Geriatric dentistry: a new specialty in Brazil

Objective: To present the current status of geriatric dentistry in Brazil. Background: In 2001, the Brazilian Dental Council established a new specialty: geriatric dentistry. This decision was based on the increase in both the elderly population and the demand for dental treatment of this cohort. Materials and methods: Data were obtained through online searches of the Brazilian Dental Council and the Brazilian Institute of Geography and Statistics. Results: Brazil has 170 dental schools offering around 14 000 undergraduate vacancies every year. At the postgraduate level, there are 19 recognised dental specialties, one of which is geriatric dentistry, comprising 18 certificate programmes, with the potential to produce 216 new specialists every 18 months. The dentist/habitant ratio was 1:870, higher than that recommended by the Word Health Organization. The Brazilian population consists of around 14.5 million elderly people (8.6%). There were 124 specialists in geriatric dentistry distributed irregularly throughout the country. The specialist/elderly population rate was 1:117 249. At the undergraduate level, this new specialty is not included in the curricula of most dental schools in Brazil. Conclusions: Geriatric dentistry should be included in the undergraduate curricula of dental schools in Brazil. Postgraduate degree courses should be developed to produce more clinical academics and researchers in this field.     

Translation and validation of the Hindi version of the Geriatric Oral Health Assessment Index

doi: 10.1111/j.1741‐2358.2011.00609.x Translation and validation of the Hindi version of the Geriatric Oral Health Assessment Index Purpose: To translate the original English version of the Geriatric Oral Health Assessment Index (GOHAI) into Hindi and assess its validity and reliability for use among people in India. Materials and Method: After translation into Hindi, a total of 385 participants aged 55+ demonstrated acceptable validity and reliability when used for people in India. Individual GOHAI items were recorded and summed as originally recommended. The questionnaire sought information about socio‐demographic characteristics and self‐reported perception of general and oral health. Clinical examination included assessment of periodontal status and number of decayed teeth, missing teeth, filled teeth and crowned teeth. Result: Mean GOHAI score was 40.9 (SD, 10.6; range, 12–60). Cronbach’s alpha for the GOHAI score was 0.88, indicating a high degree of internal consistency and homogeneity between the GOHAI items. The test–retest correlation coefficient for add‐GOHAI scores was 0.72, indicating good stability. Add‐GOHAI scores increased with poorer perceived general and oral health. Convergent validity, construct validity and discriminant validity of the GOHAI were demonstrated. Conclusion: It could therefore be used as a valuable instrument for measuring oral health–related quality of life for people in this region.     

Need for gerodontology education in India

Objectives: To evaluate the status and need for education in Geriatric Dentistry in India. Materials and methods: The status of dental education in India was studied. India has 185 dental schools producing 12 000 dental graduates every year. At postgraduate level, there are nine recognised specialities in Dentistry, and approximately 58 institutions offer 1160 places for postgraduate degree courses. Dental education is shaped and administered by the Dental Council of India. Results: So far, Geriatric dentistry has not developed as a separate, independent speciality at postgraduate level. The undergraduate curriculum does not have any significant component of geriatric dentistry. The lack of training results in poor understanding of special needs of older adults in young graduates. Without adequate training and personal experience of growing old, young graduates may not be able to understand the physical, socio‐economic and psychological problems of the elderly and the complexities involved in treatment planning for patients with multiple chronic diseases and medication. Conclusions: It is emphasized that geriatric dentistry should be included in each of the pre‐clinical, para‐clinical and clinical subjects at the undergraduate level. Graduate students should be encouraged to treat elderly patients in clinics under supervision using a multi‐disciplinary approach. Also, postgraduate diploma and degree courses in geriatric dentistry should be developed to address the needs of the vast elderly population in India.     

