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)

Terapia endodóntica en pacientes adultos mayores ¿qué debemos tener en cuenta? / Endodontic therapy in elderly patients, what should we consider?

De acuerdo con la tendencia mundial, el número de personas de 60 años y más va en aumento. Este crecimiento demográfico de la población, el aumento de las expectativas de vida de las personas y la tendencia a la disminución de pacientes edéntulos, produce una mayor demanda de procedimientos endodónticos en la población anciana. Es fundamental que el odontólogo conozca la fisiología del envejecimiento para poder abordar, en forma eficaz, el tratamiento en los pacientes pertenecientes a este grupo etario. Se ha descripto que los tejidos dentales sufren cambios a lo largo de la vida; entre ellos, la reducción del número de fibroblastos, de odontoblastos, de vasos sanguíneos y de fibras nerviosas; el aumento de fibras colágenas, de masas calcificadas, aposición de cemento, de dentina secundaria y de dentina de reparación. El objetivo del presente trabajo es realizar una revisión bibliográfica en relación a los cambios que presentan la pulpa dental, la dentina y el cemento, relacionados con el proceso de envejecimiento y sus posibles dificultades al momento de realizar el tratamiento endodóntico; sin olvidar cómo pueden inferir en el éxito del tratamiento las posibles patologías sistémicas que presentan los pacientes a consecuencia de la edad (AU)

According to the world trend, the number of people aged 60 and over is increasing. This demographic growth of the population, the increase in people's life expectancies and the tendency to decrease edentulous patients, produces a greater demand for endodontic procedures in the elderly population. It is essential that the dentist knows the physiology of aging to be able to effectively address the treatment in patients belonging to this age group. It has been described that dental tissues suffer changes throughout life, including the reduction of the number of fibroblasts, odontoblasts, blood vessels and nerve fibers; the increase of collagen fibers, calcified masses, apposition of cement, secondary dentin and repair dentin. The objective of the present work is to carry out a bibliographic review in relation to the changes that the dental pulp, dentine and cement have in relation to the aging process and its possible consequences in the endodontic treatment; without forgetting how it can infer in the success of the treatment the possible systemic pathologies that patients present as a result of age (AU)

Domiciliary dental care among homebound older adults: A nested case-control study in Japan.

AIM: Improving the availability of dental care is essential to maintain older adults' general health and wellbeing. Domiciliary dental care is a feasible alternative. The present study aimed to investigate factors affecting the use of domiciliary dental care among home-dwelling dependent older adults. METHODS: A retrospective nested case-control study was carried out. We identified long-term care recipients who used home care services between April 2012 and March 2014 using Japan's nationwide long-term care service claim database. One-to-one case-control matching was carried out between those with and without domiciliary dental care, based on sex, age and the time home care service use was started. We carried out multivariable conditional logistic regression analyses to assess various factors associated with using domiciliary dental care. RESULTS: We identified 3 377 998 eligible homebound long-term care beneficiaries aged ≥65 years. Of these, 278 302 (8.2%) received domiciliary dental care. Factors associated with a higher probability of receiving domiciliary dental care were: higher level of care need (odds ratio [OR] 1.99, 95% confidence interval [CI] 1.93-2.06), exemption from out-of-pocket payment (OR 1.35, 95% CI 1.32-1.39]), living in a group home (OR 7.93, 95% CI 7.71-8.16), using other domiciliary services such as physician visits (OR 3.15, 95% CI 3.08-3.22) and a large number of dental clinics providing domiciliary dental care in their municipality (OR 1.74, 95% CI 1.70-1.77). Significant barriers to receiving domiciliary dental care were living alone (OR 0.64, 95% CI 0.62-0.66) and dementia (OR 0.89, 95% CI 0.88-0.91). CONCLUSIONS: Our findings might help to improve the availability of dental care in this population. Geriatr Gerontol Int 2019; 19: 679-683.

Pragmatic care for an aging compromised dentition.

