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Tervonen J, Julkunen L, Saarela RKT, Hiltunen K, Mäntylä P. Dentitions of Long-Term Care Residents: Tooth Types, Roles in Occlusion and Association with Dementia. Healthcare (Basel) 2024; 12:1886. [PMID: 39337227 PMCID: PMC11430873 DOI: 10.3390/healthcare12181886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 09/13/2024] [Accepted: 09/19/2024] [Indexed: 09/30/2024] Open
Abstract
Background/Objectives: Many older adults living in long-term care (LTC) environments have varying numbers of retained natural teeth. The objective of this study was to assess the disease findings based on tooth type and estimate the role of tooth types in occlusion. Methods: We conducted clinical oral examinations of 276 LTC residents. The disease findings were analyzed for each tooth type and to determine their associations with dementia. Results: In total, 67.8% of the participants had molar teeth. Premolars/canines were often present as residual roots and had caries. Deepened periodontal pockets and higher plaque index (PI) values for molars had odds ratios of 2.5 (95% confidence interval [CI] of 1.59-3.91) and 1.61 (95% CI of 1.29-2.02), respectively. Participants with dementia were more likely to have incisors and premolars/canines in the form of root remnants and higher PI scores for all tooth types (p ≤ 0.01), as well as more deepened periodontal pockets in all teeth (p = 0.029), than those without dementia. The median number of remaining molars per participant was 3 out of a maximum of 12 (95% CI 3.4-4.0); thus, they often lacked occlusal contact. Conclusions: The LTC residents' molars were more prone to periodontal problems, whereas their premolars/canines often had caries or were present in the form of root remnants, especially in the participants with dementia. People's teeth should be treated in an easy-to-maintain way before they move into LTC to enable daily oral hygiene measures and maintain oral health.
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Affiliation(s)
- Jesse Tervonen
- Institute of Dentistry, University of Eastern Finland, 70211 Kuopio, Finland;
| | - Lina Julkunen
- Oral and Maxillofacial Diseases Outpatient Clinic, Helsinki University Hospital, 00290 Helsinki, Finland;
| | - Riitta K. T. Saarela
- Social Services, Health Care and Rescue Services Division, Oral Health Care, City of Helsinki, 00530 Helsinki, Finland;
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00014 Helsinki, Finland;
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, 70211 Kuopio, Finland;
- Oral and Maxillofacial Diseases, Kuopio University Hospital, 70210 Kuopio, Finland
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Arany S, Cavalcanti L, Phildor D, Watson GE, Kopycka-Kedzierawski DT, Eliav E, Medina-Walpole A, Caprio T. Implementation of a 4Ms approach in age-friendly oral health care at an Academic Specialty Care Dental Clinic. J Am Geriatr Soc 2024. [PMID: 38661080 DOI: 10.1111/jgs.18925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/17/2024] [Accepted: 03/24/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Implementing the Age-Friendly Health System (AFHS) framework into dental care provides a significant opportunity to link oral health to healthy aging. This project aimed to implement the AFHS 4Ms (what matters, medications, mentation, and mobility) in the provision of oral health care. This article describes the planning, integration, training development, and outcome measurements supporting a 4Ms approach at an academic dental clinic. METHODS The Eastman Institute for Oral Health (EIOH) implemented screening instruments based on the 4Ms framework recommended for ambulatory care clinics by the Institute for Health Care Improvement (IHI). These ambulatory instruments were integrated into the workflows of a Specialty Care Clinic through the development of a plan-do-study-act cycle, utilization of available clinic resources, and creation of interdisciplinary collaborations. RESULTS This project demonstrated the feasibility of implementing an AFHS checklist and tracking forms in dental practice by integrating available resources and prioritizing the 4Ms elements. This effort necessitated interdisciplinary collaborations between dental, medical, and social service professionals. It also created a new age-friendly focused education and training curriculum for dental residents and faculty. CONCLUSIONS This pilot project is the first to establish dental standards for AFHS implementation, adapting the 4Ms assessment and metrics to oral health. This AFHS underscores key oral health processes, including assessment, planning, and personalized oral health care, adapted to the unique needs of the older adult population, especially those with cognitive impairment.
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Affiliation(s)
- Szilvia Arany
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Lia Cavalcanti
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Doris Phildor
- Alzheimer's Association Rochester New York Chapter, Rochester, New York, USA
| | - Gene E Watson
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, USA
- Department of Pharmacology and Physiology, University of Rochester, Rochester, New York, USA
| | - Dorota T Kopycka-Kedzierawski
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
- Department of Dentistry, University of Rochester Medical Center, Rochester, New York, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
- Department of Dentistry, University of Rochester Medical Center, Rochester, New York, USA
| | - Annette Medina-Walpole
- Medicine-Division of Geriatrics & Aging, University of Rochester Medical Center, Rochester, New York, USA
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Thomas Caprio
- Medicine-Division of Geriatrics & Aging, University of Rochester Medical Center, Rochester, New York, USA
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
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Chuang JCP, Pradhan A, Walsh LJ, Lopez Silva CP. Singapore dentists' attitudes toward dental care provision for older adults with disabilities. Gerodontology 2024; 41:59-67. [PMID: 36924433 DOI: 10.1111/ger.12685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES This study aimed to assess dentists' attitudes toward providing dental care for older adults with disabilities in Singapore and the factors influencing their willingness to provide care. BACKGROUND Dentists face a rapidly ageing patient demographic. Practitioner unwillingness to circumvent the attending challenges of care provision prevents older adults from accessing the dental care necessary for better oral and systemic health. Previous studies have reported on dentists' attitudes toward caring for older adults with disabilities; however, these are mostly limited to dependent older adults and exclude frail, community-dwelling older persons. METHODS A cross-sectional study was conducted in 2020 using a self-administered questionnaire. Quantitative data analysis was presented in the form of descriptive statistics, followed by bivariate analyses. RESULTS There were 193 respondents, a response rate of under 9%. Dentists were less willing, confident and involved in the care of older adults with disabilities as the individual's severity of impairments increased. Less than half of respondents were willing to treat individuals with severe disabilities in cooperation (23.3%), swallowing (30.6%), mobility (33.7%) and communication (45.1%). Dentists with training in geriatric dentistry were more willing to provide care. However, younger dentists, general dental practitioners, private practitioners and public sector dentists had specific restraining and driving forces, which further modulated their willingness to provide care. CONCLUSIONS The current areas of training needs among Singapore dentists are in severe impairments of swallowing, communication, cooperation and mobility. Further geriatric dentistry training may effectively increase dentists' willingness to provide care; however, additional specific targeted interventions are also needed.
