bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of four home‐care fluoride programs on the caries incidence in the elderly
Authors: Fure S. , Gahnberg L. , Birkhed D. 
Published: January 2004

Abstract Objective: To estimate the caries preventive effect of 4 fluoride programs over 2 years in the elderly. Setting: The Public Dental Clinics of Balsta and Knivsta and the Faculty of Odontology in Göteborg, Sweden Subjects: One hundred and sixty‐four individuals, aged 60 years and older (mean age 71.5 years) who were considered to be at risk from caries. Design: The participants were randomly assigned either to: 1) rinse twice a day with a 0.05% NaF solution (n=49; rinsing group), 2) suck twice a day on a 1.66 mg NaF tablet (n=51; tablet group). 3) brush their teeth three times a day using a toothpaste slurry rinsing technique (n=32; slurry group), or 4) brush their teeth in their usual manner (n=32; control group). The participants in all 4 groups used a fluoride toothpaste (containing 0.32% NaF) at least twice daily. Results: No new carious lesions were found in 67% of the participants in the rinsing, 43% in the tablet, 25% in the slurry and 16% in the control group over the 2 years. The mean (± SD) 2‐year caries increment was 0.8±1.4, 1.4±1.7, 1.9±1.9 and 2.3±2.1 DFS in the rinsing, tablet, slurry and control groups, respectively; it was significantly lower in the rinsing than in the control group (p<0.01). A lower incidence of DFS was also found in the tablet group than in the slurry group, but only for the lingual surfaces (p<0.05). Conclusion: The type of fluoride program may be of importance in the reduction of new caries lesions in an older population.
Reasons for referral of very elderly patients to the Community Dental Service in rural England and the implications for developing oral health care services
Authors: Fenwick J.E. , Batchelor P.A. , Samarawickrama D.Y.D. 
Published: January 2004

Abstract Objective: To analyse the medical conditions and dental treatment requirements. Design: Retrospective analysis. Setting: Rural South West Surrey, England. Subjects: 100 patients aged 75 or over who were referred for dental treatment to the Community Dental Services (CDS) because of various medical disabilities. Measurements: Age, sex, medical history including drug intake, dental treatment provided, time taken for treatment. Results: Two‐thirds of the patients required domiciliary care; two‐thirds had problems of mental confusion. In addition, 89% were dependent on carers. Treatment requirements indicate that the majority of dental care, although time consuming, were simple in nature and within the technical scope of a competent general dental practitioner (GDP). Conclusion: This study implies that the reasons for referral are other than lack of dental skills and may be due to perceived difficulties in managing patients. Further research is recommended to establish whether aspects of patient management are problematic so that resources, including appropriate training programmes, can be developed to enable a quality service to be provided. In the evolving health care system in the United Kingdom (UK) these issues will need to be considered when developing contracts at a local level.
Burning mouth in Parkinson's Disease sufferers
Authors: Clifford T.J. , Warsi M. J. , Burnett C. A. , Lamey P.J. 
Published: January 2004

Abstract Objective. The purpose of the study was to determine the prevalence of burning mouth (BM) in a population of Parkinson's Disease (PD) sufferers and also to assess the use of pain profiles in identifying the type of burning sensation experienced. Design. Subjects were surveyed by means of a one shot postal questionnaire for which ethical approval had previously been granted. Anonymity was guaranteed and therefore no attempt was made to follow up non‐respondents. Main outcome. BM was reported by 24% of respondents. The pain profiles were completed by 17 BM sufferers. Conclusion. Burning mouth is reported to occur in 24% of PD sufferers which is 5 times greater than that of the general population. The reason for this is uncertain but the result has implications for the future care of PD patients and indicates the need for increased dental input at PD outpatient clinics.
Affective state and acceptance of dentures in elderly patients
Authors: Golębiewska Maria , Sierpiñska Teresa , Namiot Dorota , Likeman Peter R 
Published: January 2004