Tooth loss and dental caries in community-dwelling older adults in northern Manhattan

doi: 10.1111/j.1741‐2358.2011.00502.x Tooth loss and dental caries in community‐dwelling older adults in northern Manhattan Objective: To examine tooth loss and dental caries by sociodemographic characteristics from community‐based oral health examinations conducted by dentists in northern Manhattan. Background: The ElderSmile programme of the Columbia University College of Dental Medicine serves older adults with varying functional capacities across settings. This report is focused on relatively mobile, socially engaged participants who live in the impoverished communities of Harlem and Washington Heights/Inwood in northern Manhattan, New York City. Materials and Methods: Self‐reported sociodemographic characteristics and health and health care information were provided by community‐dwelling ElderSmile participants aged 65 years and older who took part in community‐based oral health education and completed a screening questionnaire. Oral health examinations were conducted by trained dentists in partnering prevention centres among ElderSmile participants who agreed to be clinically screened (90.8%). Results: The dental caries experience of ElderSmile participants varied significantly by sociodemographic predictors and smoking history. After adjustment in a multivariable logistic regression model, older age, non‐Hispanic Black and Hispanic race/ethnicity, and a history of current or former smoking were important predictors of edentulism. Conclusion: Provision of oral health screenings in community‐based settings may result in opportunities to intervene before oral disease is severe, leading to improved oral health for older adults.     

Prevalence of oral and dental disorders in institutionalised elderly people in Rasht,Iran

doi:10.1111/j.1741‐2358.2009.00313.x
Prevalence of oral and dental disorders in institutionalised elderly people in Rasht, Iran Objective: The aim of this study was to determine the prevalence of dental and oral mucosal lesions in institutionalised elderly people in Rasht. Background: Oral health in the elderly people is important to tailor the health programmes for this increasing age group within the population. Methods: A total of 216 elderly people residing in a geriatric nursing home were included in the study. Subjects were interviewed and examined clinically and registered in a data collection form and analysed using spss version 11 program (SPSS Inc, Chicago, Illinois, USA). Results: The prevalence of dental and oral disorders was 44.9% and 86.1% respectively. The most frequent oral disorders were dry mouth (42.1%), fissure tongue (25.9%), atrophic of tongue (25%), sublingual varicosity (22.7%), burning sensation (16.7%) and varix (15.3%). The prevalence of edentulousness was 56% (95%CI: 49–63%). The mean level of retained teeth was 3.22. The odds of an oral mucosal disorder in females were significantly more than in males (OR = 2.79, 95%CI: 1.25–6.23). Discussion: The findings revealed a high prevalence of dental and oral disorders in institutionalised elderly people in Rasht in comparison to similar studies. The mean of retained teeth was also much lower than in other reports. Therefore, the necessity for regular oral examination of these rapidly expanding age groups of people is essential.     

Oral and general health status in patients treated in a dental consultation clinic of a geriatric ward in Bern, Switzerland

doi: 10.1111/j.1741‐2358.2011.00529.x Oral and general health status in patients treated in a dental consultation clinic of a geriatric ward in Bern, Switzerland Introduction: This audit reports on the oral and general health of patients who were treated in a dental consultation clinic of a geriatric hospital. Material and Methods: Dental and medical records were obtained from 112 female and 80 male patients (mean age, 83.7 ± 8.2 years) who attended a dental consultation. Data analysis included the general health [American Society of Anesthesiologists (ASA) classification, number of diagnoses, cognitive function] and dental state in the age strata 60–69, 70–79, 80–89 and 90–99 years. Results: Seventy‐four per cent of patients were aged over 80 years. The prevalence of ASA‐P4 and P3 varied between age groups. Most patients (>86%) had more than three chronic diseases. Cognitive impairment was present in almost half of both older age cohorts (43 and 50%). Half of the patients (52%) were edentulous. In dentate patients, the average number of teeth was 12 ± 6 and differed in the maxilla significantly between age groups (p = 0.005). There was no significant association between dental state, ASA classification and systemic conditions. Conclusions: The profile of this cohort reflects a poor oral and general health status. The results underline the importance of an interdisciplinary consultation in a geriatric ward where oral health care is an integral part.