Oral hygiene caregivers' educational programme improves oral health conditions in institutionalised independent and functional elderly.

OBJECTIVE: The goal of this study was to determine the impact of an oral hygiene education programme for caregivers on the oral health of institutionalised elderly and to examine the effect of disability and low muscle strength on programme outcomes. MATERIALS AND METHODS: The subjects of this study were geriatric patients (n = 80) from a nursing home. Katz Index for activities of daily living, handgrip strength and mucosal-plaque score (MPS) was evaluated at baseline and 1 year after intervention. The intervention consisted of an educational programme and specific guidelines for caregivers (to perform oral hygiene for dependent elderly and to supervise the independent elderly during oral hygiene practices). Differences on MPS were evaluated using a paired-sample t-test. A stratified analysis was carried out to identify differences in response to the programme according to the Katz Index and handgrip strength of elderly. RESULTS: The MPS was significantly reduced (p = 0.001) at follow-up; however, a separate analysis showed that only the independent elderly (p = 0.002) and those with normal muscle strength (p = 0.006) showed a reduction in MPS during the follow-up examination. CONCLUSION: The oral hygiene education programme for caregivers resulted in a positive impact on oral hygiene of the independent and functional elderly.

Vulnerability and the psychosocial aspects of tooth loss in old age: a Southern Brazilian study.

Extensive tooth loss and edentulism can have a negative impact on the general health and quality of life of older adults. The extent to which psychological and social factors affect an individual's decision to undergo tooth extraction and mouth clearance (extraction of all teeth), and the theoretical relationships between social structure, social life and oral health can be unraveled through qualitative research. This study aimed to explore the social and psychological factors involved in tooth extraction and mouth clearance within a historical perspective among rural Southern Brazilian older adults. It is based on qualitative data gathered via a series of eight focus groups among 41 older adults. Underlying the focus group discussions of different levels of health risks and resources for prevention of disease was the concept of vulnerability. Participants' responses illustrated that tooth loss and mouth clearance were related to a lack of public dental health policies and programs, were influenced by social norms (including values pertaining to gender), and were associated with a low level of oral health knowledge. The social and program-dependent contexts of vulnerability were shown to have played a major role in the development of norms and values towards tooth extraction and mouth clearance. Vulnerability must be reduced in order to prevent disease particularly among rural populations. The influence of fatalistic beliefs about the inevitable loss of teeth with age may negatively influence the acceptance of dental treatment and predilection for oral health self-care.

Hand function and oral hygiene in older institutionalized Brazilians.

OBJECTIVES: To evaluate whether the oral hygiene of institutionalized older people differs significantly between groups of participants with different degrees of hand function. DESIGN: Cross-sectional study. SETTING: Residents of a long-term institution of Porto Alegre, Brazil. PARTICIPANTS: Forty-nine institutionalized older people. Subjects restricted to bed or with Mini-Mental State Examination (MMSE) scores less than 15 were excluded. MEASUREMENTS: Dental (Silness and Löe Index) and denture plaque (Modified Ambjornsen Plaque Index) scores were assessed as a measure of oral hygiene. Hand functions were assessed using the Jebsen-Taylor and the Purdue pegboard tests. Participants were grouped according to their levels of hand function (regarded as good if test values were at the median or higher in the case of Purdue pegboard test and below the median in the case of Jebsen-Taylor test). Existence of differences between groups was checked using univariate analysis of variance, adjusting for age, sex and cognitive status according to MMSE. RESULTS: Dentate participants with poor hand function according to the Dominant Hand Purdue test harbored significantly more dental plaque after adjustment for age, sex, and cognitive status. Complete denture wearers with poor hand function according to the Dominant Hand and Sum of Three Steps Purdue tests and the total Jebsen-Taylor test also had significantly more denture plaque after adjustment. CONCLUSION: The results support the notion that hand function plays a central role in oral hygiene, mainly removal of dental and denture plaque, in institutionalized older people.

Reproducibility of a hemi mandible positioning device and a method for measuring alveolar bone loss area in mice.

The objective of this study was to determine the reproducibility of a positioning device and a method for measuring the area of alveolar bone loss (ABL) in hemi mandibles of mice. Mucoperiosteal flaps were raised in CF1 Mus domesticus mice (n = 10) on the buccal aspects of the left side of the mandibles. Twenty-one days after surgery, the animals were sacrificed, and the mandibles were resected and stained with 1% toluidine blue. Two positioning devices, one for the buccal and the other for lingual aspect, were fabricated to keep the hemi mandibles in a standard position. The reliabilities of the positioning device and the method for measuring ABL area were analyzed using two series of pictures. The photographs were digitized and ABL measured as the exposed root area. Measurements were performed by two blinded examiners using image analysis software. Intra- and inter-examiner reproducibility of the positioning method ranged from -1.5 to +1.33 mm, while intra- and inter-examiner reproducibility of the measurement technique ranged from -3.37 to 14.70. Our results indicate that, due to the small variation observed in ABL area assessment, the positioning device and method for measuring ABL area represent useful techniques for evaluating ABL in mice.

Sindrome de sjogren: relato de caso / Spogrens syndrome: case report

Objetivos: Apresentar um caso clínico enfantizando a abordagem terapêutica realizada pelo cirurgião dentista com a finalidade de melhorar a qualidade de vida dos pacientes acometidos pela Sindome Sjogren. Descrição do caso: Paciente feminina com síndrome de Sjogren encaminhada para reabilitação protética apresentava ressecamento da face, olhos, lábios e toda mucosa bucal. Queixava-se de dificuldade para falar, mastigar e engolir. Foi realizada a adequação bucal e foram dadas instruções relacionadas à dieta alimentar. Para a reabilitação do espaço edentado tipo classe III de Kennedy, optou-se por uma prótese parcial removível convencional com redentores extracoronários. Foi prescrito flúor em forma de bochecho diário e gel oral umidificador, duas vezes ao dia. Foi delineado um programa de acompanhamento e manutenção para a paciente pudesse manter, com sucesso, a saúde bucal estabelecida. Conclusões: A síndrome de sjogren compreende anormalidades em diversos setores do organismo, incluindo a saliva, que desempenha importante papel na fisiologia e biologia do ser humano. Portanto, a interdisplinaridade, com envolvimento do cirurgião dentista, é exterma importância para o sucesso terapêutico desta doença.