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Oral Health Assessment in Primary and Institutional Care

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Gerodontology Essentials for Health Care Professionals

Part of the book series: Practical Issues in Geriatrics ((PIG))

Abstract

Gradual improvement in the prevention and treatment of oral diseases lead to the current and future older adults being likely to keeping all, or at least most teeth for life. However, age-related risk factors render elder persons more susceptible for rapid oral health deterioration, and consequently they often present worse oral health compared to younger cohorts. Due to limited income, reduced mobility and a shift in priorities, many older adults have irregular access to oral healthcare and a lower uptake of dental services. Yet, preserving oral health and a functional dentition is important for the general well-being. Beyond just preventing local pain, maintaining appropriate oral health reduces the risk of infection and oral bacteria spreading to other organs, helps keeping adequate nutritional intake, and maintains the appearance, thus fostering social interaction. Frequent oral health examinations allow for prevention, and if necessary early intervention, especially for oral cancer. As older patients consult with primary care providers more often than with dentists, it is strategic for primary care providers to understand the importance of oral health for the well-being of older adults and systematically screen for oral health problems during patients interviews and physical examinations. This chapter describes how primary care providers can perform quick and efficient oral health screenings for their patients, leading to a decision about when a patient needs to be referred to a dentist.

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References

  1. Slade GD, Akinkugbe AA, Sanders AE. Projections of U.S. edentulism prevalence following 5 decades of decline. J Dent Res. 2014;93(10):959–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Felton DA. Complete edentulism and comorbid diseases: an update. J Prosthodont. 2016;25(1):5–20.

    Article  PubMed  Google Scholar 

  3. Marchini L, Hartshorn JE, Cowen H, Dawson DV, Johnsen DC. A teaching tool for establishing risk of oral health deterioration in elderly patients: development, implementation, and evaluation at a U.S. Dental School. J Dent Educ. 2017;81(11):1283–90.

    Article  PubMed  Google Scholar 

  4. Boscato N, Schuch HS, Grasel CE, Goettems ML. Differences of oral health conditions between adults and older adults: a census in a southern Brazilian city. Geriatr Gerontol Int. 2016;16(9):1014–20.

    Article  PubMed  Google Scholar 

  5. Marchini L, Recker E, Hartshorn J, Cowen H, Lynch D, Drake D, et al. Iowa nursing facility oral hygiene (INFOH) intervention: a clinical and microbiological pilot randomized trial. Spec Care Dentist. 2018;38:345.

    Article  PubMed  PubMed Central  Google Scholar 

  6. De Visschere LM, Grooten L, Theuniers G, Vanobbergen JN. Oral hygiene of elderly people in long-term care institutions—a cross-sectional study. Gerodontology. 2006;23(4):195–204.

    Article  PubMed  Google Scholar 

  7. Katsoulis J, Schimmel M, Avrampou M, Stuck AE, Mericske-Stern R. Oral and general health status in patients treated in a dental consultation clinic of a geriatric ward in Bern, Switzerland. Gerodontology. 2012;29(2):e602–10.

    Article  PubMed  Google Scholar 

  8. Zuluaga DJ, Ferreira J, Montoya JA, Willumsen T. Oral health in institutionalised elderly people in Oslo, Norway and its relationship with dependence and cognitive impairment. Gerodontology. 2012;29(2):e420–6.

    Article  PubMed  Google Scholar 

  9. Ornstein KA, DeCherrie L, Gluzman R, Scott ES, Kansal J, Shah T, et al. Significant unmet oral health needs of homebound elderly adults. J Am Geriatr Soc. 2015;63(1):151–7.

    Article  PubMed  Google Scholar 

  10. Gil-Montoya JA, de Mello AL, Barrios R, Gonzalez-Moles MA, Bravo M. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review. Clin Interv Aging. 2015;10:461–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Scannapieco FA, Cantos A. Oral inflammation and infection, and chronic medical diseases: implications for the elderly. Periodontol 2000. 2016;72(1):153–75.

    Article  PubMed  Google Scholar 

  12. Delwel S, Binnekade TT, Perez RS, Hertogh CM, Scherder EJ, Lobbezoo F. Oral health and orofacial pain in older people with dementia: a systematic review with focus on dental hard tissues. Clin Oral Investig. 2017;21(1):17–32.

    Article  PubMed  Google Scholar 

  13. Bomfim RA, de Souza LB, Corrente JE. Tooth loss and its relationship with protein intake by elderly Brazilians—a structural equation modelling approach. Gerodontology. 2018;35(1):51–8.