Abstract Objective: To examine the relationship between the affective state and acceptance of dentures by elderly patients. Setting: Dental Outpatient clinics and a residential home for the elderly. Bialystok, Poland. Design: Cross sectional survey of denture wearers. Subjects: One hundred and forty one patients between the ages of 60–94. Intervention: A semi‐structured interview, which focused on the patient's self‐evaluation of their affective state, and a clinical examination. Results: There was a trend for the negative affects (irritability, boredom, anger, loneliness, helplessness) to relate to denture intolerance and for the positive affects (joy, peace, usefulness) to relate to denture acceptance. Conclusions: Anger related significantly t o intolerance of upper and lower dentures. The relationship of age and gender to the acceptance of dentures in the present sample was not significant.
The effect of variation of the lingual shape of mandibular complete dentures on lingual resistance to lifting forces
Authors: Miller William P. , Monteith Brian , Heath M. Robin 
Published: January 2004

AbstractIncreasing life expectancy, age related reduction in adaptability and progressive severe mandibular resorption all add to the importance of any factor improving the prosthetic success. Objective: To investigate the effect of two different lingual shapes of lower dentures on patients' ability to resist lifting forces. Design: Tongue pressures on the lingual surface of complete mandibular experimental dentures were recorded from mid‐line, premolar and molar transducers. Two experimental prostheses were fabricated for each subject: one conventionally contoured, the other formed by piezography. Setting: A clinical research laboratory. Subjects Five experienced complete denture wearers between age 64 and 82 years. Intervention Lifting forces were applied at the midline, left and right premolar sites in random order. Main outcome measures: Peak resistance to lifting forces and lingual pressures used during these tests. Results: Lingual pressures exerted anteriorly were dramatically higher than those on premolar and molar surfaces. Significantly higher pressures were used to resist lifting forces applied to piezographically than conventionally formed contours; correspondingly, significantly higher lifting peak forces were, on average, resisted. Conclusions: Providing a lower denture with a piezographically produced lingual surface was shown, in this preliminary study, to enhance tongue retentive ability over a conventional design. It seems reasonable to maximise retentive potential with oblique sublingual polished surfaces and minimise the adaptive demand, particularly for older patients, by using a piezographic technique which “customises” the contour and precludes over‐extension.
Double blind clinical trial of a remineralizing dentifrice in the prevention of caries in a radiation therapy population
Authors: Papas A. , Russell D. , Singh M. , Stack K. , Kent R. , Triol C. , Winston A. 
Published: January 2004

Abstract Objectives:The purpose of this study is to determine the efficacy and safety of a specially formulated remineralizing toothpaste in controlling caries in a group of high risk, head and neck radiation patients. Design:The study compares the performance of the remineralizing toothpaste with a leading conventional fluoride dentifrice using double‐blind randomization. Test ProductsThe products compared both contain equivalent quantities of fluoride (1150ppm). The remineralizing toothpaste also delivers soluble calcium and phosphate ions, the essential components of teeth. Subjects:On completion, 50 subjects who received >50 Gy of radiation to the head and neck. Measurements:Examinations include coronal and root caries using the Pitts Diagnostic Criteria, salivary flow rate, plaque and gingival indices and microbiological counts over one year. Results:At this point subjects are enrolled in the study at various phases. However, the current average for the net increment per month per subject is −0.12 (±1.30) for coronal caries and 0.06 (±0.73) for root caries in subjects using the remineralizing toothpaste and 0.53 (±1.62) for coronal caries and 0.45 (±0.98) for root caries in subjects using the conventional fluoride dentifrice. Non‐parametric analysis of rank scores for net root surface increments/month was statistically significant (p=0.02), suggesting lower net root surface increment/month for the remineralizing toothpaste relative to the conventional toothpaste. No significant differences were noted on coronal surfaces. Conclusions:The results to date indicate that the remineralizing toothpaste is significantly superior to the conventional fluoride dentifrice in preventing root caries in high risk patients.
The impact of oral health on stated ability to eat certain foods; Findings from the National Diet and Nutrition Survey of Older People in Great Britain
Authors: Sheiham A. , Steele J.G. , Marcenes W. , Finch S. , Walls A.W.G. 
Published: January 2004