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Affiliation(s)
- Janice Cheah Ping Chuang
- Tan Tock Seng Hospital, Singapore, Singapore
- The University of Queensland Oral Health Centre, Herston, Queensland, Australia
| | - Archana Pradhan
- The University of Queensland Oral Health Centre, Herston, Queensland, Australia
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Altuwaijri SH, Champirat T, Wyatt C. Appointments Needed for Complete Denture for Frail Older Adults Residing in Long-Term Care Facilities: A Cross-Sectional Study. Dent J (Basel) 2024; 12:36. [PMID: 38392240 PMCID: PMC10888039 DOI: 10.3390/dj12020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Frail older adults who reside in long-term care (LTC) facilities face multiple barriers in receiving dental care. In edentulous LTC patients, the fabrication of complete dentures (CDs) can present challenges, leading to an increase in procedural or post-insertion appointments. The aim of this cross-sectional study was to document the number of fabrication and post-insertion follow-up appointments for CDs in frail older adults residing in LTC facilities. Data were collected from electronic patient records (AxiUm) and the Index of Clinical Oral Disorder in Elders (CODE) software utilized by the University of British Columbia Geriatric Dentistry Program from 2002 to 2018. A total of 362 CDs were fabricated between 2002 and 2018 in 272 patients. The mean number of visits required was 4.13 and 4.32, with standard deviations (Std) of 1.45 and 1.25 needed to fabricate maxillary CDs and mandibular CDs, respectively. The mean number of follow-up visits was 1.04 for maxillary dentures and 1.09 for mandibular dentures, with an Std of 1.25 for both, similar to the results obtained for adult patients in community dental clinics. Several factors were found to be associated with an increased number of CD fabrication and follow-up visits. Pre-operative assessment of the patient's cognitive/physical status and intra-oral condition may indicate the estimated time needed to fabricate CDs.
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Affiliation(s)
- Sahr H Altuwaijri
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Tharee Champirat
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Chris Wyatt
- Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Lee GKY, Tan MN, Gao X, Wee HL, Lai BWP, Hong CHL, Hu S. Acceptance of silver diamine fluoride use in community dwelling older adults, nursing home residents, and caregivers. J Dent 2024; 141:104819. [PMID: 38128821 DOI: 10.1016/j.jdent.2023.104819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES To compare the level of acceptance of silver diamine fluoride (SDF) treatment between different functional groups of older adults aged 65-years-old and above. METHODS Three groups were recruited representing functionally-independent ("Community dwelling"), frail ("Nursing home"), and functionally-dependent older adults ("Caregiver": proxy respondent involved in caring for an older adult of all functional levels). Participants viewed a video on SDF and an interviewer-led questionnaire collected demographics, dental experience and perception on SDF use. RESULTS The study recruited 201 participants (100 "Community dwelling", 51 "Nursing home", 50 "Caregiver"). Overall, 73 % of participants were accepting of SDF treatment. Those in the "Community dwelling" group were most accepting (85 %), followed by the "Nursing home" group (61 %) and "Caregiver" group (60 %) (p<0.001). Participants were more accepting of SDF use on posterior (73 %) compared to anterior teeth (46 %). They were more accepting when SDF was presented as a treatment to avoid infection and pain (87 %), and general anesthesia (78 %). In a regression analysis, "Nursing home" and "Caregiver" participants were three times less likely to accept SDF (OR 0.27 [95 % CI: 0.13 to 0.60], and OR 0.27 [95 % CI: 0.12 to 0.58] respectively) compared to "Community dwelling" participants. After adjusting for other factors, only the "Caregiver" group remained significant (Adjusted OR 0.32 [95 % CI: 0.13 to 0.78]). CONCLUSIONS Older adults were accepting of SDF and this treatment modality has the potential to be a routine treatment option in dental caries management in this population. However, this was less certain among frail and functionally dependent older adults. CLINICAL SIGNIFICANCE An SDF program to manage caries is likely to be well-received by functionally-independent older adults. However, the acceptance among frail and functionally-dependent older adults were lower even though SDF is mostly likely to benefit these populations. There is a need to investigate this relatively lower levels of acceptance.
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Affiliation(s)
| | - Mei Na Tan
- National University Centre for Oral Health Singapore, National University Health System, Singapore
| | - Xiaoli Gao
- Faculty of Dentistry, National University of Singapore, Singapore; Saw Swee Hock School of Public Heath, National University of Singapore, Singapore
| | - Hwee Lin Wee
- Saw Swee Hock School of Public Heath, National University of Singapore, Singapore
| | - Bien Wen Pui Lai
- Paediatric Dentistry Unit, National Dental Centre Singapore, Singapore
| | | | - Shijia Hu
- Faculty of Dentistry, National University of Singapore, Singapore.
