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Oral Health Problem of the Elderly

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Oral Health Problem of the Elderly Narumanas Korwanich Department of Community Dentistry Chiangmai University Xerostomia subjective report of oral dryness related to ... – PowerPoint PPT presentation

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Title: Oral Health Problem of the Elderly


1
Oral Health Problem of the Elderly
  • Narumanas Korwanich
  • Department of Community Dentistry
  • Chiangmai University

2
WHO, 2002
3
UN, 2001
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Thailand age pyramid 2004
Female
Male
6
?????????????????.??? ?.???? 2550
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???????????????? ?.????????????? ?.????????? 2549
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Thailand Projection
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WHO, 2002
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Active Ageing
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  • Oral health is an important component of Active
    Ageing and is included in policy proposals
    related to health, one of the three basic
    pillars.

Petersen Yamamoto, 2005
14
  • Reduce risk factors associated with major
    diseases and increase factors that protect health
    throughout the life course
  • - Tobacco - Physical activity
  • - Nutrition - Healthy eating
  • - Oral Health - Psychological factors
  • - Alcohol and drugs - Medication

15
WHO, 2002
16
Oral Health Problem in Elderly
Petersen Yamamoto, 2005
17
Tooth Loss
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Epidemiology of Edentulousness
WHO, 2005
19
National Oral Health Survey
????????? 2551
20
Tooth Loss Predictors
  • 201 participants (104 edentulous) in the Healthy
    Old People in Edinburg (HOPE) study
  • Age
  • Social Class
  • National Adult Reading Test IQ
  • Self Esteem Score
  • Dietary Assessment Score
  • Cognitive testing score

Starr et al., 2009
21
Association with Chewing Ability
Sarita et al., 2003
22
Association with Chewing Ability
Sarita et al., 2003
23
Association with Chewing Ability
  • Shortened dental arched with intact premolar
    regions and at least one occluding pair of molars
    provide sufficient chewing ability
  • Shortened dental arched with 3-4 pairs of
    occluding premolars and asymmetric arches with a
    long side result in impairment of chewing
    ability, especially of hard food
  • In extremely shortened dental arches comprising
    0-2 occluding premolars, chewing ability is
    severe impaired

Sarita et al., 2003
24
Cognitive Impairment
  • 5 extracted molar versus 5 non-extracted molar
    rats were compared to each other in learning
    ability and acetylcholine release in parietal
    lobe brain
  • To examine the effects of tooth loss on the
    central nervous system

Kato et al., 1997
25
5 Rats aged 11 weeks old kept in 23c,
50humidity, 12 h light/dark
Extract all maxillary and mandibular molars
135 weeks
Test in radial arm maze
9 weeks
Test of Acetyl-choline releasing from parietal
cortex
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  • It has been demonstrated that the neuronal
    activity in the brain and the cerebral blood flow
    were increased by mastication
  • Thus, one possible explanation may be that the
    dysfunction of cholinergic neuronal system in the
    teethless aged rats is caused by the long term
    decrease of neuron activity of the brain and/or
    the cerebral blood flow by the loss of teeth

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Tooth Loss and Quality of Life
OIDP index
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Tooth Loss and Quality of Life
34
Denture Related Condition
35
Denture Related problems
  • Plaque
  • Stomatitis and Oral Candidiasis
  • Malodor
  • Reservoir of Infection
  • Hygiene
  • Denture
  • Denture Hyperplasia
  • Traumatic Ulcer

36
Denture Stomatitis
  • 11-67 prevalence
  • Correlate with
  • Amount of denture plaque
  • Use of denture at night
  • Neglect of denture cleaning
  • Use of defective or unsuitable denture

37
Denture Hyperplasia
  • 4-26 prevalence of complete denture users
  • Frequently in
  • Ill fitting denture
  • Unretentive denture

38
Dental Caries
39
Dental Caries
  • Dental caries is an infectious, communicable
    disease resulting in destruction of tooth
    structure by acid-forming bacteria found in
    dental plaque, in the presence of sugar
  • During the past few decades, changes have been
    observed not only in the prevalence of dental
    caries, but also in the distribution and pattern
    of the disease in the population

NIH, 2001
40
Dental Caries
  • It is identified a shift toward improved
    diagnosis of noncavitated, incipient lesions and
    treatment for prevention and arrest of such
    lesions
  • Restorations repair the tooth structure, do not
    stop caries, have a finite life span and are
    susceptible to disease

Fontana and Zero, 2006
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Fejerskov, 1997
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Takahashi Nyvaad, 2008
60
Periodontal Disease
61
Periodontitis as a risk for health
  • Diabetes
  • Cardiovascular disease
  • Pulmonary disease
  • Adverse pregnancy

62
Effect of systemic disease to periodontium
  • Osteoporosis
  • Renal dysfunction
  • Immunodeficiency disease
  • Pregnancy

63
Xerostomia
64
  • Saliva affects all three of components of Keyes
    classic Venn Diagram of caries etiology
  • Dodd et al., 2005

65
Lenander-Lumikari Loimaranta, 2000
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Buffer Capacity
Lenander-Lumikari Loimaranta, 2000
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Guggenheimer Moore, 2003
70
Diagnosis of Xerostomia
Bardow, 2001
71
Guggenheimer Moore, 2003
72
Oral Cancer and Precancer
73
Global Perspective
74
WHO 2002
75
WHO 2002
76
Risk Factors
  • Alcohol and Tobacco
  • Dietary factors
  • Human papilloma virus
  • Other factors

77
WHO 2006
78
Thank You
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