follow-ups (p < .001). After 1 year, satisfaction with the mandibular prosthesis increased significantly, and the overall OHIP-Edent score decreased by 79.2%. No effects were found for the maxillary denture (p = .420). Due to dissatisfaction with treatment, two participants (11.1%) required additional implants after the 1-year follow-up and were considered as prosthodontic failures. CONCLUSION: Single-implant mandibular overdenture retained by a short implant showed favorable outcomes after 1 year. Further studies with larger samples and longer follow-up periods are needed to confirm the findings of this single-group prospective study. The present study was registered at the Brazilian Clinical Trials Registry (REBEC), identifier RBR-7p2xmg. The trial registry occurred during the study execution, and its final approval was delayed because of several formatting adequacies required by the platform REBEC.

Dental plaque control strategies for the elderly population: A scoping review.

OBJECTIVE: To review the scientific literature and identify dental plaque control strategies focussed on elderly people that improve plaque indices. DESIGN: Scoping review (Joanna Briggs protocol). DATA SOURCES: Individual search strategies developed for six databases. The selection of the manuscripts in two phases: title and abstract review, and complete review. ELIGIBILITY CRITERIA: Studies on interventions for plaque control in elderly people (60y+). Epidemiological studies and those focussed on caregivers, health professionals and periodontal maintenance therapies were excluded. RESULTS: The initial search yielded 2803 studies, 26 were included. The results were classified into: exclusively chemical (10), educational (9), exclusively mechanical (6), and combined mechanical and chemical (1). The studies reported different types of interventions: sugarless chewing gum, chlorhexidine (CHX) in different preparations and concentrations, mouthwash based on essential oils, stannous/sodium fluoride dentifrice and lactoferrin/lactoperoxidase tablets. Additionally, conventional and alternative toothbrushes and professional brushing were tested. Educational interventions included oral hygiene guidance, verbal information, and demonstrations of dental and denture cleaning procedures, and lifestyle changes. Many studies have reported strategies that improve dental plaque indices but without statistical significance when compared to control groups. Promising results were found with the use of CHX, sugarless chewing gum, professional brushing and educational strategies with demonstration, but the results were not long-lasting. CONCLUSION: The literature reports that mechanical, chemical and educational strategies have some efficacy in dental plaque control in the elderly population. The results should be viewed with caution, considering the type of intervention (isolated or combined) and the maintenance of the results obtained.

Proposal for a Conceptual Framework for the Development of Geriatric Dentistry.

Demographic changes with an increasingly higher proportion of older adults worldwide and an epidemiologic transition resulting in more teeth retained and higher demand and expectations set up new scenarios for the oral health of the older population. Thus, geriatric dentistry must be reconfigured, transitioning from the traditional focus on prosthesis to a more holistic discipline, actively incorporating geriatric and gerontologic aspects. We describe some situations that provide the rationale for a new conceptual framework for the advancement of geriatric dentistry as a clinical specialty. On the basis of scientific evidence and our academic experience, we propose 4 concepts that should steer the discipline during the following years and become its structural pillars: minimal intervention dentistry, oral functionality, patient-centered care, and interdisciplinary teamwork. Since data and evidence are limited, a special focus on poor and developing countries is incorporated. Adjusting clinical guidelines and public health policies around these concepts will increase access to oral care for older people, including those with physical or social barriers, and will ensure better oral health-related quality of life and well-being. These concepts have deep consequences in the education and training of new dentists and specialists, at the public and private levels.

COVID-19 e atenção a pessoas com deficiência e grupos especiais na clínica-escola de Odontologia / COVID-19 and assistance to people with disabilities and special groups in dental school clinic

O presente artigo tem como finalidade abordar orientações e sugestões para o atendimento odontológico de pacientes com necessidades especiais(pessoas com deficiência)e idosos nas clínicas de graduação, considerando as implicações daCOVID-19.A partir da publicação de orientações nacionais e internacionais de biossegurança, cuidados em saúde bucal e condutas odontológicas, foram elaboradasdiretrizespara esta abordagem clínica.Espera-se a disseminação do conhecimento, informações e adaptações necessárias no ensino para uma melhor assistência e contribuição educacional aos graduandos, além da realização das atividades práticas de maneira segura no ambiente universitário (AU).

