Risks, consequences, and prevention of falls of older people in oral healthcare centers

Complications Arising from Dental Trauma Incurred from Falls Involving Geriatric Patients: A Case Report

Elderly patients have a high incidence of falls that result in facial injuries. Many cases present with dental crown fractures and soft-tissue lacerations. The initial diagnosis is especially important in this type of dental trauma, since an initial error can result in the failure to establish the correct treatment from the very beginning, worsening the prognosis, which, in the worst case, can compromise the teeth affected by the trauma. Case report: We present the case of a patient, a 79-year-old woman, who suffered an accidental fall. The patient was examined by a dentist in the emergency room. She was diagnosed with a simple crown fracture of the right upper central incisor and right upper lateral incisor without any pulpal involvement and with laceration of the lower lip. Months later, she had an episode of inflammation in the lower lip, and she developed edema and pain. An X-ray of the lower lip revealed a radiopaque mass compatible with a fragment of dental tissue due to the inclusion of remnants of the dental tissue resulting from the previous accident fall. Conclusions: The population of geriatric patients is steadily increasing in our society, and a higher frequency of falls has been observed in this age group, affecting the maxillofacial region, with consequent dental trauma on many occasions. Therefore, as professionals, we must pay special attention to the prevention and treatment of this problem, insisting on the importance of routine investigation in the emergency visit for dental trauma, which includes a meticulous examination of the soft tissues accompanied by a radiographic examination, when the inclusion of foreign bodies is suspected.

Smart homes for the older population: particularly important during the COVID-19 outbreak

Osteoporosis, one of the leading causes of disability in older adults, significantly reduces the quality of life and leads to loss of independence. Dynamic development of “smart” solutions based on artificial intelligence more and more commonly applied in older people’s houses may be an answer to the above issues.

The aim of this study is to present selected “smart home” solutions for the diagnosis and prevention of falls in the older population through a literature review. The conducted meta-analysis based on a review of the scientific literature available in English and Polish in the Medline/PubMed, Embase, Scopus, and GBL databases was undertaken from 01.01.2015 to 01.10.2020 with the string search method using key words.

According to the authors of this study, the development of new technology based on artificial intelligence allows older people to live independently, which contributes to a higher level of life satisfaction and quality.

The link between falls, social isolation and loneliness: A systematic review

BACKGROUND

The chances of experiencing a fall among those aged 60 years and older increase as risk factors accumulate. In the last few decades, several studies have identified different risk factors for falls in older people, including the role of social isolation and loneliness. This systematic review provides an overview of published literature that analyzes the bidirectional relation between falls and social isolation or loneliness.

MATERIAL AND METHODS

Two databases (PubMed and Europe PMC) were used to search for publications investigating the relationship between falls, social isolation and/or loneliness in older people. Similar articles and references were screened against the inclusion criteria.

RESULTS

17 studies met the inclusion criteria and were included. Only a few studies assessed the association between falls and social isolation/loneliness among older people. Therefore, articles examining the association between falls and living alone status among people aged 60 and older were included as well. In all studies loneliness, social isolation, and living alone were significantly associated with falls in older people.

CONCLUSIONS

The findings emphasize the importance of the relationship between falls and social isolation, loneliness and living alone among older people. As there are only a few studies assessing the relationship between falls and loneliness or social isolation, further research in this field should be conducted. In particular, longitudinal studies that utilize standardized measurement instruments should be carried out.

Xerostomia and hyposalivation in orthogeriatric patients with fall history and impact on oral health-related quality of life

Purpose

Falls are a common cause of morbidity and mortality in older people, and identification of risk indicators and risk factors to prevent falling is essential. Dry mouth (xerostomia and hyposalivation) can exacerbate conditions known to be fall risk indicators, such as nutritional status and sarcopenia. But there is little evidence regarding whether it is an independent risk factor for falling. We explored xerostomia prevalence and intensity and objective salivation rates in hospitalized geriatric patients to determine whether they were associated with an increased risk of falling.

Patients and methods

Hospitalized geriatric patients with and without a fall history were compared. We investigated several oral health issues including xerostomia, stimulated and unstimulated salivation rates, total number of teeth and prosthetics, periodontal status, and oral health-related quality of life.

Results

Forty patients were included, 28 in the fall history group and 12 in the control group. All patients had oral health issues that impacted on their oral health-related quality of life. However, there were no significant differences between the groups, including xerostomia and hyposalivation, apart from increased dysphagia and less flavor in food in patients with a fall history.

Conclusion

Dry mouth does not appear to be an independent risk factor for falling in this population, but oral health was impaired. Thus, it is important that dentists and geriatricians are aware of and investigate these conditions in their patients and that appropriate action is taken to reduce the consequences of impaired oral health, including a potential reduction in falls.