Abstract Objectives. To assess how the dental status of older people's mouths affected their stated ability to eat common foods. Design. Cross sectional study. Subjects. Survey was part of the oral health component of the nationwide British National Diet and Nutrition Survey: people aged 65 years and older. Two separate representative samples aged 65 and over: a free‐living and an institutional sample. 881 free‐living and 275 institution subjects had a dental exam and were interviewed about ability to eat key foods. Results. Significant percentages of free‐living people had difficulty or could not eat at least 4 of 16 foods, and about 1 in 5 dentate stated they had difficulty eating or could not eat raw carrots, apples, well‐done steak or nuts. More of the edentate subjects stated that they had difficulty eating than the dentate. Perceived chewing ability increased with increasing numbers of natural teeth and pairs of opposing posterior teeth. Subjects reporting a sociodental impact were more likely to consider that they were unable to eat foods that required more chewing. Associations remained valid after correction for the effects of age, sex, social class and denture wearing status and region. Perceived dryness did not affect significantly the stated ease of eating most foods. There were more dietary restrictions reported by the institution sample. Some foods, such as nuts, apples and raw carrots could not be eaten easily by over half of edentate people in the institution sample. Conclusions. The stated selection of foods are substantially affected by numbers of teeth and occluding pairs of posterior teeth and presence of full dentures in significant percentages of older people.
Age‐related changes in cellular activity in human submandibular glands as evaluated by argyrophilic nucleolar organizer regions
Authors: Saito Masaji , Shimizu Yoshinaka 
Published: January 2004

Abstract Objective: To examine the age‐related changes in cellular activity of epithelial components of human submandibular glands, evaluated on the basis of argyrophilic nucleolar organizer regions (AgNORs). Design: Epithelial components of human submandibular glands were divided into serous acinar cells, mucous acinar cells, intercalated duct cells, striated duct cells, and interlobular duct cells. The mean AgNOR number of each cell type was compared among six age groups. Setting: The study was conducted at the Department of Oral Pathology, Tohoku University School of Dentistry, Japan. Subjects: Necropsy specimens from 66 males and 57 females 1 to 97 years old. Results: In all cell types except for intercalated duct cells, the mean AgNOR number was lowest in the 0‐14 year‐old group and highest in the 15‐29 year‐old group. The value then gradually decreased with advancing age and ultimately reached a similar level to that in the 0‐14 year‐old group. In intercalated duct cells, the mean AgNOR number did not differ significantly between any age group. There were no significant sex‐related differences. Conclusions: The cellular activity of almost all components of human submandibular glands rises in adolescence and young adulthood and then decreases with aging. These results suggest that intercalated duct cells are capable of not only proliferation but also division into other components; these cells may thus compensate for the reduced activity of other components in elderly subjects.
Caries activity and associated risk factors in elderly hospitalised population – 15‐months follow‐up in French institutions
Authors: Guivante‐Nabet C , Berenholc C , Berdal A 
Published: January 2004