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Archer N, S Jayawardena D, Wong J, Doshi M. The prevalence of denture loss within community residential settings. Br Dent J 2024:10.1038/s41415-023-6714-8. [PMID: 38212530 DOI: 10.1038/s41415-023-6714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/28/2023] [Accepted: 08/08/2023] [Indexed: 01/13/2024]
Abstract
Introduction Denture loss prevalence in community settings is unknown and results in deteriorating residents' systemic and psychosocial wellbeing.Materials and methods An electronic survey was distributed nationally through professional networks to community residential settings.Results Of the 156 responses from community residential settings, 69% of settings experienced at least one denture lost in the last two years. Sixty percent of responders reported no dentures were labelled, only 64% had received training about how to care for dentures and 86% felt they would benefit from further training on mouth care. In addition, 68% of staff found arranging dental care for their residents challenging.Discussion Extrapolated data suggest that at least 10,205 dentures are lost annually in community residential settings and are never found, costing the NHS Business Service Authority more than £3 million. A high prevalence of denture loss in community residential settings is likely due to residents with multiple comorbidities and frailty. Remaking dentures poses financial, logistical, and patient challenges, which may result in patients being unable to wear a remade denture.Conclusion The prevalence of denture loss within community residential settings needs to be understood to encourage targeted interventions, inform stakeholders, and encourage workflows that will improve service delivery and patients' oral health-related quality of life.
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Affiliation(s)
- Natalie Archer
- Speciality Registrar in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley St, London, WC1E 6DG, UK.
| | - Don S Jayawardena
- Speciality Registrar in Restorative Dentistry, Royal London Dental Hospital, Turner St, London, E1 1FR, UK
| | - Jason Wong
- Interim Chief Dental Officer, The Maltings Dental Practice, Commercial Rd, Grantham, NG31 6DE, UK
| | - Mili Doshi
- Consultant in Special Care Dentistry, East Surrey Hospital, Canada Avenue, Redhill, RH1 5RH, UK
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7
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Giok KC, Veettil SK, Menon RK. Comparative effectiveness of types of denture adhesives in enhancing retention and function of complete dentures: a systematic review with network meta-analysis. Clin Oral Investig 2024; 28:78. [PMID: 38183500 DOI: 10.1007/s00784-023-05467-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/19/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVES The purpose of this systematic review with network meta-analysis was to assess the comparative efficacy of various types of denture adhesives in complete denture patients. MATERIAL AND METHODS A search was conducted for trials published in Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until July 2023 (PROSPERO: CRD42023451045). A network meta-analysis was performed to assess the comparative efficacy of different denture adhesive types and ranked using the Surface Under the Cumulative Ranking (SUCRA) system. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the level of certainty of evidence. RESULTS Seventeen articles were included in the quantitative analysis. Cream denture adhesives significantly increased bite force in both incisal region (RR = 7.63[95%CI: 3.34, 11.91]) (P < .05) as well as premolar and molar regions (RR = 33.66[95%CI: 15.15, 52.16]). Cream adhesives significantly improved retention of dentures as assessed by the reduced number of denture dislodgments (RR = -5.35[95%CI: -9.93, -0.77]) (P = 0.022), Kapur's index of retention (maxillary denture) (RR = 0.80[95%CI: 0.18, 1.42]) (P = 0.012) and Kapur's index of retention (mandibular denture) (RR = 1.27[95%CI: 0.67, 1.87]) (P < .05). Powder adhesives significantly increased premolar and molar bite force (RR = 36.00[95%CI: 16.20, 55.79]) (P < .05) and Kapur's index of retention (mandibular denture) (RR = 1.54[95%CI: 0.58, 2.49]) (P = 0.002). None of the adhesives were statistically significant for remaining outcomes. CONCLUSIONS Cream and powder denture adhesives are effective in enhancing the retention of mandibular dentures (Kapur's index) and bite force in the premolar/molar region in complete denture wearers (moderate level of certainty of evidence). CLINICAL RELEVANCE Cream and powder denture adhesives are effective in improving the retention and function of complete dentures.
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Affiliation(s)
- Koay Chun Giok
- School of Dentistry, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Sajesh K Veettil
- School of Pharmacy, Department of Pharmacy Practice, College of Pharmacy, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Rohit Kunnath Menon
- Department of Clinical Sciences, College of Dentistry, Ajman University, Al Jerf, University Street, J1 P.O 346, Ajman, United Arab Emirates.
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Johnsen DC, Marchini L, Ettinger RL. How can dental research deliver better outcomes to frail older adults? Essay on considerations. SPECIAL CARE IN DENTISTRY 2023; 43:375-379. [PMID: 36715103 DOI: 10.1111/scd.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 01/31/2023]
Affiliation(s)
- David C Johnsen
- Department of Pediatric Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Leonardo Marchini
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
| | - Ronald L Ettinger
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
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Ghezzi EM, Niessen LC, Jones JA. Innovations in Geriatric Oral Health Care. Clin Geriatr Med 2023; 39:343-357. [PMID: 37045537 DOI: 10.1016/j.cger.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Older adults are retaining their teeth and need strategies for a lifetime of oral health care. Daily prevention and professional preventive care have the most significant impacts on reducing oral disease in the aging population. Providers of oral health care extend beyond traditional dental professionals to include caregivers and health care providers through teledentistry and interprofessional collaboration. Dental and aging organizations advocate for the inclusion of a dental benefit in Medicare to address access to care. Innovations in geriatric oral health care involve advances in clinical oral health care, delivery and models of care, funding, research, education, and policy.
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Affiliation(s)
- Elisa M Ghezzi
- University of Michigan School of Dentistry, 26024 Pontiac Trail, South Lyon, MI 48178, USA.
| | - Linda C Niessen
- College of Dental Medicine, Kansas City University of Medicine and Biosciences, 2901 St. John's Boulevard, Joplin, MO 64804, USA
| | - Judith A Jones
- University of Detroit Mercy School of Dentistry, 2700 Martin Luther King Jr. Boulevard, Room 401, Detroit, MI 48208-2576, USA
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Ettinger R, Marchini L, Hartshorn J. Consideration in Planning Dental Treatment of Older Adults. Clin Geriatr Med 2023; 39:311-326. [PMID: 37045535 DOI: 10.1016/j.cger.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
When caring for the oral health of frail and functionally dependent older adults, it is important to understand their general health and oral health problems to make a diagnosis. There are multiple treatment strategies available to care for their needs; many may not be evidence based. Dental treatment planning for older adults is as much art as science and requires clinicians to understand how patients are functioning in their environments and how oral health care fits into their needs and lifestyle. This article discusses a variety of treatment planning techniques and illustrates the problem with a longitudinal case history.
