Influences on the perceptions of and responses to periodontal disease among older adults

Periodontal health: A national cross-sectional study of knowledge, attitudes and practices for the public oral health strategy in China

AIM

To assess the status of periodontal health knowledge, attitudes and practices (KAP) among Chinese adults.

MATERIALS AND METHODS

A cross-sectional study was conducted in a nationally representative sample of adults (N = 50,991) aged 20 years or older from ten provinces, autonomous regions, and municipalities. Percentages of Chinese adults with correct periodontal knowledge, positive periodontal attitudes, and practices were estimated. Multiple logistic regression analyses were used to examine the related factors.

RESULTS

Less than 20% of Chinese adults were knowledgeable about periodontal disease. Very few (2.6%) of Chinese adults use dental floss ≥once a day and undergo scaling ≥once a year and visit a dentist (6.4%) in the case of gingival bleeding. Periodontal health KAP was associated with gender, age, body mass index, marital status, place of residence, education level, income, smoking status, and history of periodontal disease.

CONCLUSIONS

Periodontal health KAP are generally poor among the Chinese adult population. Community-based health strategies to improve periodontal health KAP need to be implemented. Increasing knowledge of periodontal disease, the cultivation of correct practices in response to gingival bleeding, and the development of good habits concerning the use of dental floss and regular scaling should be public oral health priorities.

A community-based culturally competent oral health promotion for migrant older adults living in Melbourne, Australia

OBJECTIVES

To evaluate the effect of a theory-based oral health promotion intervention in a community environment by a nondental peer educator on the oral hygiene and gingival health of independent-living Italian older adults.

DESIGN

A quasiexperimental design with a pretest-posttest nonequivalent control group with no intervention.

SETTING

Ten Melbourne-based Italian social clubs participated in this evaluation.

PARTICIPANTS

One hundred forty-four active members of the social clubs.

INTERVENTION

A series of oral health seminars and four supervised brushing sessions at club premises. The intervention did not involve any direct oral health professional clinical care. Clubs were allocated to the control or intervention group.

MEASUREMENTS

Dental plaque levels and gingival bleeding scores were determined. A series of one-way analyses of covariance were conducted using the baseline measures as covariates.

RESULTS

Controlling for pretest scores, the experimental group was significantly more likely than the control group to have improved gingival status and self-efficacy. No significant effects were found regarding dental plaque.

CONCLUSION

Within the setting of Italian social clubs, the intervention was effective at increasing self-efficacy and reducing gingival bleeding. As such, it represents a useful approach for the design of oral health interventions in older migrant adults.

Different strategies used in the retention phase of orthodontic treatment

OBJECTIVE: To identify most frequent clinical conducts, considering the following variables: 1) used appliances; 2) time of use; 3) protocol of use in daily hours and evolution with along time; 4) percentage of patients in follow up 1 year after treatment; and 5) most frequent observed relapses.. METHODS: It was used a questionnaire distributed to all specialization course of Orthodontics inscribed in the Brazilian Federal Council of Dentistry until October of 2005. RESULTS AND CONCLUSION: It was obtained 91 valid questionnaires. For data analysis were used descriptive statistics and chi-square for linear tendency and chi-square for linear trend and chi-square for multivariate linear trend. We can conclude that: 1) on upper arch, the most used appliances were Hawley, wraparound and acetate plate; in the lower multi-stranded rod, steel rod not bonded to incisors and rod bonded to the incisors; 2) it was indicated its use for more than 24 months for the upper arch, with a trend toward its less use than in the lower arch; 3) the protocol of use in the upper arch begins with 24 hours/day, reducing after the second year; for the lower arch the protocol of hours/day was kept stable; 4) after 1 year of retention most than 50% of treated cases were re-examined; 5) most common relapses were crowding, giroversion and opening of diastemas.

Oral diagnostics for the geriatric populations: current status and future prospects

Because it is a noninvasive technique, there is growing interest in replacing blood with oral-based methods of diagnostics. Oral diagnostics may be used for diagnosis and therapeutic drug monitoring of both oral diseases (eg, caries, periodontal disease,oral lesions, oral cancer) and systemic diseases (eg, infectious diseases, including HIV and AIDS, autoimmune diseases, cancer,and endocrine disorders). The authors address both existing techniques and oral-based diagnostics that will be applicable to the aging population in the future. They also highlight those techniques that are uniquely suited to point-of-care applications.

The elderly at risk for periodontitis and systemic diseases

The increasing population of older subjects with dental care needs will become a major challenge to our society and its care providers. To manage the health care needs of the elderly, a coordination between medical and dental care providers will become necessary. From the dental perspective, it is important to develop skills in the risk assessment of older patients. Such risk assessment of older subjects should take an approach that is holistic and focused on the reduction of the infectious burden and the improvement of self-efficacy.

Progressing toward a more culturally competent approach to dental care for African American elders

This study was conducted to understand perceptions that may influence oral self-care behaviors among elderly African American adults living in an urban community. Four focus groups at two senior centers were recruited, involving a total of 25 participants. Content analysis and ethnographic summaries were used to identify themes, common concepts and language. The results indicated that although the participants recognized the advantages of routine brushing, the importance of keeping teeth clean to prevent gum disease was not widely acknowledged. On the basis of these focus groups, the authors suggest that health promotion approaches for adults who are elderly should be linked to the audience's cultural norms and perceptions regarding the benefits of oral hygiene practices.

Socio-medical condition and oral functional status in an older institutionalised population

OBJECTIVES

To investigate the association between the general medical condition, the socio-economic status, and some factors related to the functional status of the stomatognathic system.

DESIGN

A survey in an elderly population.

SUBJECTS

257 older adults, with a mean age of 83.7 years.

SETTING

Residential homes for the elderly.

INTERVENTION

Examination of the medical records on the overall health and the drugs consumed, a structured interview on the socio-economic status, the complaints for xerostomia, the subjective chewing difficulties, and a clinical evaluation of the number of natural teeth and the number of posterior occluding pairs of teeth contacts (premolars and molars).

RESULTS

Multiple pathology and polypharmacy were recorded. 25% of the residents had no occluding posterior tooth contact (natural or prosthetic) and 62% were edentulous. 43% of the residents reported complaints for xerostomia, and 46% for chewing difficulties when eating specific food types. Xerostomic feelings and chewing problems were not related to age. Chewing difficulties were not related to the number of natural teeth, but to the number of posterior occluding teeth contacts, natural or prosthetic (less than two). From all medical conditions examined, only the psychiatric disorders were significantly related to dental status (p < 0.05). Moreover, the number of remaining natural teeth was related to socio-economic status, while the number of posterior occluding teeth contacts was also inversely related to the duration of institutionalisation (p < 0.05).

CONCLUSIONS

Psychiatric disorders, low socio-economic status and increased duration of institutionalisation were most closely related to poor dental status. The presence of more than two posterior occluding teeth contacts, natural or prosthetic, benefit the very old patient in terms of reduced subjective chewing difficulty. A formal oral care delivery system for the institutionalised elderly, and particularly for those suffering from psychiatric disorders, is imperative.