AbstractOnly a few studies have been published concerning hospitalised elderly disabled people. Objectives: 1) to investigate the oral health status of elderly French patients hospitalised in the two main geriatric hospitals of Paris. 2) to describe the respective influences of general parameters (type of hospitalisation, pathologies and medication) on oral environment parameters. 3) to analyse the influences of these oral parameters on caries activity in Long‐Term Care (LTCF) and in rehabilitation facilities (RF) patients and to study the incidence and the time‐course of caries in these specific population. Subjects: 117 subjects (mean age=83.0 years, SD=7.8, range=64 to 102 years) were examined at baseline and 32 of the 50 LTCF subjects were reexamined 15‐months later. Methods: The general parameters recorded were age, gender, type of hospitalisation, period of stay, removable prosthesis, general diseases, number of diagnoses, medications with hyposalivary side‐effects. The oral environment parameters recorded were flow rate, buffer capacity, mutans streptococci and lactobacilli counts, measured at baseline by tests on stimulated saliva, and plaque index. Crown and root surfaces were recorded according to a modified caries activity index. Results: Among the polypathological subjects (85.5% of the population), the number of diseases ranged from 2 to 8. The LTCF patients had a significantly higher mean number of diagnoses (3.5; SD=1.5) than the RF patients (2.8; SD=1.4). 76.9% of patients were taking medications with hyposalivary side‐effects. The stimulated flow rate ranged from 0.02 ml/min to 5 ml/min. Its mean was significantly lower for LTCF patients (0.67 ml/min; SD=0.51) than for RF patients (1.12 ml/min; SD=0.89). The plaque index was significantly higher in LTCF subjects and in patients with mental diseases. At baseline, 17,442 crown and root surfaces were examined. Flow rate was related to crown caries and buffer capacity to root caries. During the 15‐months follow‐up, the mean number of active root surfaces was significantly increased: from 0.148 (SD=0.116) at baseline vs. 0.250 (SD=0.174) at the second examination. Conclusions: The strongest relationship in the present study between oral parameters and caries activity was the negative relationship between buffer capacity and active root caries. This study confirms an association between the type of hospitalisation and both salivary parameters flow rate and plaque index. This investigation illustrates the critical need for hygiene and oral care, in this elderly disabled population.
The importance of oral health to older people's quality of life
Authors: McGrath Colman , Bedi Raman 
Published: January 2004

Abstract ObjectivesThis study was designed to determine whether older people perceive oral health as being important to Quality of Life (QoL) and if so, to identify the most important ways in which their lives are affected. In addition, to identify if subgroups of older people perceive its importance differently. Design: Nationwide qualitative face to face interviews with older people were carried out utilising the Office for National Statistics Omnibus survey in Great Britain. Subjects and methods 454 adults aged 65 or older took part in this study, part of a random probability sample of adults in the UK. Setting Respondents were interviewed in their homes. Results 72% (313) perceived their oral health status as important to their QoL through a variety of physical, social and psychological ways. Most frequently its impact on function: eating (29%, 126) and symptoms: comfort (14%, 59) were considered most important. Gender and social class variations were apparent (P<0.05). Conclusion Older people perceive oral health as being important to life quality in a variety of different ways. There are significant social class and gender variations which must be taken into consideration when assessing oral health needs of older people.
Mobility in old age
Authors: Walsh K , Roberts J , Bennett G 
Published: January 2004

AbstractImmobility is common In older people and may impact on their dental care. Immobility in old age may have physical, psychological and environmental causes. Immobile elderly people often suffer from a number of diseases which worsen their mobility. Arthritis, osteoporosis, hip fracture, stroke and Parkinson's disease are among the most common causes of immobility in old age. Complications of immobility such as orthostatic hypotension may occur in the dental patient. Careful history‐taking and a thorough physical examination by the physician are the most important parts of the assessment process. This assessment should lead to a list of active problems and treatment should then be aimed at these problems. Active management, carried out by the multidisciplinary team, will lead to improvements in mobility and lessen the frequency and severity of the complications of immobility. This broad description thus provides the basis for a wide understanding for the special problems that the immobile patient present to the practitioner and ways of overcoming the problems.
Behind the screens: care staff observations on delivery of oral health care in nursing homes
Authors: Frenkel H F 
Published: January 2004