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Affiliation(s)
- Ronald Ettinger
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, N-409 Dental Science, Iowa City, IA 52242, USA
| | - Leonardo Marchini
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, N337-1 Dental Science, Iowa City, IA 52242, USA.
| | - Jennifer Hartshorn
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, W327 Dental Science, Iowa City, IA 52242, USA
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Marchini L, Ettinger RL. The Prevention, Diagnosis, and Treatment of Rapid Oral Health Deterioration (ROHD) among Older Adults. J Clin Med 2023; 12:jcm12072559. [PMID: 37048643 PMCID: PMC10094847 DOI: 10.3390/jcm12072559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
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 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.
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12
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Bulgarelli AF, Santos CM, Tôrres LHN, Childs CA, Souza FLR, Gehrke GH, Marchini L. What influences dental students' attitudes regarding the treatment of older adults? A scoping review. J Dent Educ 2023. [PMID: 36928643 DOI: 10.1002/jdd.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/04/2023] [Accepted: 01/28/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE The aim of this study is to investigate the literature to evaluate dental students' attitudes regarding the treatment of older adults. METHODS A scoping review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses/PRISMA guidelines to identify articles from four electronic databases: MEDLINE via the PubMed interface, Embase, Cumulative Index to Nursing and Allied Health Literature, and AgeLine. Gray literature searches were also performed in Scopus, Web of Science, and ProQuest Dissertations and Theses-Health and Medicine. RESULTS Eleven articles were assessed. The majority (72, 72%) were published between 2011 and 2020, evidencing various contexts of dental students, such as different countries and cultures, and levels of education. The most commonly used tool/instrument to survey dental students' attitudes was the Aging Semantic Differential Scale. Student age, race, and marital status did not seem to interfere with dental students' attitudes regarding the treatment of older adults. CONCLUSIONS Dental students tend to have a positive attitude toward older people. In this context, female students, students who interact with older people, and clinical students have more positive attitudes than male and nonclinical students.
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Affiliation(s)
- Alexandre F Bulgarelli
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Postgraduate Program in Dentistry, the Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Camila M Santos
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Postgraduate Program in Dentistry, the Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luísa H N Tôrres
- Departament of Stomatology, Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, Brazil
| | - Christopher A Childs
- Hardin Library for the Health Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Fernanda L R Souza
- Departament of Stomatology, Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, Brazil
| | - Gabriela Hammes Gehrke
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Postgraduate Program in Dentistry, the Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo Marchini
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Tong N, To S, Wyatt CCL. Impact of the COVID-19 pandemic on the University of British Columbia Geriatric Dentistry Program: Clinical education and service. Gerodontology 2021; 39:348-353. [PMID: 34580910 PMCID: PMC8652979 DOI: 10.1111/ger.12591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
Background and Objective In Canada, the COVID‐19 pandemic was associated with significant morbidity and mortality in older adults, particularly those in long‐term care (LTC). Access to oral health services was limited during the pandemic due to public health restrictions. The aim of this paper was to describe the impact of the pandemic on the clinical education and service of the University of British Columbia (UBC) Geriatric Dentistry Program (GDP), which provides care to LTC residents. Methods Data were collected from UBC GDP AxiUm dental software records, including number of dental appointments in 2019 and 2020. Data on revenue in 2019 and 2020 based on clinical production were collected through financial summary reports. Data on the number of educational rotations were collected from summary reports from scheduling software. Results In 2020, significant reductions in clinical service, revenue, and productivity were observed in the UBC GDP relative to 2019. The number of GDP appointments for June‐December 2020 was lower by 68%. The clinical productivity reduced by 67% for the same period. Expenses were slightly reduced. The overall number of LTC clinical rotations for students were only slightly lower for undergraduate students in 2020 than in 2019, and it increased for graduate students. Conclusion The COVID‐19 pandemic and associated public health restrictions had a negative impact on the clinical service and productivity of the UBC GDP in 2020 relative to 2019. However, clinical educational rotations to LTC were slightly increased in 2020 relative to 2019. Dental care for LTC residents can be provided if rigorous administrative controls, engineering controls and personal protective equipment are employed.
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Affiliation(s)
- Nicholas Tong
- Program Director- General Practice Residency Program, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Shunhau To
- University of British Columbia Geriatric Dentistry Program, Vancouver, BC, Canada
| | - Chris C L Wyatt
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Kamil W, Kruger E, McGeachie J, Jean G, Tennant M. Distribution of Australian dental practices in relation to the ageing population. Gerodontology 2021; 39:302-309. [PMID: 34331336 DOI: 10.1111/ger.12585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/14/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The purpose of this study was to analyse and map the distribution of the ageing population, by sociodemographic profiling, in private and public dental practices in Australia. BACKGROUND The rapid increase in the aged population in Australia requires a comprehensive approach to ensure accessibility to geriatric dental services. However, the availability of dental services for the older people requires further investigation of the demographic distribution of need. MATERIALS AND METHODS Dental practices were located and mapped against the ageing population data. The address for each dental practice in Australia was compiled from online access sources. Australian socioeconomic data were integrated with dental practices, clinic locations and older populations using Geographic Information System (GIS) technology. RESULTS There was an uneven distribution of dental practices across Australia's States and Territories (NT and ACT). Tasmania had the highest ratio of private practices to the older population (1:1000) and the highest percentages of this ageing cohort (32%, 61%) that lived more than 5 km from private and public dental practices respectively. Higher percentages of dental practices were located in areas of lower socioeconomic status in Tasmania, Queensland and South Australia (47%, 42% and 38%) respectively, however, these areas were associated with higher ageing population densities. CONCLUSION There is a geographic maldistribution of dental practices in relation to the spatial distribution of Australia's older population, with the inequity most pronounced in the most disadvantaged areas. This inequality requires a National approach to match dental services to the population that they serve.