As our population ages, dentists face challenges in maintaining compromised teeth in aging patients. For the most part, elderly patients (i.e., over 65 years of age) prefer to keep their natural teeth and in some cases, avoid removable dentures altogether. Ideally, patients should not be rendered edentate late in life, as they are unlikely to successfully adapt to the limitations of complete replacement dentures. However, this is not always possible and care should ideally be planned to avoid edentulism, or at least, to carefully manage the transition to the edentate state. In the course of planning care, the dentist needs to recognise the need for age appropriate care, factoring in the impact of the elderly patient's health status and social circumstances. For elderly patients with a compromised dentition, the dentist should try to provide care which is minimally invasive and with as low a burden of maintenance as possible. In this paper, principles of pragmatic care for elderly patients with a compromised dentition will be outlined using clinical cases. Three pathways will be outlined: (i) maintenance of a functional natural dentition using adhesive restorative techniques; (ii) use of overlay prostheses and complete replacement overdentures to manage toothwear and toothloss, complete replacement overdentures, and; (iii) staging a transition to the edentate state using transitional removable partial dentures.

Focus on the Different Projects of Telemedicine Centered on the Elderly In France.

Telemedicine is now in vogue, allowing computer and communication tools to be deployed in different fields of health, such as Cardiology, Dermatology, areas in which it has received interest, and in international studies. As the population ages, older people are increasingly concerned about this innovative practice. This is a narrative review of both the literature and Internet pertaining to telemedicine projects within the field of geriatric subjects in France. Since the beginning of the 2000's, several telemedicine projects and trials focused on chronic heart failure have been developed in the elderly, and also in the field of dermatology. The potential contribution of second-generation telemedicine projects in terms of mortality, morbidity, and the number of hospitalizations avoided is currently under study. Their impact in terms of health economics is likewise being investigated, taking into account that the economic and social benefits brought up by telemedicine solutions were previously validated by the original telemedicine projects. We take a look at telemedicine projects in France concerning the elderly.

The underestimated problem of oral Candida colonization-An observational pilot study in one nursing home.

Objectives: Older people are at increased risk of intraoral yeast colonization. In this observational case series, we assessed Candida colonization among nine nursing home residents to investigate possible correlations with their individual characteristics, general health parameters, and oral care. We also described the effect of professional dental cleaning (PDC) including prosthesis cleaning on colonization cases. Materials and methods: General clinical and oral health was assessed in nine residents, and samples were taken from six oral mucosa sites or prosthetic surfaces. PDC was performed to achieve macroscopically clean results, and residents were re-examined 2 weeks later. Results: We found that six residents were intraorally colonized with Candida albicans; four also had Candida glabrata. Prostheses were particularly infected. Dementia, multimorbidity, and presence of prostheses reduced oral hygiene ability; requiring assistance for oral hygiene care was a risk indicator for Candida colonization. PDC reduced C. albicans (at the expense of increased C. glabrata) but was not optimal for maintaining Candida reduction. Conclusion: In this pilot study, Candida colonization is prevalent among nursing home residents, especially those with cognitive impairment, multimorbidity, or reduced oral hygiene capacity. Potential negative effects on general health necessitate diagnostic and therapeutic guidelines. PDC alone did not maintain the reduction in Candida colonization; additional methods for daily oral care are necessary.

Beliefs about managing dental problems among older people and dental professionals in Southern Brazil.

OBJECTIVES: To explore the sociocultural context in which patients and dentists in urban and rural communities in Southern Brazil interpret dental problems. METHOD: Beliefs and experiences related to dental problems were explored in eight focus groups involving a total of 41 older patients, and in direct interviews with two dentists and two dental assistants. The interactions were audio recorded and transcribed for thematic analysis. RESULTS: The beliefs and experiences of the participants focused on four main themes: cultural beliefs; dental services; decisions to extract teeth; and expectations for change. A culture of pre-nuptial tooth loss and complete dentures was considered beneficial to young women. Although dental services at the time were scarce in the region, demands for relief of pain were extensive despite the fear and anxiety of the participants. Extraction of teeth and fabrication of complete dentures were the usual dental treatments available, although some participants felt that dentists withheld other treatment options. Participants were hopeful that dental services would improve for their children. CONCLUSIONS: Patients and dental professionals in urban and rural communities of Southern Brazil managed dental problems within a culture of limited access and availability of services that favoured dental extractions and complete dentures.