AbstractObjective: To identify qualitatively carer staff attitudes, practices and clinical comments related to oral health care of functionally dependent nursing home clients.Design: Open‐ended questions included in a longer quantitative questionnaire.Setting: 22 randomly selected nursing homes in the Bristol area.Subjects: 416 carers employed in these homes.Results: The majority of carers thought that clients had a right to good oral health, accepted the carers' role in helping clients with oral and denture hygiene, but recognised that oral health care provision was deficient. However, some carers believed oral health care to be solely the clients' responsibility despite high disability levels. Main barriers to providing oral health care were low prioritisation of oral health by nursing management, lack of co‐operation from cognitively impaired clients, and lack of training. Carers were critical of homes' lack of arrangements for routine professional dental cheeks, lack of commitment to staff training, low standards of oral health care by colleagues, and lack of provision of oral hygiene aids and cleansing materials for clients. Many responses indicated ways in which nursing home oral health care could be improved. Carers reported contrasting experiences of dental treatment, and deplored recent decreased availability of subsidised dental care.Conclusions: Carers' generally positive attitudes towards clients' oral health care should encourage health educators. Insights gained from qualitative data can help to identify the less obvious causes for poor oral care delivery, which can then be addressed in education and training initiatives in nursing home settings.
The orodental status of a group of elderly in‐patients: A preliminary assessment
Authors: McNally Lisa , Gosney Margot A , Doherty Una , Field E Anne 
Published: January 2004

AbstractObjective: To provide a preliminary assessment of the orodental status and dental treatment requirements of a group of elderly in‐patients. Design: Cross‐sectional.Setting: Acute Care of the Elderly and Stroke Rehabilitation units at teaching hospitals in Merseyside.Subject: 150 patients aged 58 to 94 years, in which a history could be validated at interview.Intervention: Questionnaire administered by dentist and clinical examination. Main outcome measures: Registration with a dentist, prosthetic status and difficulties with dentures, denture hygiene and identification marking, dental treatment needs and evidence of mucosal pathology.Results: Only 27% of patients claimed registration with a dentist. Three quarters of the patients were edentulous and 66 patients wore full dentures; 18 had no prostheses. Difficulties were experienced by one quarter of patients with upper dentures, compared with a half of lower denture wearers. Of the dentures available for inspection, 61 % had removable soft debris, 66% were left out at night and 75% were cleaned by the patient, whilst on the ward. No dentures had evidence of identification marking. Of the 39 partially dentate patients, 75% required interventive dental treatment. Denture stomatitis was diagnosed in 29% of patients and 19 had evidence of benign mucosal pathology.Conclusions: The orodental status of this group of elderly in‐patients was poor, with a high proportion being edentulous. Few were registered with a dentist and denture hygiene was inadequate. Lack of identification marking is a matter of concern. Closer liaison between hospital staff responsible for elderly in‐patients is required, to improve the orodental health and quality of life of this medically compromised group of patients.
An Index of Clinical Oral Disorder in Elders (CODE)
Authors: MacEntee M I , Wyatt C C L 
Published: January 2004

AbstractAttempts to construct an index of oral health or disorder suitable for older adults have been limited in clinical scope or based on the judgement of very few individuals. Consequently, we present here a multidimensional index of Clinical Oral Disorder in Elders (CODE) based on a breadth of clinical measures relevant to elders. The data for the index are detived from a clinical examination of jaw function, dentures, mucosa, teeth, and periodontium. Weighting or ranking for each disorder within the context of an elderly person was established as mild, moderate or severe by experienced dental clinicians and dental hygienists. Subsequently, the index was constructed by transforming the weights into a numerical value for each clinical measure. Individual scores can relate to the heaviest weight identified during the examination or to the sum of the weights assigned throughout the examination, and the average score during a series of examinations will reflect the clinical status of a particular population. Clinical applications in elderly residential‐care populations indicate that the index can be constructed efficiently and with reasonable reliability. We suggest, therefore, that the CODE index is suitable for descriptive and comparative research by providing a clinical format for measuring oral disorder in disabled elders, and, when combined with a psychosocial index, it should be very comprehensive indicator of oral dysfunction in older adults