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Affiliation(s)
- Wisam Kamil
- Department of Anatomy Physiology & Human biology, School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - Estie Kruger
- Department of Anatomy Physiology & Human biology, School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - John McGeachie
- Department of Anatomy Physiology & Human biology, School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - Gillian Jean
- Department of Anatomy Physiology & Human biology, School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - Marc Tennant
- Department of Anatomy Physiology & Human biology, School of Human Sciences, The University of Western Australia, Perth, WA, Australia
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15
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Abstract
The elderly individual is becoming the most common patient in clinical practice due to the increasing average life span, especially in developed countries. The current elderly patients are different from those of some decades ago. They usually have an active social life, want to be informed, and are actively involved in the current society with consequent high expectations for medical and dental treatment. However, not all the elderly patients are like this. Some of them show limited financial resources, reduced mental and manual skills, and poor motivation. The purpose of this communication is to make a brief characterization of the new elderly population in view of prosthetic and dental management.
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Abstract
Older adults are retaining their teeth and need strategies for a lifetime of oral health care. Daily prevention and professional preventive care have the most significant impacts on reducing oral disease in the aging population. Providers of oral health care extend beyond traditional dental professionals to include caregivers and health care providers through teledentistry and interprofessional collaboration. Dental and aging organizations advocate for the inclusion of a dental benefit in Medicare to address access to care. Innovations in geriatric oral health care involve advances in clinical oral health care, delivery and models of care, funding, research, education, and policy.
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Affiliation(s)
- Elisa M Ghezzi
- University of Michigan School of Dentistry, 26024 Pontiac Trail, South Lyon, MI 48178, USA.
| | - Linda C Niessen
- College of Dental Medicine, Kansas City University of Medicine and Biosciences, 2901 St. John's Boulevard, Joplin, MO 64804, USA
| | - Judith A Jones
- University of Detroit Mercy School of Dentistry, 2700 Martin Luther King Jr. Boulevard, Room 401, Detroit, MI 48208-2576, USA
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17
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Mueldener EJ, McQuistan MR, Qian F, Hartshorn JE, Oishi MM. An evaluation of the geriatric dental curricula within Advanced Education in General Dentistry and General Practice Residency programs in the United States. SPECIAL CARE IN DENTISTRY 2020; 41:210-217. [PMID: 33382104 DOI: 10.1111/scd.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To compare the geriatric dentistry curricula between Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs. METHODS A 108-item survey was developed to assess residents' didactic and clinical experiences pertaining to geriatric patients. Surveys were mailed in 2018 to all AEGD (N = 89) and GPR (N = 180) program directors. Statistical analysis consisted of descriptive and bivariate analyses with the chi-square test, Fisher's exact test, and the Wilcoxon rank sum test (alpha = .05). RESULTS Twenty-four AEGD and fifty-eight GPR directors completed surveys (response rate = 30%). Seventy-one percent of responding programs reported mandatory didactic training pertaining to frail and functionally dependent geriatric adults. Ninety-nine percent of respondents reported that residents provided treatment to geriatric patients; however, they were less likely to perform procedures on frail and functionally dependent patients. Only 15% of respondents provided nursing home care. Considering all patient encounters, responding GPR programs were more likely than AEGD programs to treat patients using IV bisphosphonates (63% vs 25%; P < .01), undergoing chemotherapy (48% vs 16%; P = .02), and undergoing head and neck radiation therapy (55% vs 25%; P = .02). CONCLUSION A majority of responding AEGD and GPR programs reported providing educational experiences pertaining to geriatric patients; however, GPR programs reported treating more medically complex patients than AEGD programs.
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Affiliation(s)
- Emma J Mueldener
- Hospital Dentistry Institute, University of Iowa, Iowa City, Iowa
| | - Michelle R McQuistan
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Fang Qian
- Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Jennifer E Hartshorn
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Matthew M Oishi
- Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
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Abstract
When caring for the oral health of frail and functionally dependent older adults, it is important to understand their general health and oral health problems to make a diagnosis. There are multiple treatment strategies available to care for their needs; many may not be evidence based. Dental treatment planning for older adults is as much art as science and requires clinicians to understand how patients are functioning in their environments and how oral health care fits into their needs and lifestyle. This article discusses a variety of treatment planning techniques and illustrates the problem with a longitudinal case history.
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19
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Nair RU, Marchini L, Johnsen DC, Xie XJ. Implementation of an online treatment planning exercise focused on vulnerable patient groups. J Dent Educ 2020; 85:941-943. [PMID: 32905621 DOI: 10.1002/jdd.12422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/12/2020] [Accepted: 09/05/2020] [Indexed: 02/24/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic presented formidable challenges in our ability to impart in-person extra-mural clinical training, including the Geriatric and Special Needs Program, to a group of 20 fourth-year dental students. A new course delivery format was developed wherein students used a validated Rapid Oral Health Deterioration (ROHD) risk assessment tool to critically appraise clinical case information relating to a young adult with special needs. In the alternative virtual educational approach that was created, students applied an interprofessional practice concept leading to patient treatment planning outcomes. Providing adequate information, additional reading resources, a response template, clear instructions and a process-oriented assessment policy all ensured a good level of participation from students in the alternative learning format. An association was noted between students' staging of risk for ROHD and their subsequent recommendations for treatment.