The aim of the currentarticle is toaddress the guidelines and suggestions for dental care of patients with special needs (people with disabilities) and elderly in undergraduate dental clinicsbytaking into account the impacts caused bythe COVID-19 pandemic. Guidelines for the Special Care Dentistry clinical approach were developed based on the publication of national and international guidelines on biosafety, oral health care,and dental procedures. Knowledgeandinformationpromotion,and the necessary adaptations in teaching areexpected to allowbetter assistance and educational contribution to undergraduate students, in addition to performingpractical activities ina safer wayin collegeenvironment (AU).

Evaluation of oral-health behavioral attitudes of dental students in Switzerland and Brazil.

PURPOSE: This study evaluated the effect of progressive training on the oral health behaviors of dental students from Switzerland and Brazil. METHODS: Dental students from two dental schools (in Zurich, Switzerland, and Goiania, Brazil) were recruited for this study. Dental behaviors of the students in the final 3 years of their 5-year dental curriculum were assessed with the 20-item Hiroshima University-Dental Behavior Inventory (HU-DBI). Nonparametric tests were used to assess intergroup and intragroup differences (significance level: α = 0.05). RESULTS: 190 students (Zurich: n = 121, mean age ± SD = 25.5 ± 4.5 years; Goiania: n = 69, mean age ± SD = 23.5 ± 2.9 years) of a possible 277 students completed the survey (response rate = 68.6%). The overall mean HU-DBI score was 8.16 ± 1.35 (8.02 ± 1.27 in Switzerland and 8.41 ± 1.47 in Brazil). Age (P = 0.225) and sex (P = 0.145) were not associated with the scores, but the respondent's nationality seemed to play a role (P = 0.024). Progressive training had no effect on the scores (P = 0.766). CONCLUSIONS: The present findings show that progressive training has no effect on the oral health behaviors of dental students but the nationality might be a factor.

Factors associated with poor oral health-related quality of life among non-institutionalized Brazilian older adults: Oral health and quality of life in older adults.

AIMS: To investigate the factors associated with poor oral health-related quality of life (OHRQoL) in a sample of Brazilian older adults. METHODS AND RESULTS: A cross-sectional study was conducted with 535 non-institutionalized elders aged 60 years or older from Piracicaba, São Paulo, Brazil. OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). Data on sociodemographic characteristics, self-perceived general health status, and health-related behaviors were obtained through a structured questionnaire. Data on chronic diseases were obtained from health records. Associations between exploratory factors and low OHRQoL (% GOHAI score <30) were evaluated using multivariate Poisson regression models to estimate adjusted prevalence ratios (PRs) and confidence intervals. The mean OHRQoL score was 30 (± 4.4). In bivariate analysis, being not married, smoking, and self-rated "fair/poor" general health status were associated with lower OHRQoL. In the adjusted model, self-rated "fair/poor" general health (PR: 1.25; 95% CI: 1.05-1.48), presence of chronic diseases (PR: 1.88; 95% CI: 1.37-2.58), smoking (PR: 1.25; 95% CI: 1.02-1.53), and reason for last dental appointment (PR: 1.34; 95% CI: 1.13-1.59) were associated with poor OHRQoL. CONCLUSION: Non-institutionalized older adults with a history of chronic diseases, who smoke, have a negative perception of their general health, and had the last dental appointment motivated by pain present significantly higher prevalence rates of poor OHRQoL.

Inter-examiner agreement in the application of an oral health assessment instrument in hospitalized elderly / Concordancia de interexaminadores en la aplicación de una herramienta de evaluación de la salud bucal en adultos mayores hospitalizados / Concordância interexaminadores na aplicação de instrumento de avaliação da saúde bucal em idosos hospitalizados

ABSTRACT Objectives: to analyze the correspondence between nurse and dental surgeon assessments in the application of an Oral Health Assessment in dental screening of elderly hospitalized patients. Methods: cross-sectional study with elderly patients (n = 54) admitted to University Hospital from the Federal University of São Paulo. Data were collected through the assessment of oral cavity. Descriptive statistical techniques were used to analyze them, using tables and graphs. Results: there was correlation and agreement between nurse and dental surgeon assessments referring to application of an Oral Health Assessment in dental screening of hospitalized elderly. Conclusions: oral Health Assessment in dental screening for hospitalized elderly by nurses demonstrated excellent reproducibility and may be a resource to identify buccal alteration, helping the planning and execution of nurse care associated to oral health.