Encuesta sobre las inquietudes y el grado de conocimientos percibido por la profesión dental en gerodontología / A survey of concerns and grade of knowlegdes perceived by dental profession about gerodontology

Introducción: El aumento de la población geriátrica en España demanda preparar a los odontólogos para poder ofrecer a este grupo de pacientes una atención específica en función de sus capacidades y necesidades. El objetivo de este trabajo es analizar el conocimiento e inquietudes en Gerodontología con la finalidad de tener una visión amplia y comprensiva de las actitudes y aptitudes que presentan los profesionales dentales para ofrecer una mejor asistencia a estos pacientes. Material y métodos: Se realizó una encuesta online a odontólogos y estudiantes de quinto curso de odontología para identificar los conocimientos e inquietudes que presentan ante la población mayor de 65 años. El cuestionario constaba con 13 ítems que se distribuyeron a 177 participantes, colegiados de la Primera Región y estudiantes de la Facultad de Odontología de la Universidad Complutense de Madrid. Resultados: La mitad de los encuestados (53%) afirmaron haber tenido una formación específica en Gerodontología, el 41,8% consideraron que hubiese sido necesaria y la mayoría (94,4%) que esa formación debería ser impartida de manera reglada. La mayor preocupación de los participantes a la hora de tratar a estos pacientes fue la farmacoterapia, principalmente los bifosfonatos, considerando el tratamiento implantológico el de mayor complejidad y la necesidad de consulta interprofesional. Conclusiones: Los profesionales de la salud oral consideran necesario una formación reglada en Gerodontología, considerando la mayor preocupación a la hora de tratar a estos pacientes la farmacoterapia, principalmente los bifosfonatos, y el tratamiento implantológico

Introduction: The increase of the geriatric population in Spain demands to prepare the dentists to be able to offer this group of patients a specific dental care according to their capacities and needs. The objective of this work is to analyze the knowledge and concerns in Gerodontology in order to have a broad and comprehensive view of the attitudes and skills presented by dental professionals to offer a better assistance to these patients. Material and methods: An online survey was conductued to dentists and fifth-year dentistry students to identify knowledges and concerns which they present about the population over 65 years of age. The questionnaire consisted of 13 items that were distributed to 177 participants, mainly members of the First Region and students of the Faculty of Dentistry of the Complutense University of Madrid. Results: Half of the respondents (53%) said that they had a specific training in Gerodontology, 41.8% considered that it should have been necessary and the majority (94.4%) that this training should be provided in a ruled way. The main concern of the participants when treating these patients was pharmacotherapy, mainly bisphosphonates, considering the implant treatment the most complex and the need for interprofessional consultation. Conclusions: Oral health professionals consider a regulated training in Gerodontology necessary, considering the main concerns when treating these patients pharmacotherapy, mainly bisphosphonates, and implant treatment

Randomised clinical trial: Efficacy of strategies to provide oral hygiene activities to nursing home residents with dementia who resist mouth care.

OBJECTIVES: The purpose of this study was to test the efficacy of MOUTh (Managing Oral Hygiene Using Threat Reduction), a nonpharmacologic, relationship-based intervention vs. control on 2 primary outcomes for nursing home (NH) residents with dementia who resisted mouth care: (i) reduction in the occurrence and intensity of care-resistant behaviours (CRBs) and (ii) improvement in oral health. Two secondary outcomes were also examined: (i) the duration of mouth care and (ii) the completion of oral hygiene activities. BACKGROUND: Persons with dementia who exhibit CRBs are at risk for inadequate mouth care and subsequent systemic illnesses. MATERIALS AND METHODS: The study used a randomised repeated measures design. Recruitment occurred in 9 nursing homes that varied in size, ownership, reimbursement patterns and location. One hundred and one nursing home residents with dementia were randomised at the individual level to experimental (n = 55) or control groups (n = 46). One hundred participants provided data for the analyses. RESULTS: Compared to the control group, persons in the experimental group had twice the odds of allowing mouth care and completing oral hygiene activities; they also allowed longer duration of mouth care (d = 0.56), but showed only small reductions in the intensity of CRBs (d = 0.16) and small differential improvements in oral health (d = 0.18). CONCLUSION: The data suggest that this intervention facilitates mouth care among persons with dementia. The management of refusal behaviour may be a clinically more realistic approach than reducing or eradicating refusals.

