New Perspectives in Oral Health for Patients with Special Needs and Compromised Older Adults

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (20 May 2023) | Viewed by 22623

Special Issue Editors


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Guest Editor
Derartment of Geriatric Dentistry, Osaka Dental University Faculty of Dentistry, 1-5-17, Otemae, Chuo-ku, Osaka 540-0008, Japan
Interests: prosthodontics; gerodontology; oral function; dysphagia rehabilitation; clinical epidemiology

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Guest Editor
Department of Comprehensive Care, Case School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
Interests: geriatric dentistry; mouth hygiene; oral health; nursing homes

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Guest Editor
Dental School, National and Kapodistrian University of Athens, Athens, Greece
Interests: gerodontology (geriatric dentistry); oral function; frailty; nursing homes

Special Issue Information

Dear Colleagues, 

Populations are aging worldwide, and this demographic change has major repercussions for the healthcare systems. Oral healthcare is no exception. The current cohort of older adults has been able to retain their dentition into old age, which is a positive outcome of modern dentistry. However, as they age, older adults become more susceptible to rapid oral health deterioration (ROHD) due to systemic health-, oral health- and socio-economic-related factors. Dentists worldwide need to recognize these factors and be prepared to prevent, diagnose, and treat the consequences of ROHD among the growing older adult population. At the same time, further research on the relationship between ROHD and the general health of older adults (disease, hyponutrition, flail, etc.), prognosis, and quality of life is needed. It is desirable that all related disciplines, not just medicine and dentistry, enter this research theme. Interdisciplinary research is expected to lead to more efficient and effective health promotion measures. We, guest editors, welcome not only reports from clinical practice, but also research with a broad social perspective, or interdisciplinary and challenging efforts in this Special Issue. Furthermore, we hope to share a new perspective on the oral health of older adults.

Topics will include:

  • The interrelationship between systemic health factors and ROHD among older adults
  • Oral health factors related to ROHD among older adults
  • Socio-economic factors related to ROHD among older adults
  • Preventing, diagnosing, and treating ROHD among older adults
  • Novel and Interdisciplinary approach to ROHD among older adults
  • Impact of ROHD on the quality of life (QOL)  

Prof. Dr. Takahiro Ono
Prof. Dr. Leonardo Marchini
Prof. Dr. Anastassia E. Kossioni
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • geriatric dentistry
  • special needs dentistry
  • oral health care
  • ROHD
  • diagnosis
  • chewing (mastication)
  • dysphagia, QOL

Published Papers (14 papers)