RESUMEN Objetivos: analizar la concordancia entre la valoración del enfermero y del cirujano dentista respecto a la comprobación del estado de salud bucal de adultos mayores hospitalizados. Métodos: se trata de un estudio transversal realizado con adultos mayores (n=54) internados en la enfermería del Hospital Universitario de la Universidad Federal de São Paulo. Los datos se recogieron mediante la evaluación de la cavidad oral y se analizaron con técnicas estadísticas descriptivas, a partir de cuadros y gráficos. Resultados: fue posible observar correlación y concordancia entre las evaluaciones del enfermero y las del cirujano dental en la aplicación del instrumento de Evaluación de la Salud Oral para el Triaje Odontológico en adultos mayores hospitalizados. Conclusiones: la aplicación del instrumento Evaluación de la Salud Bucal para el Triaje Odontológico de parte del personal de enfermería en adulos mayores hospitalizados, demostró una excelente reproducibilidad, que puede llegar a convertirse en un recurso para examinar e identificar las alteraciones bucodentales, así como ayudar en la planificación y ejecución de los cuidados de enfermería asociados a la atención de la cavidad oral.

RESUMO Objetivos: analisar a concordância entre a avaliação do enfermeiro e a do cirurgião dentista em relação à verificação da condição da saúde bucal de idosos hospitalizados. Métodos: estudo transversal realizado com idosos (n=54) internados em enfermarias do Hospital Universitário da Universidade Federal de São Paulo. Os dados foram coletados por meio de avaliação da cavidade oral e foram analisados por técnicas de estatística descritiva, a partir de tabelas e gráficos. Resultados: houve correlação e concordância entre as avaliações do enfermeiro e as do cirurgião dentista na aplicação do instrumento Avaliação da Saúde Bucal para Triagem Odontológica em idosos hospitalizados. Conclusões: a aplicação do instrumento Avaliação da Saúde Bucal para Triagem Odontológica, em idosos internados pelo enfermeiro, demonstrou excelente reprodutibilidade, o que pode se tornar um recurso para examinar e identificar alterações bucais, bem como auxiliar no planejamento e execução da assistência de enfermagem associada aos cuidados com a cavidade oral.

Effect of dental education on knowledge and clinical behavior of turkish dentists' regarding oral-systemic health of geriatric patientsOral-systemic health of geriatric patients (Running title) / Efeito da educação odontológica no conhecimento e comportamento clínico de dentistas turcos em relação à saúde oral e sistêmica de pacientes geriátricos

Objective: The aim is to evaluate the perspectives of dentists' clinical approaches in terms of their knowledge and education regarding oral-systemic health relation of geriatric patients with a digital survey. Materials and Methods: The demographics, oral-systemic health-related lectures in participants' dentistry education, the level of awareness of the oral-systemic health relationship, and behaviors related to clinical applications were investigated on a digital platform with 49 multiple-choice questions. The results were analyzed with the SPSS 24.0 program. Results: Of a total of 410 dentists (206 women and 204 men), 23% have doctoral and/or specialty titles. While 93.1% of dentists had taken systemic health-related lectures, 21.3% of them rated these courses as "adequate" and 49.3% as weak. 72% of the participants received medical history only at the initial appointment, while 17.9% of them received it at each appointment. Dentists more often associate diabetes and cardiovascular diseases with periodontitis, compared to the development of dental caries. Dentists who think that they should work with physicians in the treatments of geriatric patients with systemic diseases refer more patients to physicians per year (p < 0.001). Conclusions: Dentists have found the lectures on the relationship between oral-systemic health of geriatric patients in dentistry education inadequate. Besides, there is a lack of information on the effects of systemic diseases on caries development, intra-oral findings, and knowledge on treatment approaches. Dentists believe that defining a curriculum that emphasizes interdisciplinary work and organizing scientific activities in partnership with medical associations will play an important role in establishing awareness of oral-systemic health. (AU)

