Developing a protocol for a preventive oral health exam for elderly people (EDePAM) using E-Delphi methodology

Abstract

The aim of this study was to develop a Preventive Oral Health Exam for Elderly People (EDePAM), using the e-Delphi technique, to diagnose oral health problems in people 65 or older. The e-Delphi technique was used with experts in multiple stages, and in a final workshop, where an agreement on an examination protocol was reached for diagnosing dental caries, oral mucosa lesions, periodontal diseases, and masticatory function disorders. Quantitative analyses of all the rounds of the e-Delphi method were conducted. It was agreed that the International Caries Detection and Assessment System (ICDAS) should be used together with a modified version of the Nyvad criteria to detect and assess caries lesions. It was also agreed that an assessment was needed of the different factors involved in determining caries risk, namely socioeconomic level, access to fluoride, level of dependence/ functionality, salivary flow, history of head and neck cancer treatment, use of medications that decrease salivary flow, diet, use of removable dental prostheses, exposure of root surfaces, and caries history. Furthermore, patients would be required to undergo an examination of the oral mucosa, where any existing lesion should be described in terms of its clinical appearance, location, and risk potential. It was also agreed that an assessment of masticatory function should be performed using the Leake index, together with chewing-gum combined with a color scale to categorize masticatory performance. The number of pairs of occluding antagonist teeth was considered as the best predictor of masticatory function. The 2018 classification by the American Academy of Periodontology (AAP) / European Federation of Periodontology (EFP) was accepted as the standard to assess periodontal status, and it was agreed that this assessment should include an evaluation of clinical attachment loss and bleeding on probing. The novel EDePAM was considered as appropriate for conducting a functional assessment of oral health by providing a comprehensive diagnosis of oral diseases.

Protocolo de validación del instrumento Examen Dental Preventivo del Adulto Mayor

“…Este plan incluye medidas preventivas, rehabilitación y un seguimiento continuo con el propósito de mejorar la calidad de vida de los adultos mayores. El EDePAM se administra anualmente junto con el EMPAM a adultos de 65-69 años, lo que brinda a los beneficiarios la oportunidad de ser atendidos y tratados de acuerdo con su nivel de riesgo (4) . Este enfoque permite una atención personalizada que tiene en cuenta la carga de enfermedad de cada individuo y contribuye a una mejor calidad de vida en la tercera edad.…”