    Article  PubMed  Google Scholar 

  14. Silva JCM, Santos JFF, Marchini L. Factors influencing patients satisfaction with complete dentures: a qualitative study. Braz Dent Sci. 2014;17(2):83–8.

    Article  Google Scholar 

  15. Munoz-Torres FJ, Mukamal KJ, Pai JK, Willett W, Joshipura KJ. Relationship between tooth loss and peripheral arterial disease among women. J Clin Periodontol. 2017;44(10):989–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Kato H, Takahashi Y, Iseki C, Igari R, Sato H, Sato H, et al. Tooth loss-associated cognitive impairment in the elderly: a community-based study in Japan. Intern Med. 2019;58:1411.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Takeuchi K, Ohara T, Furuta M, Takeshita T, Shibata Y, Hata J, et al. Tooth loss and risk of dementia in the community: the Hisayama study. J Am Geriatr Soc. 2017;65(5):e95–e100.

    Article  PubMed  Google Scholar 

  18. Saito S, Ohi T, Murakami T, Komiyama T, Miyoshi Y, Endo K, et al. Association between tooth loss and cognitive impairment in community-dwelling older Japanese adults: a 4-year prospective cohort study from the Ohasama study. BMC Oral Health. 2018;18(1):142.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Koka S, Gupta A. Association between missing tooth count and mortality: a systematic review. J Prosthodont Res. 2018;62(2):134–51.

    Article  PubMed  Google Scholar 

  20. Sanz M, Ceriello A, Buysschaert M, Chapple I, Demmer RT, Graziani F, et al. Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol. 2018;45(2):138–49.

    Article  CAS  PubMed  Google Scholar 

  21. Azarpazhooh A, Tenenbaum HC. Separating fact from fiction: use of high-level evidence from research syntheses to identify diseases and disorders associated with periodontal disease. J Can Dent Assoc. 2012;78:c25.

    PubMed  Google Scholar 

  22. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation. 2012;125(20):2520–44.

    Article  PubMed  Google Scholar 

  23. van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. 2013;30(1):3–9.

    Article  PubMed  Google Scholar 

  24. Masood M, Newton T, Bakri NN, Khalid T, Masood Y. The relationship between oral health and oral health related quality of life among elderly people in United Kingdom. J Dent. 2017;56:78–83.

    Article  PubMed  Google Scholar 

  25. Echeverria MS, Wunsch IS, Langlois CO, Cascaes AM, Ribeiro Silva AE. Oral health-related quality of life in older adults-longitudinal study. Gerodontology. 2019;36(2):118–24.

    Article  PubMed  Google Scholar 

  26. Bidinotto AB, Santos CM, Torres LH, de Sousa MD, Hugo FN, Hilgert JB. Change in quality of life and its association with oral health and other factors in community-dwelling elderly adults-a prospective cohort study. J Am Geriatr Soc. 2016;64(12):2533–8.

    Article  PubMed  Google Scholar 

  27. National_Institute_on_Aging. Obtaining an older patient’s medical history. 2017. https://www.nia.nih.gov/health/obtaining-older-patients-medical-history.

  28. Kossioni AE, Hajto-Bryk J, Janssens B, Maggi S, Marchini L, McKenna G, et al. Practical guidelines for physicians in promoting oral health in frail older adults. J Am Med Dir Assoc. 2018;19(12):1039–46.

    Article  PubMed  Google Scholar 

  29. Kossioni AE, Hajto-Bryk J, Maggi S, McKenna G, Petrovic M, Roller-Wirnsberger RE, et al. An expert opinion from the European College of Gerodontology and the European Geriatric Medicine Society: European policy recommendations on oral health in older adults. J Am Geriatr Soc. 2018;66(3):609–13.

    Article  PubMed  Google Scholar 

  30. Chen X, Zimmerman S, Potter GG, Sloane PD, Cohen LW, Reed D. Assessment of dentally related function in individuals with cognitive impairment: the dental activities test. J Am Geriatr Soc. 2017;65(3):580–5.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Delwel S, Binnekade TT, Perez R, Hertogh C, Scherder EJA, Lobbezoo F. Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues. Clin Oral Investig. 2018;22(1):93–108.

    Article  PubMed  Google Scholar 

  32. Skoskiewicz-Malinowska K, Malicka B, Zietek M, Kaczmarek U. Oral health condition and occurrence of depression in the elderly. Medicine (Baltimore). 2018;97(41):e12490.

    Article  Google Scholar 

  33. Hybels CF, Bennett JM, Landerman LR, Liang J, Plassman BL, Wu B. Trajectories of depressive symptoms and oral health outcomes in a community sample of older adults. Int J Geriatr Psychiatry. 2016;31(1):83–91.

