Geriatric dentistry--meet the need

Geriatric dentistry or gerodontics is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal ageing and age-related diseases as part of an inter-disciplinary team with other health care professionals. Geriatric health is an ignored and under-explored area worldwide. Oral health reflects overall well being for the elderly population. Conversely, elderly patients are more predisposed to oral conditions due to age-related systemic diseases and functional changes. The major barriers to practising geriatric dentistry are the lack of trained faculty members, a crowded curriculum and monetary concerns. For successful treatment, the practitioner must adopt a humanitarian approach and develop a better understanding of the feelings and attitudes of the elderly. Prevention and early intervention strategies must be formulated to reduce the risk of oral diseases in this population. In future, dental professionals must have a proper understanding of the magnitude of the services to be provided to the elderly. This could only be realised through an education programme in geriatric dentistry, which should be started without further delay. This article hence sets out the objectives, needs, present scenario, strategies and types of dental treatment required by the elderly population.     

Analysis of socio-demographic and systemic health factors and the normative conditions of oral health care in a population of the Brazilian elderly

doi: 10.1111/j.1741‐2358.2010.00446.x
Analysis of socio‐demographic and systemic health factors and the normative conditions of oral health care in a population of the Brazilian elderly Objective: To investigate the association of socio‐demographic and systemic health factors according to the normative conditions of oral health care (dental caries, edentulism, periodontal disease and oral mucosal lesion) in elderly individuals. Material and methods: A cross‐sectional study was carried out in a group of elderly with access to community health care (n = 200). The normative conditions of oral health were then investigated according to the WHO and the SB Brazil criteria. Bivariate analyses were evaluated by the chi‐square test and Fisher’s exact test. An estimation of prevalence for the covariates was performed using Poisson’s regression models. Results: The prevalence of edentulism and oral mucosal lesions was detected in 58% and 21.5% of elderly patients, respectively. In the dentate subjects, the prevalence of dental caries and periodontal disease was 51.2% and 20.8%, respectively. Older men and individuals from lower‐income groups exhibited a higher prevalence of dental caries. Elderly women, illiterate individuals, and individuals over the age of 65 years exhibited a higher prevalence of edentulism. Elderly 60–64 years old and those who are employed had a significant association with periodontal disease. Conclusion: Socio‐demographic factors were associated with some notable oral diseases in the elderly.     

Prevalence of soft tissue oral lesion in elderly and its relations with deleterious habits

doi: 10.1111/j.1741‐2358.2011.00618.x Prevalence of soft tissue oral lesion in elderly and its relations with deleterious habits Introduction: With ageing, the oral mucosa becomes more susceptible to external stimuli. Objective: To investigate the prevalence of soft tissue oral lesion in elderly and its relations with deleterious habits. Materials and methods: It was a quantitative research conducted at the dental clinic of UNIFOR, Fortaleza‐CE, in the period from 1998 to 2006. The sample consisted of all 756 records of the elderly, and the data were processed by SPSS 15.0 (SPSS, Inc., Chicago, IL, USA). Results: The majority (63.0) were women, age 60–92, mean age 67 ± 6. The most significant proportions were married (48.4%), retired (42.3%) and incomplete primary school (31.5%). It was found a prevalence of 18.3% of oral lesions, with the risk being 1.6 times higher (p = 0.030) among youngest (up to 65 years) and 1.7 times higher among smokers (p = 0.048). Although this risk is 1.6 times higher among those who drank alcohol, it was not statistically significant (p = 0.122). Conclusion: The elderly showed a high prevalence of oral lesion, being the youngest, the smokers and the alcohol consumers those most vulnerable to the emergence of these diseases. Dental services need to implement programs of elderly care and health education, essential to clarify the risks and their associations with oral diseases, aiming to promote health.     

Discussions on oral health care among elderly Chinese immigrants in Melbourne and Vancouver

doi: 10.1111/j.1741‐2358.2011.00568.x Discussions on oral health care among elderly Chinese immigrants in Melbourne and Vancouver Background: This study explored how elderly Chinese immigrants value and relate to how acculturation influences oral health and subsequent service use. Methods: Elders who had immigrated to Melbourne and Vancouver within the previous 15 years were recruited from local community centres and assigned to focus groups of 5–7 participants in Vancouver (4 groups) or Melbourne (5 groups). Results: Following an iterative process of thematic analysis, the discussions revealed that immigrants care about the comfort and appearance of their teeth, and they value Western dentistry as a supplement to traditional remedies, but they have difficulty getting culturally sensitive information about oral health care. Accessing dentistry, they explained, is distressing because of language problems and financial costs that impose on their children. Consequently, many immigrants obtain dental treatment in China when they return for occasional visits. They felt that separation of dentistry from national health care programmes in Canada and Australia disregards natural links between oral health and general health. Conclusions: The similarity of concerns in both cities suggests that dissemination of information and availability of services are the important themes influencing oral health, and that, beliefs developed over a lifetime play an important role in interpreting oral health in the host country.     