A ascensão da odontogeriatria no Brasil através do panorama de suas publicações / The rise of odontogeriatrics in Brazil through the panorama of its publications

A saúde bucal é parte integrante da saúde do idoso, e juntamente com a Odontogeriatria proporciona uma manutenção de uma boa qualidade de vida ao mesmo. É a base da pirâmide para a saúde do idoso através da qual se dá a mastigação e se inicia o processo digestivo, influenciando diretamente na condição nutricional e consequentemente na qualidade de vida da pessoa idosa. O aumento da população idosa produz um impacto nos serviços de saúde. Conhecendo as problemáticas é possível oferecer um melhor serviço com qualidade e capacitação adequada do profissional de Odontogeriatria, focando na preservação e manutenção da saúde bucal. A Odontogeriatria é uma especialidade relativamente nova, tendo muito ainda a ser explorada, mas mesmo nova observa-se que está em plena ascensão. Diante das inovações das leis e da conscientização da população brasileira quanto aos diretos e deveres dos idosos as tendências de publicação em Odontogeriatria poderão aumentar sucessivamente no Brasil, tornando-a cada vez mais como uma especialidade de agregar grandes valores

Single-implant overdentures retained by the Novaloc attachment system: study protocol for a mixed-methods randomized cross-over trial.

BACKGROUND: Overdentures retained by a single implant in the midline have arisen as a minimal implant treatment for edentulous mandibles. The success of this treatment depends on the performance of a single stud attachment that is susceptible to wear-related retention loss. Recently developed biomaterials used in attachments may result in better performance of the overdentures, offering minimal retention loss and greater patient satisfaction. These biomaterials include resistant polymeric matrixes and amorphous diamond-like carbon applied on metallic components. The objective of this explanatory mixed-methods study is to compare Novaloc, a novel attachment system with such characteristics, to a traditional alternative for single implants in the mandible of edentate elderly patients. METHODS/DESIGN: We will carry out a randomized cross-over clinical trial comparing Novaloc attachments to Locators for single-implant mandibular overdentures in edentate elderly individuals. Participants will be followed for three months with each attachment type; patient-based, clinical, and economic outcomes will be gathered. A sample of 26 participants is estimated to be required to detect clinically relevant differences in terms of the primary outcome (patient ratings of general satisfaction). Participants will choose which attachment they wish to keep, then be interviewed about their experiences and preferences with a single implant prosthesis and with the two attachments. Data from the quantitative and qualitative assessments will be integrated through a mixed-methods explanatory strategy. A last quantitative assessment will take place after 12 months with the preferred attachment; this latter assessment will enable measurement of the attachments' long-term wear and maintenance requirements. DISCUSSION: Our results will lead to evidence-based recommendations regarding these systems, guiding providers and patients when making decisions on which attachment systems and implant numbers will be most appropriate for individual cases. The recommendation of a specific attachment for elderly edentulous patients may combine positive outcomes from patient perspectives with low cost, good maintenance, and minimal invasiveness. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03126942 . Registered on 13 April 2017.

How do we incorporate patient views into the design of healthcare services for older people: a discussion paper.

BACKGROUND: Across the European Union costs for the treatment of oral disease is expected to rise to €93 Billion by 2020 and be higher than those for stroke and dementia combined. A significant proportion of these costs will relate to the provision of care for older people. Dental caries severity and experience is now a major public health issue in older people and periodontal disease disproportionately affects older adults. Poor oral health impacts on older people's quality of life, their self-esteem, general health and diet. Oral health care service provision for older people is often unavailable or poor, as is the standard of knowledge amongst formal and informal carers. The aim of this discussion paper is to explore some of the approaches that could be taken to improve the level of co-production in the design of healthcare services for older people. MAIN TEXT: People's emotional and practical response to challenges in health and well-being and the responsiveness of systems to their needs is crucial to improve the quality of service provision. This is a particularly important aspect of care for older people as felt, expressed and normative needs may be fundamentally different and vary as they become increasingly dependent. Co-production shifts the design process away from the traditional 'top-down' medical model, where needs assessments are undertaken by someone external to a community and strategies are devised that encourage these communities to become passive recipients of services. Instead, an inductive paradigm of partnership working and shared leadership is actively encouraged to set priorities and ultimately helps improve the translational gap between research, health policy and health-service provision. DISCUSSION: The four methodological approaches discussed in this paper (Priority Setting Partnerships, Discrete Choice Experiments, Core Outcome Sets and Experience Based Co-Design) represent an approach that seeks to better engage with older people and ensure an inductive, co-produced process to the research and design of healthcare services of the future. These methods facilitate partnerships between researchers, healthcare professionals and patients to produce more responsive and appropriate public services for older people.