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Research

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11 pages, 1132 KiB  
Article
An Overview of Systemic Health Factors Related to Rapid Oral Health Deterioration among Older People
by Gert-Jan van der Putten and Cees de Baat
J. Clin. Med. 2023, 12(13), 4306; https://doi.org/10.3390/jcm12134306 - 27 Jun 2023
Cited by 1 | Viewed by 1124
Abstract
The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. This paper aims to present an overview of the published evidence on systemic health factors that contribute to rapid oral health deterioration [...] Read more.
The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. This paper aims to present an overview of the published evidence on systemic health factors that contribute to rapid oral health deterioration in older individuals, and to explore the implications of these factors for both general healthcare and oral healthcare provision. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral healthcare providers, other healthcare providers, and informal caregivers. Oral healthcare providers have a responsibility to advocate for the importance of maintaining adequate oral health and to raise awareness of the serious consequences of weakened oral health. By doing so, we can prevent weakened oral health from becoming a geriatric syndrome. Full article
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13 pages, 309 KiB  
Article
Association between Oral Hygiene Information Sources and Daily Dental and Denture Care Practices in Urban Community-Dwelling Older Adults
by Kalliopi Konstantopoulou and Anastassia E. Kossioni
J. Clin. Med. 2023, 12(8), 2881; https://doi.org/10.3390/jcm12082881 - 14 Apr 2023
Cited by 2 | Viewed by 1359
Abstract
The purpose of this cross-sectional study was to explore the sources of daily oral hygiene information among urban community-dwelling older adults in Athens, Greece and associate them with their dental and denture care habits. One hundred and fifty-four older adults (aged 71.7 ± [...] Read more.
The purpose of this cross-sectional study was to explore the sources of daily oral hygiene information among urban community-dwelling older adults in Athens, Greece and associate them with their dental and denture care habits. One hundred and fifty-four older adults (aged 71.7 ± 9.2 years) participated in the study, and their dental status, denture use, daily oral care habits according to current gerodontology recommendations, and oral care information sources were investigated. Daily oral hygiene practices were poor, and a small number of individuals recalled having received oral hygiene advice from a dentist. Only 41.7% of the 139 dentate participants performed toothbrushing with fluoride-based toothpaste at least twice a day, and 35.9% completed regular interdental cleaning. Among 54 denture wearers, 68.5% removed their denture(s) at night, and 54% cleaned them at least twice a day. Oral hygiene information sources included dentists (for approximately half of the participants), media, friends/relatives, non-dental health care providers and dental technicians. Dentate participants who had received oral hygiene information from dentists had a greater probability of brushing their teeth with fluoride toothpaste at least twice a day (p = 0.049, OR = 2.15) and performing regular interdental cleaning (p < 0.001, OR = 29.26). Denture wearers who had received instructions about denture hygiene from dentists were more likely to use a brush and mild soap (p = 0.016, OR = 14.67) and remove their denture(s) at night (p = 0.003, OR = 8.75). Dentists should improve their oral health prevention and promotion strategies for their older patients. Full article
13 pages, 963 KiB  
Article
Prevalence of Possible Dementia in Patients with Maxillofacial Defects and Difficulty of Inserting Obturator in Maxillectomy Patients: Toward Better Provision of Supportive Care
by Hongli Yu, Haruka Fujita, Masako Akiyama, Yuka I. Sumita and Noriyuki Wakabayashi
J. Clin. Med. 2023, 12(7), 2722; https://doi.org/10.3390/jcm12072722 - 05 Apr 2023
Cited by 1 | Viewed by 1053
Abstract
As society ages, it is important to understand the prevalence of dementia and the difficulties of inserting prostheses in patients with maxillofacial defects in order to clarify issues in supportive care. We screened 183 patients for dementia using the revised Hasegawa’s dementia scale [...] Read more.
As society ages, it is important to understand the prevalence of dementia and the difficulties of inserting prostheses in patients with maxillofacial defects in order to clarify issues in supportive care. We screened 183 patients for dementia using the revised Hasegawa’s dementia scale (HDS-R) at the Clinic for Maxillofacial prosthetics, Tokyo Medical and Dental University, and investigated age and sex differences in HDS-R score. We asked 47 of the 183 participants about the difficulty of inserting a maxillofacial obturator prosthesis and collected subjective comments, information about the prosthesis, and data from five assessments. Multiple regression analysis was used to reveal factors associated with insertion difficulty. Overall, 8.7% of the participants were judged to have possible dementia. Men were more likely than women to have possible dementia, and the risk increased with age. Of the 47 participants, 26 reported difficulty inserting their prosthesis, 12 of whom attributed it to their oral defect. Fourteen patients advised following doctor’s instructions to practice insertion in order to become accustomed to it. A lower HDS-R score had a significant impact on insertion difficulty. Cognitive function and difficulty inserting maxillary obturator prostheses should be considered in the provision of continuous supportive care to patients with maxillary defects. Full article