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Affiliation(s)
- Rohit U Nair
- Department of Preventive & Community Dentistry, The University of Iowa College of Dentistry & Dental Clinics, Iowa City, Iowa, USA
| | - Leonardo Marchini
- Department of Preventive & Community Dentistry, The University of Iowa College of Dentistry & Dental Clinics, Iowa City, Iowa, USA
| | - David C Johnsen
- Department of Pediatric Dentistry, The University of Iowa College of Dentistry & Dental Clinics, Iowa City, Iowa, USA
| | - Xian J Xie
- Iowa Institute for Oral Health Research , Department of Preventive & Community Dentistry, The University of Iowa College of Dentistry & Dental Clinics, Iowa City, Iowa, USA
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20
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Marchini L, Ettinger RL. Coronavirus disease 2019 and dental care for older adults: New barriers require unique solutions. J Am Dent Assoc 2020; 151:881-884. [PMID: 33066871 PMCID: PMC7427571 DOI: 10.1016/j.adaj.2020.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/31/2020] [Accepted: 08/08/2020] [Indexed: 02/03/2023]
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Craig T, Johnsen DC, Hartshorn JE, Cowen H, Ashida S, Thompson L, Pendleton C, Xie XJ, Marchini L. Teaching rapid oral health deterioration risk assessment: A 5-year report. J Dent Educ 2020; 84:1159-1165. [PMID: 32700333 DOI: 10.1002/jdd.12309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 11/08/2022]
Abstract
PURPOSE/OBJECTIVES The purpose of this study was to present a 5-year report about the outcomes of using a teaching tool that guides dental students through the thought process of the expert about how to assess the risk of rapid oral health deterioration (ROHD) among older adults and provide viable treatment alternatives. METHODS A teaching tool was previously developed using ROHD risk factors identified in the literature and the steps that experts apply in their treatment decision making, summarized in 10 questions. During 5 years, 188 senior dental students were introduced to the teaching tool and asked to use the 10-question set to present a case they have treated during their Geriatric and Special Needs Program. Two evaluators were asked to grade the students on each question. Students were graded "G" if they answered the question and grasped the principles behind it, "A" if they only answered the question, or "M" if they missed the question. Additionally, the students were given a form to grade the importance of and comment on the exercise. RESULTS More than 75% of the students had an A or G for most questions, agreement between the 2 evaluators was above 85%, and students' performances improved during the 5-year period. Additionally, 94.4% of the students considered the teaching tool as important or very important for the general dentist. CONCLUSION The vast majority of the students had an A or G grade, examiner agreement was high, and the students appreciated the importance of this teaching tool for the general dentist.
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Affiliation(s)
- Trevor Craig
- College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, USA
| | - David C Johnsen
- College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, USA
| | - Jennifer E Hartshorn
- Preventive and Community Dentistry, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, USA
| | - Howard Cowen
- Preventive and Community Dentistry, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, USA
| | - Sato Ashida
- Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, USA
| | - Lena Thompson
- Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, USA
| | | | - Xian Jin Xie
- Iowa Institute for Oral Health Research & Department of Preventive & Community Dentistry, The University of Iowa, Iowa City, USA
| | - Leonardo Marchini
- Preventive and Community Dentistry, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, USA
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22
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Valdez E, Wright FAC, Naganathan V, Milledge K, Blyth FM, Hirani V, Le Couteur DG, Handelsman DJ, Waite LM, Cumming RG. Frailty and oral health: Findings from the Concord Health and Ageing in Men Project. Gerodontology 2019; 37:28-37. [DOI: 10.1111/ger.12438] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Eduardo Valdez
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Fredrick A. Clive Wright
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Kate Milledge
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- School of Public Health Sydney Medical School The University of Sydney Sydney NSW Australia
| | - Fiona M. Blyth
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Concord Clinical School Concord Repatriation and General Hospital The University of Sydney Concord NSW Australia
| | - Vasant Hirani
- Charles Perkins Centre School of Life and Environmental Sciences The University of Sydney Sydney NSW Australia
| | - David G. Le Couteur
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - David J. Handelsman
- ANZAC Research Institute Concord Repatriation General Hospital The University of Sydney Concord NSW Australia
| | - Louise M. Waite
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- Department of Geriatric Medicine and Rehabilitation Medicine Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
| | - Robert G. Cumming
- Centre for Education and Research on Ageing Concord Clinical School The University of Sydney Concord NSW Australia
- Ageing and Alzheimer's Institute Concord Repatriation General Hospital Sydney Local Health District Concord NSW Australia
- School of Public Health Sydney Medical School The University of Sydney Sydney NSW Australia
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Marchini L, Ettinger R, Caprio T, Jucan A. Oral health care for patients with Alzheimer's disease: An update. SPECIAL CARE IN DENTISTRY 2019; 39:262-273. [PMID: 30964560 DOI: 10.1111/scd.12375] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/14/2019] [Accepted: 03/24/2019] [Indexed: 12/11/2022]
Abstract
Alzheimer's disease and related disorders (ADRD) are among the age-associated chronic conditions that are most challenging to health care systems around the globe, as patients with dementia require full-time, intensive care for multiple years. Oral health care is negatively impacted by cognitive decline, and consequently poor oral health is common among people with ADRD. Poor oral health status is linked with many undesirable consequences for the well-being of people with ADRD, from excruciating local pain to life-threatening conditions, as aspiration pneumonia. In this paper, the authors provide an update on the most current concepts about Alzheimer's disease epidemiology, etiology, and management, current oral health care for patients with Alzheimer's disease, oral health promotion strategies for this population, as well as current research and future direction for improving oral health care for patients with Alzheimer's disease. It concludes that oral health care should be included in the patient's routine health care as early as possible in the progression of Alzheimer's disease for preventing rapid oral health deterioration. Establishing oral hygiene routines and providing dental treatment that is customized to the patients' individual needs and disease stage are important to achieve good oral health outcomes and prevent quality of life decline.
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Affiliation(s)
- Leonardo Marchini
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | - Ronald Ettinger
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | - Thomas Caprio
- Departments of Medicine, Public Health Science and Nursing, University of Rochester Medical Center, Rochester, New York
| | - Adina Jucan
- Departments of Dentistry and Medicine, University of Rochester Medical Center, Rochester, New York
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24
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Allen PF, Da Mata C, Hayes M. Minimal intervention dentistry for partially dentate older adults. Gerodontology 2019; 36:92-98. [DOI: 10.1111/ger.12389] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/04/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Martina Hayes
- Cork University Dental School & Hospital, Wilton Cork Ireland
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25
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Lexomboon D, Tan ECK, Höijer J, Garcia-Ptacek S, Eriksdotter M, Religa D, Fastbom J, Johnell K, Sandborgh-Englund G. The Effect of Xerostomic Medication on Oral Health in Persons With Dementia. J Am Med Dir Assoc 2018; 19:1080-1085.e2. [DOI: 10.1016/j.jamda.2018.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/17/2018] [Accepted: 05/20/2018] [Indexed: 12/11/2022]
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Tonetti MS, Bottenberg P, Conrads G, Eickholz P, Heasman P, Huysmans MC, López R, Madianos P, Müller F, Needleman I, Nyvad B, Preshaw PM, Pretty I, Renvert S, Schwendicke F, Trombelli L, van der Putten GJ, Vanobbergen J, West N, Young A, Paris S. Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing - Consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol 2018; 44 Suppl 18:S135-S144. [PMID: 28266112 DOI: 10.1111/jcpe.12681] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems. AIMS The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing. METHODS Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion. RESULTS Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders. CONCLUSIONS Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders.