Objetivo: O objetivo é avaliar as perspectivas das abordagens clínicas dos dentistas em relação ao seu conhecimento e educação sobre a relação da saúde oral e sistêmica de pacientes geriátricos através de um questionário digital. Material e Métodos: Os dados demográficos, as aulas relacionadas à saúde oral-sistêmica na educação odontológica dos participantes, o nível de conhecimento da relação saúde oral e sistêmica e os comportamentos relacionados às aplicações clínicas foram investigados em uma plataforma digital com 49 questões de múltipla escolha. Os resultados foram analisados com o programa SPSS 24.0. Resultados: De um total de 410 dentistas (206 mulheres e 204 homens), 23% possuem título de doutor e / ou especialidade. Enquanto 93,1% dos dentistas tiveram aulas sobre saúde sistêmica, 21,3% avaliaram esses cursos como "adequados" e 49,3% como fracos. 72% dos participantes recebem histórico médico apenas na consulta inicial, enquanto 17,9% deles recebem em cada consulta. Os dentistas associam mais frequentemente diabetes e doenças cardiovasculares à periodontite, em comparação ao desenvolvimento de cárie dentária. Os dentistas que acham que devem trabalhar em conjunto com médicos no tratamento de pacientes geriátricos com doenças sistêmicas encaminham mais pacientes ao médico por ano (p <0,001). Conclusões: Os cirurgiões-dentistas consideram inadequadas as palestras sobre a relação entre saúde oral e sistêmica de pacientes geriátricos no ensino de odontologia. Além disso, faltam informações sobre os efeitos das doenças sistêmicas no desenvolvimento de cárie, achados intraorais e conhecimento sobre as abordagens de tratamento. Os dentistas acreditam que a definição de um currículo que enfatize o trabalho interdisciplinar e a organização das atividades científicas em parceria com as associações médicas terá um papel importante no estabelecimento da consciência sobre a saúde oral e sistêmica (AU)

Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review

Abstract: This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.

Autopercepção de saúde bucal por idosos atendidos pelo sistema público de um município de Minas Gerais / Self-perception of oral health by the elderly assisted by the public system of a municipality in Minas Gerais

Objective:To analyze the self-perception of oral health by the elderly assisted by the public system of a municipality in Minas Gerais. Methods: descriptive, cross-sectional study with a quantitative approach, carried out with 100 elderly people during dental care in a public clinic and in a reference center. The data were treated using simple descriptive statistical analysis. Results: it was observed that the changes not noticeable by the elderly were: dry mouth sensation, decreased taste, decreased salivary flow and increased gingival problems. These consider it impossible to avoid tooth loss, however they reported that care for the remaining teeth and periodic consultation with the dentist are necessary. The reasons for seeking the professional were: toothache, gum pain, need for dental treatment and mouth injury. Conclusion: the elderly showed a satisfactory perception of their oral health. You are aware of oral changes resulting from aging, as well as care

Objetivo: analisar a autopercepção de idosos atendidos em uma clínica odontológica pública e em um centro de referência de um município de Minas Gerais sobre sua saúde bucal. Métodos: trata-se de um estudo descritivo, transversal, com abordagem quantitativa, realizada com 100 idosos durante atendimento odontológico em uma clínica pública e em um centro de referência. Utilizou-se um questionário semiestruturado, adaptado e validado. O tratamento dos dados se deu por meio de análise estatística descritiva simples. Resultados: observou-se prevalência de idosos do sexo feminino, casado, branco, renda de 1-2 salários, ensino médio completo e de outros municípios. As alterações não perceptíveis pelos idosos são: sensação de boca seca, diminuição do paladar, diminuição no fluxo salivar e aumento dos problemas gengivais. Os idosos consideram ser impossível evitar a perda dentária, todavia relataram que cuidados com os dentes remanescentes e consulta periódica ao cirurgião-dentista são necessários. Os motivos da procura ao dentista foram: dor de dente, dor na gengiva, necessidade de tratamento dentário e lesão na boca. Conclusão: a maior parte dos idosos apresenta uma percepção satisfatória quanto a sua condição atual de saúde bucal. Tem ciência das alterações bucais advindas do processo de envelhecimento, bem como das medidas de cuidados

Objetivo: Analizar la autopercepción de salud bucal por ancianos asistidos por el sistema público de una ciudad de Minas Gerais. Métodos: estudio descriptivo, transversal, con enfoque cuantitativo, realizado con 100 ancianos durante la atención odontológica en una clínica pública y en un centro de referencia. Los datos fueron tratados mediante análisis estadístico descriptivo simple. Resultados: se observó que los cambios que los ancianos no notaron fueron: sensación de boca seca, disminución del sabor, disminución del flujo salival y aumento de los problemas gingivales. Estos consideran imposible evitar la pérdida de dientes, pero informaron que es necesario cuidar los dientes restantes y consultar periódicamente con el dentista. Las razones para buscar al profesional fueron: dolor de muelas, dolor de encías, necesidad de tratamiento dental y lesiones en la boca. Conclusión: los ancianos mostraron una percepción satisfactoria de su salud bucal. Tiene consciencia de los cambios orales resultantes del envejecimiento, así como de la atención