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9 pages, 753 KiB  
Article
Impact of COVID-19 on the Surrounding Environment of Nursing Home Residents and Attitudes towards Infection Control and Oral Health Care among Nursing Home Staff in Japan
by Rena Hidaka, Koichiro Matsuo, Tomoka Maruyama, Kyoka Kawasaki, Itsuki Tasaka, Masami Arai, Satoshi Sakoda, Kazunori Higuchi, Erina Jinno, Tsuyoshi Yamada and Shunsuke Minakuchi
J. Clin. Med. 2023, 12(5), 1944; https://doi.org/10.3390/jcm12051944 - 01 Mar 2023
Viewed by 1262
Abstract
The environments of nursing home staff and residents have dramatically changed since the onset of the COVID-19 pandemic, with greater demand for infection control. This study aimed to clarify the changes and regional differences in the surrounding environment of nursing home residents as [...] Read more.
The environments of nursing home staff and residents have dramatically changed since the onset of the COVID-19 pandemic, with greater demand for infection control. This study aimed to clarify the changes and regional differences in the surrounding environment of nursing home residents as well as the working environment of staff, including oral health care, after the spread of SARS-CoV-2. A self-administered questionnaire survey was sent to nursing staff at about 40 nursing homes in different areas of Japan in September and October 2021. The questionnaire consisted of items centered around: (1) the surrounding environment of nursing home residents, (2) awareness and attitudes towards daily work among staff, and (3) attitudes to and procedures for oral health care among staff. A total of 929 respondents included 618 (66.5%) nursing care workers and 134 (14.4%) nurses. Regarding changes in resident daily life, 60% of staff perceived decreases in psychosocial and physical function after the start of the pandemic due to limited family communication and recreational activities, especially in urban areas. Concerning infection control, most respondents adopted routines of disinfecting hands before and after their duties. Oral health care was part of the regular duties of over 80% of respondents. Many participants answered that the frequency and time of oral health care only slightly changed after the onset of COVID-19, but many also reported disinfecting hands both before and after oral health care, particularly in rural areas. Our findings suggested that the COVID-19 pandemic decreased the daily living activities of residents, leading to psychosocial and physical decline, especially in urban areas. The results also indicated that the spread of SARS-CoV-2 triggered improvements in the awareness and attitudes towards infection control in daily work, including oral health care, among nursing care staff, notably in rural areas. Such an effect may contribute to a more positive perception of oral health care infection measures after the pandemic. Full article
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9 pages, 248 KiB  
Article
Factors Associated with Selection of Denture Adhesive Type: A Cross-Sectional Survey
by Kohei Yamaguchi, Yohei Hama, Hitomi Soeda, Keita Hatano, Mitsuzumi Okada, Ryota Futatsuya and Shunsuke Minakuchi
J. Clin. Med. 2023, 12(3), 873; https://doi.org/10.3390/jcm12030873 - 21 Jan 2023
Viewed by 1254
Abstract
The type of denture adhesive, cream or home-liner, chosen by regular denture adhesive users and oral conditions contributing to this selection require elucidation. The factors associated with denture adhesive selection were investigated through a face-to-face survey on oral and denture conditions. Age, sex, [...] Read more.
The type of denture adhesive, cream or home-liner, chosen by regular denture adhesive users and oral conditions contributing to this selection require elucidation. The factors associated with denture adhesive selection were investigated through a face-to-face survey on oral and denture conditions. Age, sex, oral moisture, masticatory performance, retention and stability of the removable denture, ridge shape, mucosal thickness, and duration of denture use were examined in cream and home-liner-type denture adhesive users who did not regularly visit a dentist. Univariate analysis and multivariate analyses were performed. There were 38 and 40 cream-type and home-liner-type adhesive users, respectively. The type of denture adhesive was significantly associated with the oral moisture value, retention, ridge shape, mucosal thickness, and duration of denture use in univariate analyses. The residual ridge conditions with large factor loadings for ridge shape and mucosal thickness and duration of denture use were significantly related to the denture adhesive selection in multivariate logistic analysis. The residual ridge conditions and duration of denture use were significant factors in the selection of cream- and home-liner-type denture adhesives. These results can provide appropriate guidance based on the adhesives patients without dental supervision are more likely to choose. Full article
8 pages, 2579 KiB  
Article
Masticatory Performance Test Using a Gummy Jelly for Older People with Low Masticatory Ability
by Kazuhiro Murakami, Tasuku Yoshimoto, Kazuhiro Hori, Rikako Sato, Ma. Therese Sta. Maria, Pinta Marito, Hinako Takano, Aye Mya Mya Khaing, Takashi Nokubi and Takahiro Ono
J. Clin. Med. 2023, 12(2), 593; https://doi.org/10.3390/jcm12020593 - 11 Jan 2023
Cited by 5 | Viewed by 1886
Abstract
Evaluation of masticatory ability has become more important in an aging society because decreased masticatory ability has the potential to affect the general health of older people. A new masticatory performance test, intended for older people with low masticatory ability, has been developed [...] Read more.
