Strategies to improve the quality of oral health care for frail and dependent older people.
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The dental profile of the population of most industrialised countries is changing. For the first time in at least a century most elderly people in the United Kingdom will soon have some of their own natural teeth. This could be beneficial for the frail and dependent elderly, as natural teeth are associated with greater dietary freedom of choice and good nutrition. There may also be problems including high levels of dental disease associated with poor hygiene and diet. New data from a national oral health survey in Great Britain is presented. The few dentate elderly people in institutions at the moment have poor hygiene and high levels of dental decay. If these problems persist as dentate younger generations get older, the burden of care will be substantial. Many dental problems in elderly people are preventable or would benefit from early intervention. Strategies to approach these problems are presented. (+info)
Mapping the literature of dental hygiene.
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Despite the long history of the dental hygiene profession, little research has been conducted on the characteristics of its literature. In this study, the bibliometric method was used to identify the core journals in the discipline and the extent of indexing of these journals. The study was a part of the Medical Library Association (MLA) Nursing and Allied Health Resources Section's project to map the allied health literature. Five journals were found to provide one-third of all references studied. Forty-two journals yielded an additional one-third of the references. MEDLINE had the best indexing coverage with 87% of the journals receiving indexing for at least one-half of the articles included. Limited coverage was provided by EMBASE/Excerpta Medica (11%) and the Cumulative Index to Nursing and Allied Health Literature (9%). The findings identified titles that should be added by indexing services as well as those that should have more complete coverage. (+info)
Anticipatory guidance in infant oral health: rationale and recommendations.
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If appropriate measures are applied early enough, it may be possible to totally prevent oral disease. The American Academy of Pediatric Dentistry recommends that infants be scheduled for an initial oral evaluation within six months of the eruption of the first primary tooth but by no later than 12 months of age. The rationale for this recommendation is provided, although the recommendation itself is not universally accepted. Specific recommendations include elimination of bottles in bed, early use of soft-bristled toothbrushes (with parental supervision) and limitation of high-carbohydrate food intake after teeth have been brushed. (+info)
Oral care of elderly patients: nurses' knowledge and views.
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It is important that healthcare professionals caring for the elderly in hospitals have a core knowledge of the orodental care requirements of their patients. The aim of this study was to determine the knowledge and views of nurses working on acute and rehabilitation care of the elderly wards about orodental care. One hundred nurses and healthcare assistants took part in this questionnaire study of which 58 were qualified nurses and 70 had been employed on care of the elderly wards for two or more years. Although the majority of the respondents were registered with a dentist and attended regularly, 40 did have 'some anxiety' about visiting their dentist. Approximately half of the study population regularly gave advice to their patients about dental care but their knowledge of and reasons for providing oral care and advice was often incorrect. The group's understanding of the availability of dental treatment provided by the National Health Service was also often inaccurate. It was concluded that a better core knowledge of the orodental care of older patients is required by all healthcare professionals who care for this group. It is also important that individuals in whom anxiety is associated with their own dental experience do not neglect to give orodental health advice to their patients. (+info)
Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity.
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In recent years, there has been a dramatic increase in the number of tumors of the head and neck. Their successful treatment is one of the greatest challenges for physicians dealing with oncotherapy. An organic part of the complex therapy is preoperative or postoperative irradiation. Application of this is accompanied by a lower risk of recurrences, and by a higher proportion of cured patients. Unfortunately, irradiation also has a disadvantage: the development of osteoradionecrosis, a special form of osteomyelitis, in some patients (mainly in those cases where irradiation occurs after bone resection or after partial removal of the periosteum). Once the clinical picture of this irradiation complication has developed, its treatment is very difficult. A significant result or complete freedom from complaints can be attained only rarely. Attention must therefore be focussed primarily on prevention, and the oral surgeon, the oncoradiologist and the patient too can all do much to help prevent the occurrence of osteoradionecrosis. Through coupling of an up-to-date, functional surgical attitude with knowledge relating to modern radiology and radiation physics, the way may be opened to forestall this complication that is so difficult to cure. (+info)
Chewing gum--facts and fiction: a review of gum-chewing and oral health.
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The world market for chewing gum is estimated to be 560,000 tons per year, representing approximately US $5 billion. Some 374 billion pieces of chewing gum are sold worldwide every year, representing 187 billion hours of gum-chewing if each piece of gum is chewed for 30 minutes. Chewing gum can thus be expected to have an influence on oral health. The labeling of sugar-substituted chewing gum as "safe for teeth" or "tooth-friendly" has been proven beneficial to the informed consumer. Such claims are allowed for products having been shown in vivo not to depress plaque pH below 5.7, neither during nor for 30 minutes after the consumption. However, various chewing gum manufacturers have recently begun to make distinct health promotion claims, suggesting, e.g., reparative action or substitution for mechanical hygiene. The aim of this critical review--covering the effects of the physical properties of chewing gum and those of different ingredients both of conventional and of functional chewing gum--is to provide a set of guidelines for the interpretation of such claims and to assist oral health care professionals in counseling patients. (+info)
Examination, classification, and treatment of halitosis; clinical perspectives.
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Patients with halitosis may seek treatment from dental clinicians for their perceived oral malodour. In this article, an examination protocol, classification system and treatment needs for such patients are outlined. Physiologic halitosis, oral pathologic halitosis and pseudo-halitosis would be in the treatment realm of dental practitioners. Management may include periodontal or restorative treatment or both, as well as simple treatment measures such as instruction in oral hygiene, tongue cleaning and mouth rinsing. Psychosomatic halitosis is more difficult to diagnose and manage, and patients with this condition are often mismanaged in that they receive only treatments for genuine halitosis, even though they do not have oral malodour. A classification system can be used to identify patients with halitophobia. Additionally, a questionnaire can be used to assess the psychological condition of patients claiming to have halitosis, which enables the clinician to identify patients with psychosomatic halitosis. In understanding the different types of halitosis and the corresponding treatment needs, the dental clinician can better manage patients with this condition. (+info)
Rationale and treatment approach in minimally invasive dentistry.
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BACKGROUND: Current methods of detecting caries, especially fissure caries, are inaccurate, causing some caries to go undetected until it has reached more advanced stages. Minimally invasive dentistry is a philosophy in which the goal of intervention to conserve healthy tooth structure. The authors review the rationale and role of air abrasion in successful practice in the 21st century that includes the philosophy of minimal intervention. CLINICAL IMPLICATIONS: This objective encompasses a range of clinical procedures that includes assessment of caries risk to reinforce patient self-help, early detection of the disease before lesion cavitation to fortify the oral environment, restoration of fissure caries with maximum retention of sound tooth structure and sealant placement in unaffected areas. This conservative approach minimizes the restoration/re-restoration cycle, thus benefiting the patient over a lifetime. (+info)