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.     

Oral health status in a group of the elderly population residing at home

doi: 10.1111/j.1741‐2358.2011.00556.x Oral health status in a group of the elderly population residing at home Objectives: To determine the oral health status and treatment needs of subjects aged 65 years and older residing in different districts of Ankara. Materials and methods: A total of 1300 patients, 751 females and 549 males, age 65 and over with a mean age of 72.8 ± 6.34 were included in this study. The subjects were visited at home and toothbrushing habits, visiting the dentist, tooth loss, denture needs were questioned and body mass index values were recorded. Results: 52.5% of the subjects were completely edentulous, 83.3% subjects reported wearing a removable denture. Females had a higher total tooth loss frequency when compared to males (p < 0.05). Total tooth loss between 65 and 69 ages was 47.3%, and increased to 62.4% among those aged 75 and over (p < 0.05). 16.2% of the subjects had not visited a dentist in the last 10 years, and only 3% visited a dentist for control check‐ups; no gender‐based difference was observed as to the frequency of dental visits (P > 0.05). No significant relationship was found between tooth loss and BMI values (P > 0.05). 46.3% of the subjects had chewing problems. Conclusions: The subjects included in this study showed high tooth loss frequency and poor oral hygiene habits. Education regarding maintenance of oral hygiene and regular dental check up should be stressed for the elderly.     

Prospects for translational regenerative medicine

Translational medicine is an evolutional concept that encompasses the rapid translation of basic research for use in clinical disease diagnosis, prevention and treatment. It follows the idea "from bench to bedside and back", and hence relies on cooperation between laboratory research and clinical care. In the past decade, translational medicine has received unprecedented attention from scientists and clinicians and its fundamental principles have penetrated throughout biomedicine, offering a sign post that guides modern medical research toward a patient-centered focus. Translational regenerative medicine is still in its infancy, and significant basic research investment has not yet achieved satisfactory clinical outcomes for patients. In particular, there are many challenges associated with the use of cell- and tissue-based products for clinical therapies. This review summarizes the transformation and global progress in translational medicine over the past decade. The current obstacles and opportunities in translational regenerative medicine are outlined in the context of stem cell therapy and tissue engineering for the safe and effective regeneration of functional tissue. This review highlights the requirement for multi-disciplinary and inter-disciplinary cooperation to ensure the development of the best possible regenerative therapies within the shortest timeframe possible for the greatest patient benefit.     

Gingival-derived mesenchymal stem cells:An endless resource for regenerative dentistry

The gingiva, the masticatory portion of the oral mucosa, is excised and discarded frequently during routine dental treatments and following tooth extraction, dental crown lengthening, gingivectomy and periodontal surgeries. Subsequent to excision, healing eventually happens in a short time period after gingival surgery. Clinically, the gingival tissue can be collected very easily and, in the laboratory, it is also very easy to isolate gingival-derived mesenchymal stem cells (GMSCs) from this discarded gingival tissue. GMSCs, a stem cell population within the lamina propria of the gingival tissue, can be isolated from attached and free gingiva, inflamed gingival tissu-es, and from hyperplastic gingiva. Comparatively, they constitute more attractive alternatives to other dental-derived mesenchymal stem cells due to the availability and accessibility of gingival tissues. They have unique immunomodulatory functions and well-documented self-renewal and multipotent differentiation properties. They display positive signals for Stro-1, Oct-4 and SSEA-4 pluripotency-associated markers, with some co-expre-ssing Oct4/Stro-1 or Oct-4/SSEA-4. They should be considered as the best stem cell source for cell-based therapies and regenerative dentistry. The clinical use of GMSCs for regenerative dentistry represents an attrac-tive therapeutic modality. However, numerous biological and technical challenges need to be addressed prior to considering transplantation approaches of GMSCs as clinically realistic therapies for humans.     

BMI and Health‐Related Quality of Life in Adults 65 Years and Older

Objective: To examine relationships of BMI with health‐related quality of life in adults 65 years and older. Research Methods and Procedures: In 1996, a health survey was mailed to all surviving participants ≥ 65 years old from the Chicago Heart Association Detection Project in Industry Study (1967 to 1973). The response rate was 60%, and the sample included 3981 male and 3099 female respondents. BMI (kilograms per meter squared) was classified into four groups: underweight (<18.5), normal weight (18.5 to 24.9), overweight (25.0 to 29.9), and obese (≥30.0). Main outcome measures were Health Status Questionnaire‐12 scores (ranging from 0 to 100) assessing eight domains: health perception, physical functioning, role limitations‐physical, bodily pain, energy/fatigue, social functioning, role limitations‐mental, and mental health. The higher the score, the better the outcome. Results: With adjustment for age, race, education, smoking, and alcohol intake, obesity was associated with lower health perception and poorer physical and social functioning (women only) but not impaired mental health. Overweight was associated with impaired physical well‐being among women only. Both underweight men and women reported impairment in physical, social, and mental well‐being. For example, multivariable‐adjusted health perception domain scores for women were 50.8 (underweight), 62.7 (normal weight), 60.5 (overweight), and 52.1 (obese), respectively. Associations weakened but remained significant with further adjustment for comorbidities. Discussion: Compared with normal‐weight people, both underweight and obese older adults reported impaired quality of life, particularly worse physical functioning and physical well‐being. These results reinforce the importance of normal body weight in older age.     

Ocular prosthesis: a brief review and fabrication of an ocular prosthesis for a geriatric patient

Objective: A review of literature for ocular prosthesis is presented along with a case report of a geriatric patient. Review of literature: The evolution of ocular prosthesis, materials and methods, fabrication techniques for custom and stock eye prosthesis, delivery and after care for the ocular prosthesis are reviewed. Case report: A 74‐year‐old female patient who had undergone enucleation of her right eye was restored with a stock ocular prosthesis. Conclusion: The use of stock ocular prosthesis of appropriate contour, size and colour can provide an acceptable aesthetic result.     

Biofeedback and behavioral treatment of persistent pain in the older adult: a review and a study

Persistent pain is a common health problem for older adults, age 60+, with a prevalence twice that in younger adults. Yet, older adults with chronic pain and headache are underrepresented in behaviorally oriented clinical programs that have proven effective for younger adults. A review of the literature indicates that older adults develop multiple pain-related problems that are similar to those of younger individuals. When offered the opportunity, older pain patients accept and benefit from multidisciplinary pain programs, cognitive–behavioral therapies and biofeedback training. A study comparing 58 older and 59 younger adults in a multidisciplinary pain program indicates that older pain patients readily acquire the physiological self-regulation skills taught in biofeedback-assisted relaxation training, and achieve comparable decreases in pain for the pain program as a whole.