Fragile elderly, systemic conditions and dental homecare - a mini-review

Abstract

Background:The oral health of elderly patients can be treated at home or in the hospital environment with adaptations. This type of home dental care is possible through the synergistic interactions among several health professionals involved in improving the quality of life of dependent and fragile elderly patients. Scientifi c articles and bibliographic databases on the dental practice-based study in the elderly were searched and analyzed. Search strategy terms were: home care, geriatric dentistry, dental home care, frail elderly, systemic diseases, Alzheimer's disease and oral health. Inclusion criteria were: published articles in English; articles indexed in databases Pubmed; articles published from 2001 to 2019, totaling 22 references.Objective: The purpose of this review is to describe a different approach in dentistry that encourages adaptation for home dental care. Conclusion:Home dental care for dependent elderly people should be prioritized as an interdisciplinary health action, as many problems in the oral cavity have direct interference in the systemic condition and the dental conduct at home should be essential, based on the sharing of clinical decisions between family and entire care team for the frail elderly.

Systemic and oral health status of older adult inpatients in an intensive care unit

“…It is necessary to implement guidelines and provide skilled care support to carry out these activities, mainly to help clean hospitalized geriatric patients' teeth, dental prostheses, and tongue dorsum. [1][2][3] Therefore, it is worth emphasizing the need to follow-up geriatric patients right after their hospitalization in ICUs in order to implement educational, preventive, and interventional actions -whenever necessary -focused on improving their oral health. 27 Absence of effective actions focused on improving patients' oral health, combined with the time spent in the ICU, can favor biofilm buildup and emergence of inflammatory and fungal conditions.…”

“…Oral hygiene measures should be performed on teeth, back of tongue, dental prostheses, and mechanical ventilation tube (artificial respirator) for effective care. 2,3,9,15 Edentulism remains common among the older Brazilian population and is associated with the need to wear dental prostheses. Thus, correct oral assessment of geriatric patients hospitalized in ICUs must take into consideration both the use of prostheses and their hygiene to help maintaining excellence in the care provided to these individuals during their time in hospital.…”

“…The Brazilian population is aging and this process is associated with frailty and diseases, such as acute myocardial infarction (AMI), stroke, ventilator-associated pneumonia, nosocomial pneumonia, systemic arterial hypertension (SAH), chronic kidney disease (CKD), and diabetes mellitus (DM), that are capable of harming these individuals' biopsychosocial condition faster and more aggressively. [1][2][3][4][5] Frail and systemically compromised geriatric people contribute to increased numbers of hospitalizations because they need more care support. 1,2 They often have poor oral health, which directly affects their quality of life.…”

“…Providing care with a focus on promoting oral health can contribute to improving patients' systemic conditions. 3 In other words, oral problems associated with infectious and inflammatory processes can affect geriatric patients' recovery. 6,7 Older patients admitted to the ICU need high quality health care provided by a multidisciplinary team.…”