[Dental visits among people over 65; a study in a general dental clinic in Drenthe, the Netherlands]. / Tandartsbezoek van 65-plussers; onderzoek uit een algemene praktijk in Drenthe.

In this study, factors that may influence the dental visiting patterns of people over 65 living independently were investigated. The results of a questionnaire (n = 164; 53% response) revealed that 89% of them regularly visited the dentist for a check-up. Factors affecting dental visits were: whether or not one had difficulty planning a visit, whether or not one was motivated to make an appointment and actually made one, the condition of one's teeth; whether or not one had dental insurance and whether or not one reacted to a dental reminder (post)card. Mobility played no greater role among non-regular dental visitors than among regular visitors. Anticipating the possibility of an older patient living independently might fail to show by means of an active call policy seems more relevant than organising transport.

Dental Care for Geriatric and Special Needs Populations.

This article reviews considerations for oral health care associated with the most common causes of mortality and morbidity in older adults. Many of these diseases result in functional or cognitive impairments that must be considered in treatment planning to ensure appropriate, safe, and effective care for patients. Many of these considerations parallel those of adults who have lived with developmental disabilities over a lifetime and similar principles can be applied. Systemic diseases, conditions, and their treatments can pose significant risks to oral health, which requires prevention, treatment, and advocacy for oral health care as integral to chronic disease management.

Pharmacological behaviour support for adults with intellectual disabilities: Frequency and predictors in a national cross-sectional survey.

OBJECTIVE: To report frequency and predictors of reported pharmacological behaviour support use among older adults with intellectual disabilities (ID) accessing dental care in Ireland. METHODS: Data from a nationally representative cross-sectional survey of adults with ID over 40 years of age allowed identification of the reported frequency of pharmacological behaviour support use. Predictors of pharmacological support were identified using multiple logistic regression. RESULTS: Most older adults with ID did not report the use of any pharmacological support to receive dental care: only 0.9% reported use of inhalation sedation; 2.4% intravenous (IV) sedation; 8.6% general anaesthesia (GA); and 16.0% oral sedation. Participants reporting challenging behaviour (OR = 1.9, 95% CI = 1.3-2.9), significant difficulty speaking (OR = 3.0, 95% CI = 1.8-4.8) and obvious oral problems (OR = 2.5, 95% CI = 1.6-4.1) had greater odds of reporting pharmacological, that is, GA or conscious sedation (CS), rather than nonpharmacological supports for dental care, compared to those who were not. CONCLUSIONS: People with ID report a diverse range of support use, with many using GA or CS, particularly oral sedation, for dental treatment. This highlights a need for training and governance for dentists who provide this care. Patients who present with challenging behaviour, oral problems and, interestingly, difficulty with expressive communication are more likely to report use of pharmacological supports. The above has implications for dental service design and delivery for this population.

Lesiones bucales en adultos mayores y factores de riesgo. Policlínico "Dr. Tomás Romay", La Habana, Cuba / Buccal lesions in older adults, and risk factors. Dr. Tomás Romay Polyclinic, Havana, Cuba

Introducción: Las lesiones en la mucosa bucal son frecuentes en la población de adultos mayores, lo cual repercute en la aparición del cáncer bucal. Objetivo: Caracterizar las lesiones en las mucosas bucales y su relación con los factores de riesgo presentes en una población geriátrica, del Policlínico Dr. Tomás Romay, Habana Vieja. Material y Métodos: Estudio descriptivo en los 137 adultos mayores de ambos sexos del consultorio 2 del Policlínico Dr. Tomás Romay, Habana Vieja, entre 2015-2016. A todos se les solicitó su consentimiento de participación, se les realizó un interrogatorio y el examen bucal. Se tuvieron en cuenta las variables edad, sexo, tipo de lesión y la localización de las mismas; además de los factores de riesgo de lesiones bucales. Resultados: El 62,8 por ciento fueron mujeres, 24,8 por ciento tenía entre 60-69 años y 45,3 por ciento presentó lesiones, con mayor frecuencia las del paladar duro (62,9 por ciento) y la mucosa del carrillo (20,9 por ciento). Se identificaron siete tipos de lesiones bucales, con una primacía de la estomatitis subprótesis (62,9 por ciento). La ingestión de alimentos calientes o muy condimentados alcanzó el mayor porcentaje (85,5 por ciento) y le siguió las prótesis desajustadas (75,8 por ciento). Conclusiones: En la población geriátrica estudiada, las mujeres son las más afectadas y los que presentan 70 años y más. Son más frecuentes las lesiones en el paladar duro y la estomatitis subprótesis, observándose mayor riesgo en los pacientes con prótesis dentales desajustadas, en los que ingieren alimentos calientes y muy condimentados, y en los fumadores(AU)

