Strategies to improve the quality of oral health care for frail and dependent older people.
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)
An exploration of oral health beliefs and attitudes of Chinese in West Yorkshire: a qualitative investigation.
This qualitative study explores oral health beliefs and attitudes among Chinese resident in West Yorkshire using six focus groups differentiated by age and gender. Focus group discussions took place in community settings led by trained Chinese facilitators. All groups believed that they were susceptible to dental disease, and that bleeding gums and total tooth loss were 'normal'; apart from the elderly, tooth loss was seen as undesirable. The elderly and adult groups believed in traditional remedies and claimed that preventive oral health measures were ineffective. These groups lacked faith in dentists, and for them cost, language difficulties and lack of awareness were the main reported barriers to accessing dental services. Traditional Chinese oral health beliefs remain influential for the elderly and adult UK Chinese. In contrast, teenagers thought that toothbrushing and sugar restriction would help to prevent dental diseases. The appropriateness of the focus group and interview methods for exploring oral health beliefs for the Chinese are discussed, as are implications of the reported intergenerational differences for oral health promotion strategy in the UK. (+info)
High-altitude illness induced by tooth root infection.
High-altitude illness may occur after recent pulmonary infection, but high-altitude illness after root canal therapy has not been described previously. A 44-year-old man is presented who skied to a 3333 m high peak in the Eastern Alps one day after he had undergone root canal therapy because of a tooth root infection. After 4 hours above 3000 m severe symptoms of high-altitude illness, including pulmonary oedema, developed. His condition improved after immediate descent. The next day he presented with local and general signs of infection which were successfully treated with gingival incisions and antibiotics. In conclusion, acute tooth root infection and root canal therapy may induce high-altitude illness at an altitude just above 3000 m. (+info)
Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity.
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)
Oral health of patients scheduled for elective abdominal aortic correction with prosthesis.
OBJECTIVE: to evaluate the frequency of potential oral foci of infection in patients scheduled for elective abdominal aortic surgery. DESIGN: prospective clinical study. MATERIALS: oral health and dentures of 50 patients (33 males and 17 females, mean age 65 years) were examined before aortic surgery. CHIEF OUTCOME MEASURES: radiographic and clinical examination with special emphasis on identifying acute and chronic oral and ontogenic conditions which may contribute to aortic prosthesis infection. RESULTS: eighty-two per cent of the patients had some oral infection foci. The mean number of remaining teeth in the cohort was 9.3, and 21% of these were potential infectious foci (62% in the patients). Twenty-six per cent of the patients suffered from oral Candida infection. Seventy-four per cent of the patients had total or partial dentures, 45% of which were ill-fitting and needed repair. CONCLUSIONS: oral infectious foci occur frequently in patients needing aortic surgery. Untreated foci may contribute to aortic prosthesis infection. Preoperative oral evaluation and elimination of intraoral infection is recommended for patients scheduled for abdominal aortic repair. (+info)
Heavy metal poisoning in glass worker characterised by severe.
The paper presents the clinical description of the masticatory organ and biochemical assessment of dental tissue in a patient employed in a glassworks for 20 years. During 12 years the patient has suffered baldness ("Alopecia areata") and atypical extensive and non-healing cutaneous lesions. Dental examination revealed changes typical of chronic poisoning by cadmium and bismuth compounds. (+info)
Persistence of deciduous molars in subjects with agenesis of the second premolars.
The purpose of the present study was to investigate persistent primary second molars in a group of young people in their late twenties with agenesis of one or two second premolars. In 1982-83 it was decided, in connection with the orthodontic evaluation of 25 patients, to allow 35 primary molars (one or two in each patient) to remain in situ. All patients had mixed dentitions and agenesis of one or two premolars. The primary teeth were generally in good condition, although root resorption and infra-occlusion (compensated by occlusal composite onlays) occurred. In 1997, 18 of the 25 patients with a total of 26 retained primary molars were reexamined, comprising a clinical examination for exfoliation, extraction, loosening, and ankylosis, and a radiographic examination for root resorption, tooth morphology (crown and root), and alveolar bone contour. The examination showed that the degree of root resorption was unaltered in 20 of the 26 primary molars. In the permanent dentitions, where these primary molars persisted, there were no morphological deviations. Three of the six remaining primary molars had been extracted and three showed extensive resorption. In three of the 26 primary molars the infra-occlusion had worsened. The present study shows that persistence of primary second molars in subjects with agenesis of one or two premolars, and normal morphology of the permanent dentition can be an acceptable, semi-permanent solution for the patient. Whether this could also be an acceptable long-term solution will be shown by follow-up studies. (+info)
Understanding the dental need and care during pregnancy: a review.
This paper reviews the oral and dental lesions that are seen during pregnancy. Trimester approach should be adopted in the management of the pregnant patients. A good dental preventive programme is essential. The significance of prescribing fluoride supplements and the use of dental radiography during pregnancy is also briefly reviewed. (+info)