Journal of Disability and Oral Health
- Cover Date:
- September 2010
- Vol:
- 11
- Issue:
- 3
Poster Abstracts
Poster Abstracts
SESSION 1: ELDERLY P101 Relationships between medical and oral assessments to provide dental treatment in institutionalised dependent elders Limeres J, Diz P, Tomás I, Perez E, Del Llano A, Feijoo JF Special Needs Unit, School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
Introduction: Oral health problems are common in the elderly, whose medical condition may determine their dental treatment plan. This study analyses the interaction between dental and medical staff to establish a dental treatment plan in institutionalised elders. Methods: This cross-sectional study involved 297 dependent elders living in a nursing home. A thorough medical history was recorded, functional and cognitive capacity were evaluated applying the Katz, Barthel, GDS and MMSE tests and an oral examination was completed to check their dental needs. Medical and dental data were analysed to obtain statistical correlations. Results and Conclusion: Dementia was present in 43% of patients, 45% of them never ate solids, and 66% had wandering problems. A relation between ‘Functional tests’ (Katz and Barthel) and periodontal status (p<0.005) was found as well as level of dental prosthesis hygiene (p<0.001). ‘Cognitive tests’ (Barthel and MMSE) were related both to number of missing teeth (p<0.05) and the calculus score (p<0.01). In 69 patients, no dental treatment was needed; 228 patients needed dental care, in 74 cases the choice of dental treatment was not influenced by their systemic status but in 154 cases, the medical staff had to be consulted (including 58 residents, where removal of all teeth was the treatment of choice). In summary, in institutionalised dependent elders, close cooperation between medical staff and dental practitioners enable more adequate dental treatment plans considering factors such as functional ability, cognitive status or life expectancy.
P103 Evaluation of the oral mucosa for the elderly by oral smear cytology Mami E1, Hiroyuki O2, Takashi M3, Hirotsugu Y2, Junichi M1 1 Nihon University School of Dentistry at Matsudo, Department of Special Needs Dentistry; 2Nihon University School of Dentistry at Matsudo, Department of Oral Pathology; 3Nihon University Hospital at Matsudo, Clinical Laboratory; Tokyo, Japan
Introduction: Oral care is important to maintain good oral health. However, functionally dependent elderly people find difficulty in performing oral health care due to the decline in the activities of daily living. Consequently, they are unable to maintain good oral health and frequently suffer from oral mucosal infections such as candidiasis with associated xerostomia. mear cytology is routinely used to screen the uterine mucosa but only a few studies have examined the cytological condition of the oral mucosa. In this study, we evaluated the oral mucosal conditions of the functionally dependent elderly by using smear cytology. Subjects and Methods: 26 elderly subjects in a nursing home were included in this study. Anamnesis was assessed and oral examination was performed. Buccal and gingival smears were obtained by using a cytobrush and stained with Papanicolaou and periodic acid-Schiff (PAS). Results: Of the samples obtained, 20 buccal mucosa samples and 7 gingival samples were classified as Class I according to Papanicolaou’s classification. Candida sp. was observed in 12 and 7 of the gingival and buccal mucosa samples, respectively. Entamoeba gingivalis was observed in 10 and 1 of the gingival and buccal mucosa samples, respectively. Conclusion: Our results suggest that smear cytology might be a useful method for evaluating and diagnosing the oral mucosal condition of the elderly.
P102 Denial of consent for full dental clearance in the treatment of patients with late-stage dementia Karve A, Schifter M, Jay E University of Sydney, Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Centre for Oral Health, Sydney, Australia
D e m en tia is a g en er ic t e r m t h a t d e s c r i b e s c h r o n i c , p r og r es s iv e dysfunction of cortical and sub-cortical functions of the central nervous system that results in complex cognitive decline. Persons with late-stage dementia, especially if residing in a long-term care facility, are regularly found to have compromised oral health and function. Barriers to oral health have been identified and range from oral and systemic changes in the patient’s health to environmental factors in the residential care facility. Contemporary guidelines outline the principles of oral health management for persons with early, moderate or late-stage dementia. In late-stage dementia, all the current guidelines recommend a preventive, minimally-invasive approach to the delivery of oral health care, unless there is the need for emergency treatment. At this time, the perceived benefits of treatment, such as the potential relief of pain and the maintenance of quality of life have to be carefully weighed and balanced against the potential risks to the patient, in that to obtain cooperation a general anaesthetic is usually mandated. However, patients with late-stage dementia are unable to give their own consent for treatment, and the power to consent rests with a legally-appointed patient guardian, most often an immediate family member of the patient. This retrospective audit investigates the reasons for denial of consent by guardians of patients with late-stage dementia, to be rendered completely edentulous.
P104 The relationship between sensory information in the anticipatory stage and feeding action. Effects on lip closing pressure during food capturing Tomita K1, Ooka T1,2, Watanabe M1, Nomura K1, Ishikawa K1, Mukai Y1 1 Showa University, Department of Hygiene and Oral Health, Tokyo, Japan; 2University of Sydney, Westmead Hospital, Sydney, Australia
A i m s : To i n v e s t i g a t e t h e e ff e c t s o f s e n s o r y i n f o r m a t i o n i n t h e anticipatory stage of feeding on lip closing pressure during food capturing; comparison of results from young adults and the elderly. Method: 12 young adults and 22 elderly were fed soft, jelly-type foods in four manners: eyes closed, eyes closed and being told what they were about to eat, eyes open and being told what they were about to eat, self feeding with their eyes open. Each action was performed three times and the food was chosen randomly from eight sorts having different taste but similar texture. A strain gauge transducer was embedded on the feeding spoon and lip closing pressure during food capturing was measured and recorded. The average of strength, duration and waveform of the lip pressure were analysed and compared between the four conditions in both age groups. Results: Without visual information the subjects demonstrated a longer pressure, which was significant in young adults. In the elderly, stability of lip closing pressure is lower than young adults especially under the condition where no sensory information of the food is given. It is suggested that sensory information affects the lip pressure by altering the duration and the stability of the pressure.
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