Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly

Geriatric oral health neglect: calculus on the attached gingiva: a case report

Introduction and importance

Aging exerts various effects on and causes changes to the oral tissues. It is often difficult to distinguish between what is caused by the physiological process of aging itself and what is caused by the individual's lifestyle or diseases. The elderly face peculiar health challenges and require special dental care. It is therefore vital that greater attention be given to the oral health needs of this rapidly population. In this article, the authors present the case of an elderly female patient with a rare case of calculus on the attached gingiva.

Case presentation

A 90-year-old retired teacher with a history of hypertension, presented with a small, painless, grayish-brown growth on her attached gingiva, noticed by her daughter-in-law. Examination revealed signs of gingivitis and significant dental issues including missing teeth, fractures, and calculus buildup. Diagnosis of chronic generalized marginal gingivitis and calculus deposition was made, and scaling and polishing were performed. Perforation of the attached gingiva was observed during scaling thus exposing the root, which facilitated the calculus accumulation. Post-procedure care included medication and oral hygiene instructions. Follow-up after 1 week showed satisfactory healing, but subsequent assessment at 3 months revealed plaque accumulation, with the patient declining further treatment.

Clinical discussion

The patient shows relative neglect in oral healthcare given the subpar oral health features she exhibited and decline of further treatment options presented to her. This is common in the population as some abnormal oral presentations and features are perceived as normal in the population, which can be attributed to poor knowledge of oral health practices, which affects the illness seeking behaviour of individual.

Conclusion

Calculus deposition in the oral cavity requires a hard surface for formation, and proper oral hygiene practices are essential to mitigate its adverse effects, particularly among the elderly who may require additional attention due to their unique physiological changes.

Head and neck cancer patients show poor oral health as compared to those with other types of cancer

PURPOSE

Several studies have found associations between periodontitis and various types of cancer. Since the site of head and neck cancer (HNC) has contiguity or proximity to the oral cavity, it may be particularly influenced by oral inflammation. This study aimed to determine whether HNC patients have poor oral health as compared to those with other types of cancer.

METHODS

This study retrospectively examined oral environmental factors including periodontal inflamed surface area (PISA), a new periodontal inflammatory parameter. A total of 1030 cancer patients were divided into the HNC (n = 142) and other cancer (n = 888) groups. Furthermore, the HNC group was divided into high (n = 71) and low (n = 71) PISA subgroups, and independent risk factors affecting a high PISA value were investigated.

RESULTS

Multivariate logistic regression analysis showed that number of missing teeth (odds ratio 1.72, 95% CI 1.15-2.56, P < 0.01), PISA (odds ratio 1.06, 95% CI 1.03-1.06, P < 0.05), and oral bacterial count (odds ratio 1.02, 95% CI 1.01-1.03, P < 0.01) were independent factors related to HNC. In addition, multivariate logistic regression analysis indicated that current smoker (odds ratio 7.51, 95% CI 1.63-34.71, P < 0.01) and presence of untreated dental caries (odds ratio 3.33, 95% CI 1.23-9.00, P < 0.05) were independent risk factors affecting high PISA values in HNC patients.

CONCLUSION

HNC patients have higher levels of gingival inflammation and poor oral health as compared to patients with other types of cancer, indicating that prompt oral assessment and an effective oral hygiene management plan are needed at the time of HNC diagnosis.

Saúde bucal e acesso aos serviços odontológicos em idosos quilombolas: um estudo de base populacional

Resumo Objetivo: investigar a condição de saúde bucal, o acesso a serviços odontológicos e fatores sociodemográficos associados a essa acessibilidade em idosos quilombolas rurais do norte do estado de Minas Gerais, Brasil. Método: trata-se de um estudo analítico e transversal de base populacional, no qual foi utilizada uma amostragem por conglomerados com probabilidade proporcional ao tamanho (n=406). A coleta de dados envolveu a realização de entrevistas estruturadas e exames clínicos odontológicos. Resultados: verificou-se que a maioria dos idosos possuía baixa renda e baixa escolaridade. Observou-se que parcela expressiva dos indivíduos relatou acesso a um cirurgião-dentista (97,5%) e que havia realizado a última consulta odontológica há três anos ou mais (60,4%). Foi verificado ainda que a maior parte dos idosos era edêntula (52,0%) e que a maioria dos pesquisados necessitava de próteses (88%). Um alto índice CPO-D foi constatado nos indivíduos estudados (valor médio de 27,25). Idade avançada, ausência de companheiro e aposentadoria se mostraram associadas ao acesso irregular aos serviços odontológicos. Conclusão: os idosos quilombolas locais possuíam uma condição precária de saúde bucal e tinham acesso restrito aos serviços odontológicos. Idade, estado conjugal e situação laboral demonstraram associação com baixa acessibilidade aos serviços de saúde bucal nos idosos investigados.