Evaluation of masticatory ability has become more important in an aging society because decreased masticatory ability has the potential to affect the general health of older people. A new masticatory performance test, intended for older people with low masticatory ability, has been developed using gummy jelly half the size of that used in the conventional masticatory performance test. This study aimed to investigate the compatibility between the new and conventional tests and the adaptation of the new test. The new test using the 8-grade visual score with half-size gummy jelly was performed among 137 removable denture wearers (mean age 75.8 ± 9.0 years) with low masticatory performance (a score of ≤4 on a conventional test). The correlation between the scores of half-size gummy jelly (VS-H) in the new test and those of full-size gummy jelly (VS) in the conventional test was evaluated. VS-H among the groups divided by VS were also compared. A strong positive correlation was detected between VS-H and VS (rs = 0.70). In groups with VS of 0 and 1, VS-H values were widely distributed from 0 to 7. There were significant differences in VS-H between the groups with VS of 0–2 but no significant differences in VS-H between the groups with VS of 2–4. Therefore, the masticatory performance test using half-size gummy jelly is suitable for a detailed evaluation of masticatory ability in older people with low masticatory ability when their visual score of full-size gummy jelly in the conventional test is 2 or less. Full article
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9 pages, 408 KiB  
Article
Relationships between the Nutrition Status and Oral Measurements for Sarcopenia in Older Japanese Adults
by Kentaro Okuno, Ryuichiro Kobuchi, Suguru Morita, Ayako Masago, Masaaki Imaoka and Kazuya Takahashi
J. Clin. Med. 2022, 11(24), 7382; https://doi.org/10.3390/jcm11247382 - 12 Dec 2022
Cited by 2 | Viewed by 1088
Abstract
Introduction: The purpose of the present study was to clarify the relationships between the risk of malnutrition as a preliminary stage of malnutrition and overall and oral measurements for sarcopenia in older Japanese adults. Methods: Forty-five participants (79.7 ± 6.1 years) were included [...] Read more.
Introduction: The purpose of the present study was to clarify the relationships between the risk of malnutrition as a preliminary stage of malnutrition and overall and oral measurements for sarcopenia in older Japanese adults. Methods: Forty-five participants (79.7 ± 6.1 years) were included in the analysis. The nutrition status of the participants was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF) and classified into two groups: normal and at risk of malnutrition. Overall measurements for sarcopenia in the present study were the skeletal muscle mass index, grip strength, and walking speed, while oral measurements were the cross-sectional area of the geniohyoid muscle, tongue pressure (TP), and oral diadochokinesis. Results: MNA-SF correlated with TP (r = 0.347, p = 0.019). We observed decreases of 5.7 kPa in TP and 3.9 kg/cm2 in BMI in the at risk of malnutrition group. A multiple regression analysis of parameters contributing to the risk of malnutrition identified TP as an independent variable (β = 0.913, p = 0.042). Conclusions: The present results demonstrate that the risk of malnutrition is associated with TP as an oral measurement for sarcopenia, but not overall measurements for sarcopenia. Therefore, low TP may be related with the risk of malnutrition. Full article
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12 pages, 868 KiB  
Article
Features of Masticatory Behaviors in Older Adults with Oral Hypofunction: A Cross-Sectional Study
by Chikako Hatayama, Kazuhiro Hori, Hiromi Izuno, Masayo Fukuda, Misao Sawada, Takako Ujihashi, Shogo Yoshimura, Shoko Hori, Hitomi Togawa, Fumiko Uehara and Takahiro Ono
J. Clin. Med. 2022, 11(19), 5902; https://doi.org/10.3390/jcm11195902 - 06 Oct 2022
Cited by 2 | Viewed by 1573
Abstract
Although many studies have shown the relationships between oral function and nutrition and health, few reports have investigated the masticatory behaviors of older people. This study aimed to clarify the relationships between oral function and the masticatory behaviors and features of masticatory behaviors [...] Read more.
Although many studies have shown the relationships between oral function and nutrition and health, few reports have investigated the masticatory behaviors of older people. This study aimed to clarify the relationships between oral function and the masticatory behaviors and features of masticatory behaviors with oral hypofunction. A total of 98 community-dwelling independent older adults participated. Seven oral conditions related to oral hypofunction were examined, and the masticatory behaviors when consuming a rice ball were measured. The participants were divided into two groups according to the criteria for oral hypofunction, and the masticatory behaviors were compared. Furthermore, the relationship between masticatory performance and the number of chews was investigated. The chewing rate of the oral hypofunction group was slower than that of the no oral hypofunction group, but there was no difference in the number of chews and chewing time. The decreased tongue–lip motor function group showed a slower chewing rate, and the decreased tongue pressure group showed a smaller number of chews and shorter chewing time. No significant correlation was observed between masticatory performance and behavior. In conclusion, older adults with oral hypofunction chewed slowly due to decreased dexterity, while, even if oral and masticatory function decreased, no compensatory increase in the number of chews was observed. Full article
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Review