    Article  PubMed  Google Scholar 

  34. Hughes S, Gibbs J, Dunlop D, Edelman P, Singer R, Chang RW. Predictors of decline in manual performance in older adults. J Am Geriatr Soc. 1997;45(8):905–10.

    Article  CAS  PubMed  Google Scholar 

  35. Marchini L, Vieira PC, Bossan TP, Montenegro FLB, Cunha VPP. Self-reported oral hygiene habits among institutionalised elderly and their relationship to the condition of oral tissues in Taubate, Brazil. Gerodontology. 2006;23(1):33–7.

    Article  CAS  PubMed  Google Scholar 

  36. Singh ML, Papas A. Oral implications of polypharmacy in the elderly. Dent Clin North Am. 2014;58(4):783–96.

    Article  PubMed  Google Scholar 

  37. Thomson WM. Dry mouth and older people. Aust Dent J. 2015;60(Suppl 1):54–63.

    Article  PubMed  Google Scholar 

  38. Trentin MS, Verardi G, De CFM, de Carli JP, da Silva SO, Lima IF, et al. Most frequent oral lesions in patients with type 2 diabetes mellitus. J Contemp Dent Pract. 2017;18(2):107–11.

    Article  PubMed  Google Scholar 

  39. Kaye EK, Heaton B, Sohn W, Rich SE, Spiro A 3rd, Garcia RI. The dietary approaches to stop hypertension diet and new and recurrent root caries events in men. J Am Geriatr Soc. 2015;63(9):1812–9.

    Article  PubMed  Google Scholar 

  40. Thomson WM. Measuring change in dry-mouth symptoms over time using the xerostomia inventory. Gerodontology. 2007;24(1):30–5.

    Article  PubMed  Google Scholar 

  41. Haber J, Hartnett E, Allen K, Hallas D, Dorsen C, Lange-Kessler J, et al. Putting the mouth back in the head: HEENT to HEENOT. Am J Public Health. 2015;105(3):437–41.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Kayser-Jones J, Bird WF, Paul SM, Long L, Schell ES. An instrument to assess the oral health status of nursing home residents. Gerontologist. 1995;35(6):814–24.

    Article  CAS  PubMed  Google Scholar 

  43. Dickinson HWC, Leathey M. The development of the THROAT: the holistic and reliable oral assessment tool. Clin Eff Nurs. 2001;5(3):104–10.

    Article  Google Scholar 

  44. Chalmers J, King P, Spencer A, Wright F, Carter K. The oral health assessment tool—validity and reliability. Aust Dent J. 2005;50(3):191–9.

    Article  CAS  PubMed  Google Scholar 

  45. Hussein AA, Helder MN, de Visscher JG, Leemans CR, Braakhuis BJ, de Vet HCW, et al. Global incidence of oral and oropharynx cancer in patients younger than 45 years versus older patients: a systematic review. Eur J Cancer. 2017;82:115–27.

    Article  PubMed  Google Scholar 

  46. Valdez JA, Brennan MT. Impact of oral cancer on quality of life. Dent Clin North Am. 2018;62(1):143–54.

    Article  PubMed  Google Scholar 

  47. Schimmel M, Christou P, Herrmann F, Muller F. A two-colour chewing gum test for masticatory efficiency: development of different assessment methods. J Oral Rehabil. 2007;34(9):671–8.

    Article  CAS  PubMed  Google Scholar 

  48. Halazonetis DJ, Schimmel M, Antonarakis GS, Christou P. Novel software for quantitative evaluation and graphical representation of masticatory efficiency. J Oral Rehabil. 2013;40(5):329–35.

    Article  CAS  PubMed  Google Scholar 

  49. Muller F, Hernandez M, Grutter L, Aracil-Kessler L, Weingart D, Schimmel M. Masseter muscle thickness, chewing efficiency and bite force in edentulous patients with fixed and removable implant-supported prostheses: a cross-sectional multicenter study. Clin Oral Implants Res. 2012;23(2):144–50.

    Article  PubMed  Google Scholar 

  50. Hasegawa Y, Ono T, Hori K, Nokubi T. Influence of human jaw movement on cerebral blood flow. J Dent Res. 2007;86(1):64–8.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Leonardo Marchini .

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Müller, F., Marchini, L. (2020). Oral Health Assessment in Primary and Institutional Care. In: Kossioni, A. (eds) Gerodontology Essentials for Health Care Professionals. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-41468-9_7

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  • DOI: https://doi.org/10.1007/978-3-030-41468-9_7

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