Needs for gerodontological treatment in the elderly living in Lower Silesia

Abstract

Background. Many factors influence decisions regarding gerodontological treatment. Apart from the clinical condition of a patient, there is a complex of crucial socioeconomic factors, comorbidities, place of residence, and psychological aspects. Therefore, gerodontological treatment plans are significantly diversified. Objectives. One of the goals of our cross-sectional epidemiological study of Lower Silesia seniors aged 65-74 was to identify all their needs related to gerodontological treatment. Material and methods. From the randomly selected sample group of 1,600 people, 387 inhabitants of Wrocław and Oława reported to take part in the study. The anamnestic study identified demographic and socioeconomic determinants, coexistence of general diseases and behavioral variables related to oral health behaviors. In the clinical study, the decayed-missing-filled (DMF) index, the community periodontal index (CPI), oral hygiene indices, clinical pathological lesions in oral mucosa, and the index of prosthetic reconstruction of missing teeth according to the World Health Organization (WHO) were determined. Criteria for the need for prosthetic treatment, dental caries treatment, periodontal disease treatment, improvement of oral hygiene, and treatment of mucosal diseases, including potentially pre-cancerous and cancerous disorders, were defined. Results. As many as 95.6% of all respondents required at least 1 form of dental treatment. The most common need (75%) was prosthetic treatment of missing teeth either in the maxilla or in the mandible. Forty-nine percent of the respondents needed treatment of caries in the clinical crown or root of at least 1 tooth. Further, these needs were related to the following factors: treatment of oral mucosal diseases (35.4%), professional periodontal treatment (35%), improvement of very bad oral hygiene (29.2%), and oncological treatment of pre-cancerous and cancerous lesions in the oral cavity (9.6%). Conclusions. The needs for gerodontological treatment found in the regional study of young Lower Silesian seniors are very high and cannot be met by services provided and funded by the state.

A Systematic Review on Caries Status of Older Adults

“…The included studies reported caries prevalence or experience of older adults at the age of 60 or above in 20 countries from six continents (Table 1). Most of them were conducted in Asia (n = 20, China [11][12][13][14][15][16], India [17][18][19][20][21][22][23][24], Singapore [25], Turkey [26][27][28][29][30][31][32][33][34][35][36][37][38] and Vietnam [29,30]) and Europe (n = 10, Finland [31], Germany [32,33], Ireland [34], Kosovo [35], Norway [36], Poland [37,38], Portugal [39] and Romania [40]). There were three studies conducted in North America (Mexico [41,42] and USA [43]), one in South America (Brazil [44]), two in Oceania (Australia [45,46]) and three in Africa (...…”

“…Fourthly, definition of caries severity in older adults should be developed. At present, WHO categorises DMFT > 4.5 and DMFT > 13.9 as a high level of caries experience in children (below 12) and adults (35)(36)(37)(38)(39)(40)(41)(42)(43)(44), respectively; however, no definition has been established for application to the older adult group [9]. With a clear definition, policymakers and general population would have an easier understanding of caries severity and health professionals would have a clear goal to achieve.…”

Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals

“…The prevalence of caries was expressed in the six types of disadvantaged subjects, starting in the description with those most affected, such as prisoners with 77% ([95% CI 66–85%]; 803 participants, three studies, I 2 = 90%) [ 22 , 23 , 24 ], elderly people with 62% ([95% CI 50–73%]; 38,133 participants, 24 studies, I 2 = 99.7%) [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ] ( Figure 2 ), alcohol and drug abusers with 60% ([95% CI 56–64]; 592 participants, two studies, I 2 = not assessable) [ 49 , 50 ], immigrants with 65% ([95% CI 18–99%]; 878 participants, three studies, I 2 = 99.1%) [ 39 , 51 , 52 ], followed by pregnant women with 29% ([95% CI 8–56%]; 506 participants, three studies, I 2 = 97.4%) [ 53 , 54 , 55 ]. All groups showed high scores of prevalence.…”

“…Caries experience (DMFT) was calculated in six types of disadvantaged individuals, of which the elderly were those with the highest DMFT 18.7 SD 2.4 ([95% CI 13.5–24]; 1160 participants, 17 studies) [ 25 , 28 , 30 , 31 , 34 , 40 , 41 , 44 , 48 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ], followed by homeless subjects with DMFT 17.3 SD 0.4 ([95% CI 12.6–22.1]; 100 participants, two studies) [ 67 , 68 ], immigrants with 14.9 SD 0.9 ([95% CI 9.6–18.7]; 843 participants, two studies) [ 51 , 52 ], alcohol and drug abusers with 12.9 SD 0.8 ([95% CI 11.2–14.6]; 1891 participants, nine studies) [ 49 , 50 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ], low-income people with9.9 SD 0.5 ([95% CI 3–16.7];3043 participants, two studies) [ 60 , 76 ], low-education people with 9.8 SD0.03 ([95% CI 9.4–10.2]; 3043 participants, two studies) [ 60 , 76 ] and prisoners with 8.9 SD 0.8 ([95% CI 6.3–10.4]; 802 participants, three studies) [ 22 , 23 , 24 ]. Lower DMFT was found in sex workers with 2.3 (249 participants) [ 77 ] and in subjects who work without any specific qualification with 2.9 (510 participants) [ 78 ].…”

New Local Drug Delivery with Antibiotic in the Nonsurgical Treatment of Periodontitis—Pilot Study

“…According to the definition by Offenbacher et al, 41.2% of the examined patients were diagnosed with periodontitis (0.7% of p1, 22.7% of p2, and 17.8% of p3). In the studies conducted in 2017 [6], the incidence of periodontitis according to DCD/AAP among the residents of Wrocław and Oława aged 65-74 was 30.7% in the cpi4 group, i.e., 47.9, out of which the disease was severe in 21.9 cases [6].…”