Introduction: Lesions of the buccal mucosa are frequent in older adults, which has an effect on the appearance of buccal cancer. Objective: To characterize lesions in the buccal mucosa, and their relation to risk factors in a geriatric population in Dr. Tomás Romay Polyclinic, Old Havana. Material and methods: A descriptive study was conducted using data from 137 older adults of both sexes treated in doctor´s office No. 2 of Dr. Tomás Romay Polyclinic in Old Havana, from 2015-2016. A consent for participation was asked to all of them, a questionnaire was applied, and buccal examinations were done. Variables such as age, sex, kind of lesion, and location of the lesions were taken into account, as well as the risk factors for buccal lesions. Results: The 62,8 percent of the participants in the study were women, 24,8 percent aged 60-69 years, and 45,3 percent presented lesions which were more frequently observed in the hard palate (62,9 percent) and the mucosa of the cheek (20,9 percent). Seven kinds of buccal lesions were identified, with a priority of subprosthesis stomatitis (62,9 percent). The ingestion of hot or very spiced food reached the highest percentage (85,5 percent), followed by prosthesis loosen (75,8 percent). Conclusions: In the geriatric population studied, the most affected people are women and those people who are 70 years old or older. The most frequent lesions are the ones that appear in the hard palate and subprosthesis stomatitis, observing a highest risk in those patients with loosening of dental prosthesis, in those people who ingest hot and very spicy food, and in smokers(AU)

Development of an Oral Assessment Sheet for Evaluating Older Adults in Nursing Homes.

A new general use oral assessment sheet (OAS), comprising three items each in three categories (i.e., oral hygiene, biting and chewing, and oral function), was developed to improve the oral health of older adults requiring nursing care. Seventy-nine care workers used the assessment sheet to evaluate oral conditions in 188 institutionalized older adults. Forty-five care workers and three dental professionals then assessed oral conditions in 45 institutionalized older adults using the test-retest method before and after dental professional guidance. Cronbach's alpha of the OAS was 0.72, and 0.65, 0.57, and 0.82 for the three subcategories of oral hygiene, biting and chewing, and oral function, respectively. After dental professional intervention, absolute and relative agreement coefficients increased to more than 0.6 and 0.89, respectively. Reliability and validity of the OAS were verified, and difficulties in oral assessment experienced by care workers were identified. [Res Gerontol Nurs. 2017; 10(5):234-239.].

A pilot study on the feasibility of training nurses to formulate multicomponent oral health interventions in a residential aged care facility.

OBJECTIVES: This 10 weeks feasibility study investigated whether residential care nurses with 12 hours advanced oral health training in assessments and saliva testing could formulate, implement and monitor individualised oral care plans of early dementia residents. METHOD: Four trained lead advocate nurses using SXI-D, OHIP14, oral health assessment tool (OHAT) assessments and a modified saliva test formulated nurse scheduled comprehensive oral care plans (NSCOCPs) by selecting and scheduling preventive products and procedures multiple times throughout the day to alkalise the mouth of 8 residents as an adjunct to assisted brushing and high-fluoride toothpaste. RESULTS: Nurse assessments, saliva tests and care plans were validated against oral health therapist (OHT) findings. Care plan agreement between Nurse and OHT intervention selection and scheduling was high (75%-88%). Untrained nurse compliance was very high, 86%-99% for the 4930 scheduled interventions. Untrained nurses delivered multiple scheduled interventions by following NSCOCPs despite initially not understanding the reason for each of 9 interventions categories. NSCOCPs could track and monitor whether a recommended intervention had been completed by general nursing staff over 3 nursing shifts. CONCLUSION: The role of nurses may have to be expanded beyond traditional roles to meet the growth and changes in oral health needs in residential facilities. Intensive training of a few lead advocate nurses to assess risk and formulate individualised NSCOCPs provides a method to transfer knowledge to untrained staff and deliver multicomponent preventive interventions soon after entry into residential care where timely visits by dental professionals to examine residents and prescribe preventive interventions are infrequent or unlikely.