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Affiliation(s)
- Maurizio S Tonetti
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China.,European Research Group on Periodontology, Genova, Italy
| | | | - Georg Conrads
- Division of Oral Microbiology and Immunology, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH University Hospital Aachen, Aachen, Germany
| | - Peter Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Peter Heasman
- Department of Restorative Dentistry, University of Newcastle, Newcastle, UK
| | - Marie-Charlotte Huysmans
- Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rodrigo López
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Phoebus Madianos
- Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Ian Needleman
- International Centre for Evidence-Based Oral Health, Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Bente Nyvad
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Philip M Preshaw
- Department of Restorative Dentistry, University of Newcastle, Newcastle, UK
| | - Iain Pretty
- Division of Dentistry, University of Manchester, Manchester, UK
| | - Stefan Renvert
- Department of Periodontology, Kristianstad University, Kristianstad, Sweden
| | - Falk Schwendicke
- Department of Operative Dentistry, Charitè - Universitätsmedizin Berlin, Berlin, Germany
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | - Gert-Jan van der Putten
- Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jacques Vanobbergen
- Community Dentistry and Oral Public Health, Ghent University, Ghent, Belgium
| | - Nicola West
- Department of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | - Alix Young
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Sebastian Paris
- Department of Operative Dentistry, Charitè - Universitätsmedizin Berlin, Berlin, Germany
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Glass Ionomer Cements for the Restoration of Non-Carious Cervical Lesions in the Geriatric Patient. J Funct Biomater 2018; 9:jfb9030042. [PMID: 29986535 PMCID: PMC6164526 DOI: 10.3390/jfb9030042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 11/23/2022] Open
Abstract
Background: The restoration of non-carious cervical lesions in geriatric patients is a demanding process. Glass ionomer cements can be promising materials for the management of these lesions in older adults. The aim of this literature review is to present the benefits of glass ionomers and how they can be used for the restoration of non-carious cervical lesions of older adults depending on the geriatric patient’s profile. Data sources: All available in vitro and in vivo studies from Google Scholar, PubMed and Scopus search engines corresponding to glass ionomer cements, geriatric dentistry, elderly patients, and non-carious lesions as key words were reviewed. Data synthesis: The advantages of glass ionomer cements, such as good retention and fluoride release, make them suitable for the restoration of non-carious cervical lesions. However, several factors related to the geriatric patient’s profile determine the most suitable material type. Conclusion: In general, the resin modified glass ionomer cements (RMGICs) appear to be preferred, but under certain circumstances the use of the conventional product is more appropriate, despite its poorer mechanical features. Further studies are required for more reliable data analysis and clinical interpretation of the relevant results.
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28
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Marchini L, Ettinger R, Chen X, Kossioni A, Tan H, Tada S, Ikebe K, Dosumu EB, Oginni FO, Akeredolu PA, Butali A, Donnelly L, Brondani M, Fritzsch B, Adeola HA. Geriatric dentistry education and context in a selection of countries in 5 continents. SPECIAL CARE IN DENTISTRY 2018; 38:123-132. [DOI: 10.1111/scd.12281] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Leonardo Marchini
- Department of Preventive and Community Dentistry; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Ronald Ettinger
- Department of Prosthodontics; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Xi Chen
- Department of Preventive and Community Dentistry; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Anastassia Kossioni
- Division of Gerodontology; Faculty of Dentistry; National and Kapodistrian University of Athens; Greece
| | - Haiping Tan
- Australian Research Centre for Population Oral Health; Adelaide Dental School; The University of Adelaide; Adelaide Australia
| | - Sayaka Tada
- Division of Preventive Dentistry; Department of Oral Health Dentistry; Niigata University Graduate School of Medical and Dental Science; Niigata Japan
| | - Kazunori Ikebe
- Department of Prosthodontics; Gerodontology and Oral Rehabilitation Osaka University Graduate School of Dentistry; Osaka Japan
| | - Elizabeth Bosede Dosumu
- Department of Periodontology & Community Dentistry; Faculty of Dentistry; University of Ibadan; Ibadan Nigeria
| | - Fadekemi O. Oginni
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Obafemi Awolowo University; Ile-Ife Nigeria
| | | | - Azeez Butali
- Department of Oral Pathology; Radiology and Medicine College of Dentistry, University of Iowa,; USA
| | - Leeann Donnelly
- Department of Oral Biological & Medical Sciences; University of British Columbia; Vancouver Canada
| | - Mario Brondani
- Department of Oral Health Sciences; University of British Columbia; Vancouver Canada
| | - Bernd Fritzsch
- Director, Center of Aging & Aging Mind and Brain Initiative, Department of Biology, College of Liberal Arts and Science; University of Iowa
| | - Henry A. Adeola
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
- Department of Oral and Maxillofacial Pathology; Faculty of Dentistry; University of the Western Cape at Tygerberg Hospital; Cape Town South Africa
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29
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Marchini L, Hartshorn JE, Cowen H, Dawson DV, Johnsen DC. A Teaching Tool for Establishing Risk of Oral Health Deterioration in Elderly Patients: Development, Implementation, and Evaluation at a U.S. Dental School. J Dent Educ 2017; 81:1283-1290. [PMID: 29093141 DOI: 10.21815/jde.017.086] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/24/2017] [Indexed: 01/09/2023]
Abstract
The aim of this study was to develop and evaluate a learning strategy using critical thinking to teach dental students how to assess the risk of rapid oral health deterioration (ROHD) among elderly patients. A learning guide was developed using risk factors identified in the literature and the steps that expert faculty members apply in their clinical decision making, summarized in a set of ten steps. A new system of labeling risk was developed for the elderly population, which correlates the level of risk with the amount of disease. Participants in the study were all 91 fourth-year dental students in two subsequent classes who took part in a five-week Geriatrics and Special Needs Clinic rotation in the spring of 2015 and 2016. The students were introduced to the ROHD concept and asked to use the guide in a presentation during their rotation. The students were graded on an A, G, or M scale (Applied concept, Grasped and applied concept, or Missed application of concept). Students were also asked to assess their learning experience, and their answers were thematically grouped and analyzed. For eight of the ten steps, at least 93% of the students were graded A or G. The exceptions were the steps about developing a communications plan, which was missed by 23.1%, and self-assessment, which was missed by 30.8%. Interexaminer agreement on students' applying (A + G grades) versus missing the step was moderate or high on six of ten items. Nearly all the students (98.7%) considered assessing the risk of ROHD an important or very important skill. In this study, a learning strategy to teach dental students how to assess the risk of ROHD among elderly patients was developed and successfully implemented.
