Dental implant care and trouble among dependent patients based on the questionnaire survey among Japanese dental practitioners

Abstract

Background Self-care and professional care of implants may prove difficult for elderly people who require nursing care. However, the actual state of care and problems remains unknown. In this study, we investigated the actual state of implant problems in elderly people living in their own home or in a nursing home who received visiting dental treatment. Methods We mailed questionnaire survey forms to 2339 representatives or specialists who were members of the Japanese Society of Oral Implantology, the Japanese Society of Gerodontology or the Japan Prosthodontic Society. We narrowed down the respondents to those who provided visiting dental treatment, and analyzed the actual state of implants observed during visiting dental treatment (type, care, problems, countermeasures, etc.). Results Of the 924 dentists who responded to the questionnaire survey, 291 (22%) provided visiting dental treatment. While the majority of implant types encountered in the previous 12 months were root-form implants, there were still a certain number of blade and subperiosteal implants. Daily implant care involved mostly cleaning with a toothbrush + auxiliary tools. The most frequent implant problems encountered in the past were difficulty in cleaning and peri-implantitis. Medication and antiphlogistic treatment were most frequently adopted as countermeasures to implant problems, followed by observation. When we classified the results into those for the dentists who provided implant treatment and those for the dentists who did not, we found that many of the dentists who did not provide implant treatment opted for observation or medication, while those who provided implant treatment also implemented removal of superstructure, retightening of screws, repair and so forth. Conclusions We found that many of the implant troubles encountered by dentists who provided visiting dental care were difficulty in cleaning or peri-implantitis, and that the actions taken against these troubles varied depending on the experience of the dentist performing the implant treatment. Our study also revealed that dentists who provide visiting dental care need to acquire knowledge and skills of implant treatment, to have actions prepared in case they encounter such cases, or to closely coordinate with dentists who specialize in implants.

Dental implant status in elderly individuals requiring domiciliary dental care in Japan

“…In this study, 2% of the total number of individuals receiving domiciliary dental care were implant patients. This proportion is slightly lower than the proportion of implant treatment in those aged 65 years and more (3.8%), according to the Survey of Dental Diseases conducted in Japan in 2016 [13]. With regard to the distribution of implant patients according to the type of facility, we found the highest percentage in PNHs (5.3%), followed by DCSs and homes.…”

“…Although, in the cases of elderly people who need long-term care, they emphasize concerns about poor oral hygiene and periimplantitis. Consequently, there is an increase in the need for domiciliary dental care [11][12][13] whereby dentists or dental hygienists provide dental treatment and specialized oral care by visiting the homes, care facilities, or hospitals of patients who cannot visit dental clinics for physical or psychological reasons. However, the visited location is usually not equipped with dental infrastructure; hence, the treatment provided primarily includes simple caries treatment, adjustment and repair of dentures, and oral care.…”

“…However, the visited location is usually not equipped with dental infrastructure; hence, the treatment provided primarily includes simple caries treatment, adjustment and repair of dentures, and oral care. However, global awareness about domiciliary dental care is inadequate, and the system differs according to the medical insurance system, number of dentists, geographical requirements, and patient populations in different countries and regions [11][12][13].…”

Prognosis of Implants with Implant-Supported Fixed Dental Prostheses in the Elderly Population: A Retrospective Study with a 5- to 10-Year Follow-Up

“…Although the effects of IARPD and a shortened dental arch (SDA) on oral health-related quality of life were reported [ 42 , 43 ], few studies have evaluated the treatment effects after conversion from ISFDP. However, in the elderly population, less invasive procedures should be considered depending on the systemic conditions of the patient, and simplifying the oral environment and oral care is recommended for future maintenance [ 19 , 20 ]. In addition, a patient who lost a single unit implant was also rehabilitated with RPD.…”

“…All patients have potential risks regarding difficulty attending maintenance appointments for their implants and prostheses, depending on their age. Previous studies have also suggested the need for effective management for future maintenance [ 18 , 19 , 20 ]. This includes the improvement and simplification of the intraoral condition.…”