哨兵动物概述

哨兵动物在我国还未作为一个＂工具＂用于实验动物微生物检测工作,但随着实验动物种类和特殊动物的日益增加,现有方法已经不能满足检测需要。探讨哨兵动物的应用,采用国外先进方法,对提高我国实验动物质量显得非常重要。本文对哨兵动物的概念、使用方法和设置做一概述。     

保健蔬菜黄秋葵的应用价值与前景

黄秋葵是一种具有较高营养价值的新型保健蔬菜,有很高的应用价值和潜力。主要介绍了黄秋葵近年来的研究概况,包括其分布与生长环境、营养成分与保健价值、贮藏与保鲜技术及其应用和开发进展等,在此基础上展望黄秋葵未来的研究热点。     

Health of infants in an Imperial Roman skeletal sample: perspective from dental microstructure

This study examines general health in the first year of life of a population of 127 subadults from the Imperial Roman necropolis of Isola Sacra (2nd-3rd century ACE). Health status was determined by analyzing 274 deciduous teeth from these children for Wilson bands (also known as accentuated striae), microscopic defects caused by a disruption to normal enamel development arising from some generalized external stressor. While macroscopic enamel defects, or hypoplasias, have long been used as proxies of general population health, we believe that this is the first population-wide study of microscopic defects in deciduous teeth. We used microstructural markers of enamel to attach very precise chronologies to Wilson band formation that allowed us to calculate maximum prevalence (MAP) and smoothed maximum prevalence (SMAP) distributions to portray what we believe to be a realistic risk profile for a past population of children. There appear to be two periods of high prevalence, the first beginning around age 2 months and continuing through month 5, and the second higher period beginning around month 6 and continuing through month 9. These results are discussed in light of historical records of Roman childhood rearing practices.     

Dimensions of health and social structure in the early intermediate period cemetery at Villa El Salvador, Peru

This paper examines relationships between the social structure of a community and the health of its members, based on analysis of human skeletal remains (N = 64) from Villa El Salvador XII (100 BC-AD 100), a prehistoric cemetery located in the lower Lurín Valley, Peru. The ambiguity of social status as conventionally inferred from archaeological context is among the principal complicating factors in such an inquiry. We use multidimensional scaling of skeletal markers to identify the presence of patterned health-based heterogeneity in our sample, without making a priori assumptions about underlying social structure at Villa El Salvador. This procedure situates every skeleton relative to all others in the sample on the basis of multiple health markers, eliciting health groups. Once recognized, the relevance of those groups to social structure can be evaluated by comparison with a broad range of presumptive archaeological status indicators. We test the hypothesis that the distribution of stress indicators in human skeletons covaries with archaeological indicators of social differentiation. Based on multivariate analysis of skeletal indicators, we conclude that the cemetery at Villa El Salvador was utilized by two social groups with different geographic affinities: one of local coastal origin, and the other probably from the upper Lurín Valley or adjacent higher altitudes. These groups differ in skeletal characteristics related to childhood health, probably reflecting systematic contrasts in the growth environments of the studied individuals. This same division is independently supported by the distribution of cranial deformation, a possible marker of ethnicity. We also document some inequality in the distribution of labor among male individuals, as reflected by the relative advancement of degenerative joint disease, and congruent with differences in the number and quality of associated funerary offerings.     

Multilevel grouped regression for analyzing self-reported health in relation to environmental factors: the model and its application

A method for modeling the relationship of polychotomous health ratings with predictors such as area characteristics, the distance to a source of environmental contamination, or exposure to environmental pollutants is presented. The model combines elements of grouped regression and multilevel analysis. The statistical model describes the entire response distribution as a function of the predictors so that any measure that summarizes this distribution can be calculated from the model. With the model, polychotomous health ratings can be used, and there is no need for a priori dichotomizing such variables which would lead to loss of information. It is described how, according to the model, various measures describing the response distribution are related to the exposure, and the confidence and tolerance intervals for these relationships are presented. Specific attention is given to the incorporation of random factors in the model. The application that here serves as an example, concerns annoyance from transportation noise. Exposure-response relationships obtained with the described method of modeling are presented for aircraft, road traffic, and railway noise.