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10 pages, 249 KiB  
Review
The Impact of Xerostomia on Food Choices—A Review with Clinical Recommendations
by Frauke Müller, Najla Chebib, Sabrina Maniewicz and Laurence Genton
J. Clin. Med. 2023, 12(14), 4592; https://doi.org/10.3390/jcm12144592 - 10 Jul 2023
Cited by 2 | Viewed by 1564
Abstract
Xerostomia and hyposalivation are highly prevalent conditions in old age, particularly among multimorbid elders, and are often attributed to the use of multiple medications. These conditions negatively affect oral functions, such as chewing, swallowing, speech, and taste. Additionally, the lack of lubrication of [...] Read more.
Xerostomia and hyposalivation are highly prevalent conditions in old age, particularly among multimorbid elders, and are often attributed to the use of multiple medications. These conditions negatively affect oral functions, such as chewing, swallowing, speech, and taste. Additionally, the lack of lubrication of the oral mucosa frequently leads to super-infections with candida. Denture retention and comfort may also be compromised. The risk of dental caries and erosion of natural teeth increases since saliva, which is essential for repairing initial lesions in tooth structures, is insufficient. The dry sensation in the mouth also impacts the emotional and social well-being of elderly individuals. Patients experiencing xerostomia often avoid certain foods that are uncomfortable or difficult to consume. However, some foods may alleviate the symptoms or even stimulate salivation. This review discusses the limited available evidence on nutritional advice for patients with xerostomia and aims to provide insight into the patient’s perspective while offering clinical recommendations. Future studies should focus on investigating the nutritional intake of individuals suffering from xerostomia or hyposalivation in order to ensure oral health comfort, prevent malnutrition, and minimize the impact on their quality of life. Full article
14 pages, 671 KiB  
Review
Assessment and Improvement of Masticatory Performance in Frail Older People: A Narrative Review
by Martin Schimmel, Noemi Anliker, Gabriela Panca Sabatini, Marcella Silva De Paula, Adrian Roman Weber and Pedro Molinero-Mourelle
J. Clin. Med. 2023, 12(11), 3760; https://doi.org/10.3390/jcm12113760 - 30 May 2023
Cited by 2 | Viewed by 1768
Abstract
According to the World Health Organization (WHO), the estimated number of older adults is around 962 million and is projected to increase to 2.1 billion by 2050. The oral frailty concept is associated with gradual oral function loss in relation to aging. There [...] Read more.
According to the World Health Organization (WHO), the estimated number of older adults is around 962 million and is projected to increase to 2.1 billion by 2050. The oral frailty concept is associated with gradual oral function loss in relation to aging. There is a need to emphasize the improvement of oral function based on an evaluation of masticatory performance in patients with various oral conditions or systemic diseases and especially in the frail elderly. The present narrative review presents an overview of the current state of the assessment and improvement of masticatory performance in frail older people. To fully encompass oral frailty, oro-facial hypofunction, or oro-facial fitness, dental Patient Reported Outcomes (dPROs) should be included; nevertheless, there are limited evidence-based rehabilitation approaches. The concept of oral frailty, oro-facial hypofunction, or oro-facial fitness should involve dental Patient Reported Outcomes (dPROs), and in this sense, there are only a few evidence-based rehabilitation procedures to improve oro-facial hypofunction besides prosthodontics. It must be considered that reduced neuroplastic capacity in old individuals might preclude a positive outcome of these strategies that might need to be accompanied by functional training and nutritional counseling. Full article
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14 pages, 963 KiB  
Review
Oral Health Factors Related to Rapid Oral Health Deterioration among Older Adults: A Narrative Review
by Jhanvi P. Desai and Rohit U. Nair
J. Clin. Med. 2023, 12(9), 3202; https://doi.org/10.3390/jcm12093202 - 29 Apr 2023
Cited by 1 | Viewed by 1802
Abstract
Older adults who face systemic health issues and lack adequate social support are at risk for oral health deterioration. How rapidly such changes take place depends on the severity of their medical condition and their ability to access oral health services in a [...] Read more.
Older adults who face systemic health issues and lack adequate social support are at risk for oral health deterioration. How rapidly such changes take place depends on the severity of their medical condition and their ability to access oral health services in a timely manner. The management of dental caries and periodontal disease in this cohort is made complex by the interaction of local and host factors such as the presence of dry mouth, involvement of root surfaces, and altered wound healing. in addition to enhanced maintenance needs to avoid recurrence or progression. Tooth replacement can be beneficial in restoring oral function, allowing patients to enjoy a healthy and nutritious diet but requires careful consideration to avoid further damage to remaining dental units. Establishing a dental home for the older adult can facilitate routine surveillance, disease prevention, and patient/caregiver education to achieve oral health goals commensurate with overall health. This narrative review details oral health factors that are related to rapid oral health deterioration among older adults. Full article
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9 pages, 255 KiB  
Review
Rapid Oral Health Deterioration in Older People—A Narrative Review from a Socio-Economic Perspective
by Linda Slack-Smith, Gina Arena and Lydia See
J. Clin. Med. 2023, 12(6), 2396; https://doi.org/10.3390/jcm12062396 - 20 Mar 2023
Cited by 1 | Viewed by 1889
Abstract
Poor oral health is a common morbidity in old age with older adults less likely to attend dental care and more likely to have dental disease; this situation is exacerbated by older adults retaining more teeth often with complex restorations. Evidence suggests that [...] Read more.
Poor oral health is a common morbidity in old age with older adults less likely to attend dental care and more likely to have dental disease; this situation is exacerbated by older adults retaining more teeth often with complex restorations. Evidence suggests that some older adults experience rapid oral health deterioration (ROHD). While more clinical and population level evidence is needed, current evidence suggests upstream changes addressing disadvantage through the social determinants of health (SDH) may impact broader disorders such as ROHD, often occurring as older adults become dependent. The aim of this paper is to conduct a narrative review to explore the social determinants of ROHD in older adults. The social determinants of health are important in understanding oral health including ROHD. This includes the important influence of the economic determinants. We explored the SDH as relevant to oral health and ROHD including using a framework based on that of the Fisher-Owens conceptual model (for children) but adapted for older adults. Better understanding of these relationships is likely to assist in future prevention and care. Full article