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Affiliation(s)
- Leonardo Marchini
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics.
| | - Jennifer E Hartshorn
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics
| | - Howard Cowen
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics
| | - Deborah V Dawson
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics
| | - David C Johnsen
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics
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Shakiba B, Hamedy R, Pak JG, Barbizam JV, Ogawa R, White SN. Influence of increased patient age on longitudinal outcomes of root canal treatment: a systematic review. Gerodontology 2016; 34:101-109. [PMID: 27198169 DOI: 10.1111/ger.12231] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To conduct a systematic review of longitudinal endodontic outcomes in elders. BACKGROUND Negative opinions about the prognosis of non-surgical root canal treatment (NSRCT) in elders affect decisions made by patients and dentists. Patient, caregiver and dentist attitudes and behaviours may interact to decrease the provision of NSRCT. Critical examination of the available evidence through systematic review could provide objective data to assist patients, caregivers, healthcare providers and third-party payers in making decisions about the efficacy of NSRCT in elders and provide a robust foundation for the health promotion of NSRCT in elders. METHODS Inclusion/exclusion criteria were used for defined searches in MEDLINE and Cochrane CENTRAL. Title lists were scanned, and abstracts read to determine utility; articles meeting inclusion/exclusion criteria were analysed. Data were extracted and compiled into a table of evidence. RESULTS Defined searching produced 3605 titles; 24 articles were included, nine prospective and 15 retrospective. Overall study quality was good. Patient samples mostly represented modern populations from countries with very high human development indices. Over 17 430 teeth were included. Meta-analysis was not attempted due to heterogeneity in reporting. All 24 included papers demonstrated that increased patient age did not decrease the success or survival rates of NSRCT. CONCLUSIONS This systematic review of longitudinal NSRCT outcomes demonstrated that increased patient age did not decrease the success of NSRCT. Patient age is not a prognostic factor for NSRCT. Age should not be considered by dentists or patients when making NSRCT decisions.
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Affiliation(s)
| | - Reza Hamedy
- School of Dentistry, UCLA, Los Angeles, CA, USA
| | | | | | - Rikke Ogawa
- School of Dentistry, UCLA, Los Angeles, CA, USA
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Türk AG, Cal E, Unal S, Güneri P, Ulusoy M, Ozden M. Glass-ceramics bonding in geriatric patients: comparison with young teeth. Gerodontology 2016; 34:49-56. [PMID: 26763665 DOI: 10.1111/ger.12222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of the study was to assess whether in geriatric patients, the shear bond strength (SBS) of glass-ceramics differed when compared to young controls. BACKGROUND In the need of aesthetic restorations for geriatric patients, reliable bonding of glass-ceramics should be accomplished; however, glass-ceramics bonding on aged tooth structures is still unclear. MATERIALS AND METHODS Sixty extracted molars from young and geriatric patients [18-25 (Y), and 65-80 (O)] were cut buccolingually to prepare enamel (E) and dentin (D) surfaces. Both surfaces were randomly divided into three groups according to the resin cements: Variolink II (V); Superbond (S); and Clearfil Esthetic Cement (C) (n = 10). Disc-shaped glass-ceramics (IPS E-max Press) (n = 120) were prepared. Specimens were bonded and subjected to thermocycling. SBS test was performed using a universal testing machine (0.5 mm/min). After debonding, the surfaces were examined using stereomicroscope and scanning electron microscope. Data were statistically analysed with Kolmogorov-Smirnov, Levene, anova and Bonferroni tests (p = 0.05). RESULTS There were no significant differences between the old and young teeth surfaces. V showed the highest SBS [MPa(SD)] on both enamel and dentin [36.7 (6.5) (YE), 23.2 (13.2) (YD), 32.1 (16.2) (OE), 25.5 (8.6) (OD), respectively]. Significant differences were observed between resin cements (p < 0.05). The failure types were 43% adhesive between tooth and cement, 48% mix, 9% adhesive between cement and ceramic, regardless of cement type. CONCLUSION In geriatric patients, the shear bond strength of glass-ceramics did not differ when compared to that of young controls. On the dentin surface, etch-rinse resin cements appear to be more appropriate for glass-ceramics bonding.
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Affiliation(s)
- Ayşe Gözde Türk
- Department of Prosthodontics, School of Dentistry, Ege University, Bornova, Izmir, Turkey
| | - Ebru Cal
- Department of Prosthodontics, School of Dentistry, Ege University, Bornova, Izmir, Turkey
| | - Sena Unal
- Department of Prosthodontics, School of Dentistry, Ege University, Bornova, Izmir, Turkey
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Bornova, İzmir, Turkey
| | - Mübin Ulusoy
- Department of Prosthodontics, School of Dentistry, Ege University, Bornova, Izmir, Turkey
| | - Meltem Ozden
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, İzmir, Turkey
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