Other

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13 pages, 1627 KiB  
Systematic Review
The Effect of Domiciliary Professional Oral Care on Root Caries Progression in Care-Dependent Older Adults: A Systematic Review
by Elisabeth Morén, Pia Skott, Kristina Edman, Nivetha Gavriilidou, Inger Wårdh and Helena Domeij
J. Clin. Med. 2023, 12(7), 2748; https://doi.org/10.3390/jcm12072748 - 06 Apr 2023
Viewed by 1600
Abstract
With care dependency, untreated root caries lesions (RCLs) and irregular dental visits are common. RCLs, if left untreated, could lead to pain, tooth loss, difficulties eating, and impact on general health. Therefore, there is a need for prevention and effective treatment for RCLs, [...] Read more.
With care dependency, untreated root caries lesions (RCLs) and irregular dental visits are common. RCLs, if left untreated, could lead to pain, tooth loss, difficulties eating, and impact on general health. Therefore, there is a need for prevention and effective treatment for RCLs, and especially in those with care dependency. The aim of this systematic review was to investigate the effect of domiciliary professional oral care on root caries development and progression, in comparison with self-performed or nurse-assisted oral care. A literature search was conducted in four databases in November 2022. Two authors independently screened the literature throughout the review process. Five of the identified studies were found to be relevant. Four of these were assessed as having moderate risk of bias and were included in the review, while one study had high risk of bias and was excluded from further analyses. Due to heterogenicity of the included studies (and of the interventions and outcomes), no meta-analysis or synthesis without meta-analysis (SWiM) was performed. The participation of dental personnel performing mechanical plaque removal and fluoride, or chlorhexidine application seems beneficial for care-dependent older adults with risk of RCLs development and progression. However, future studies are needed. Full article
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14 pages, 2030 KiB  
Essay
The Prevention, Diagnosis, and Treatment of Rapid Oral Health Deterioration (ROHD) among Older Adults
by Leonardo Marchini and Ronald L. Ettinger
J. Clin. Med. 2023, 12(7), 2559; https://doi.org/10.3390/jcm12072559 - 28 Mar 2023
Cited by 1 | Viewed by 2078
Abstract
The world’s population is aging. Older adults are at risk for multiple chronic medical problems as they age. The management of these diseases requires these people to take a variety of medications, which may have undesired side effects. These medical issues can impact [...] Read more.
The world’s population is aging. Older adults are at risk for multiple chronic medical problems as they age. The management of these diseases requires these people to take a variety of medications, which may have undesired side effects. These medical issues can impact oral healthcare and result in a precipitous decline in oral health. A standardized teaching model has been developed to help novice dental practitioners learn how to access and treat oral health problems in older adults. This model is called rapid oral health deterioration (ROHD) risk assessment. The model has four steps for assessment and four categories of risk. This paper describes the components of the ROHD risk assessment, and how it can be used to prevent, diagnose and treat ROHD among older adults. Full article
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