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Oral Health and Dental Care in Older Adults

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (15 August 2023) | Viewed by 18998

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Special Issue Editors

Dr. Márcio Diniz-Freitas

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Guest Editor

Special Care Dentistry Unit, School of Medicine and Dentistry and Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
Interests: oral medicine; oral surgery; special care dentistry

Dr. Pilar Gándara-Vila

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Guest Editor

Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), School of Medicine and Dentistry and ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
Interests: oral medicine; oral surgery; oral implantology

Special Issue Information

Dear Colleagues,

As medical progress has dramatically reduced mortality rates, the adult population is increasing. As people age, they often develop general health problems that can determine their oral health and complicate dental management. The most prevalent oral diseases, such as dental caries, periodontal disease and tooth loss, are common in the elderly. Deficient oral health affects not only the ability to chew (leading to weight loss and malnutrition) but also appearance, self-esteem and self-confidence, as well as the ability to speak and communicate effectively. A clear association has also been demonstrated between oral and systemic diseases, and findings in this field continue to generate new evidence on a constant basis. Therefore, oral health affects and determines the general health condition and quality of life of older adults.

Although prevention, maintenance and restoration of oral health can be a challenge in old age, particularly in social isolation conditions (low income or dependency), these measures are considered to be particularly important for healthy aging.

This Special Issue will present original articles, narrative and systematic reviews and meta-analyses on odontology in older adults, covering topics including:

Geriatric dentistry education and sensitization for providing oral health care for older adult patients.
Prevention of the most prevalent oral diseases (caries and periodontal disease) in older adult patients and application of new materials and technology for their treatment.
The relationship between oral health and the most prevalent systemic diseases in advanced age (dementia, Alzheimer’s disease, diabetes and cardiovascular diseases).
Oral health care for dependent or institutionalized older adults.
Oral health care for frail older adults and end-of-life care.

Dr. Márcio Diniz-Freitas
Dr. Pilar Gándara-Vila
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

geriatric dentistry
oral health
preventive dentistry
edentulism
dementia
quality of life
end-of-life care

Published Papers (10 papers)

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Research

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14 pages, 6117 KiB

Open AccessArticle

Immediate Loading of Implants with Fixed Rehabilitations in Geriatric Edentulous Patients; Biological Complications

by Eugenio Velasco-Ortega, Laura Carretero-Barrado, Jesús Moreno-Muñoz, Ivan Ortiz-García, Enrique Núñez-Márquez, José Luis Rondón-Romero, José López-López, Álvaro Jiménez-Guerra and Loreto Monsalve-Guil

J. Clin. Med. 2023, 12(20), 6548; https://doi.org/10.3390/jcm12206548 - 16 Oct 2023

Viewed by 866

Abstract

Background: This study aimed to report the outcomes of the immediate loading of implants with fixed rehabilitations in edentulous geriatric patients. Methods: Edentulous geriatric patients were diagnosed with an oral examination, radiographic evaluation, and intermaxillary relations and treated with fixed rehabilitation over several implants. After immediate surgery, the implants were immediately loaded with a fully fixed prosthesis. Results: Twenty-four patients (20 females and 4 males) were treated using a total 210 implants. All patients (100%) had a previous history of periodontitis. Eleven patients (45.8%) were smokers. Eleven patients (45.8%) suffered from chronic medical diseases (i.e., diabetes, cardiovascular diseases). The study’s clinical follow-up period extended for three years, during which thirty-three fixed prostheses were installed over the implants in 24 patients. The average marginal bone loss measured was 1.33 ± 0.17 mm. The success rate of the implants and prosthodontics being placed in this study yielded 98.5% and 97%, respectively. One patient (4.2%) showed some kind of technical complications. Eleven patients (45.8%) showed mucositis, and 25 implants (11.9%) in 10 patients (41.7%) were associated with peri-implantitis. Conclusions: This study shows that the treatment of edentulous geriatric patients by immediate loading of implants with fixed rehabilitations is a clinically successful protocol but with a high prevalence of peri-implant diseases. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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11 pages, 1659 KiB

Open AccessArticle

Improvements in Maximum Bite Force with Gum-Chewing Training in Older Adults: A Randomized Controlled Trial

by Kenta Kashiwazaki, Yuriko Komagamine, Wu Shanglin, Xiangyu Ren, Nanaka Hayashi, Mirai Nakayama, Sahaprom Namano, Manabu Kanazawa and Shunsuke Minakuchi

J. Clin. Med. 2023, 12(20), 6534; https://doi.org/10.3390/jcm12206534 - 15 Oct 2023

Viewed by 1357

Abstract

No specific methods have been officially proposed for the prevention and improvement of oral hypofunction. Therefore, in this randomized controlled trial, we aimed to develop a gum-chewing training program and determine its effects in older adults. A total of 218 older adults, aged 65–85 years, were randomly allocated to the intervention or control groups. The intervention group chewed the experimental gum daily, whereas the control group consumed the experimental granular food daily. The outcome assessments measured the maximum bite force, occlusal contact areas, oral dryness, tongue pressure, tongue and lip functions, masticatory function, and gum-chewing time. The measured values for each outcome were compared between groups using the Mann–Whitney U test and within groups pre- and post-intervention using the Wilcoxon signed-rank test. A total of 211 participants completed the study. After 2 months, the intervention group had a significantly higher maximum bite force than the control group (p = 0.01), indicating that gum-chewing training improved maximum bite force in older adults. This was determined using one type of bite force measuring device. Therefore, it is suggested that gum-chewing training has a high potential to improve oral hypofunction. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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20 pages, 612 KiB

Open AccessFeature PaperArticle

Salivary Complaints in Burning Mouth Syndrome: A Cross Sectional Study on 500 Patients

by Federica Canfora, Elena Calabria, Gianrico Spagnuolo, Noemi Coppola, Niccolò Giuseppe Armogida, Cristina Mazzaccara, Domenico Solari, Luca D’Aniello, Massimo Aria, Giuseppe Pecoraro, Michele Davide Mignogna, Stefania Leuci and Daniela Adamo

J. Clin. Med. 2023, 12(17), 5561; https://doi.org/10.3390/jcm12175561 - 26 Aug 2023

Viewed by 1957

Abstract

Background: Xerostomia and sialorrhea often accompany Burning Mouth Syndrome (BMS) despite no change in saliva quantity. This study analyzed BMS patients with different symptom combinations: burning only (B), burning and xerostomia (BX), burning and sialorrhea (BS), and burning with xerostomia and sialorrhea (BXS), using a large sample of 500 patients from the University of Naples Federico II. Methods: After a medical evaluation, patients were divided into four groups based on their reported symptoms: B (140), BX (253), BS (49), and BXS (58). Patient data on education, BMI, smoking/alcohol habits, comorbidities, medication use, pain intensity, quality, and psychological profile were collected. Results: The BX group showed a higher prevalence of patients taking blood thinners. Additional symptoms varied among groups, with the BX group experiencing more dysgeusia and globus, and the BS group reporting more tingling. Multivariate analysis identified BMI, dysgeusia, globus, and blood thinner use as significant factors in the B and BX groups, while male gender, tingling, alcohol use, and pain quality were significant in the BS and BXS groups. Conclusions: Overall, BMS patients display a complex range of symptoms, with xerostomia being the most frequent additional symptom. Sociodemographic, psychological, and medical factors cannot fully explain the variations in symptomatology among different patient subgroups. Further research is needed to understand the underlying causes and develop tailored treatment approaches. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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9 pages, 563 KiB

Open AccessArticle

Effect of New Complete Dentures and Simple Dietary Advice on Cognitive Screening Test among Edentulous Older Adults: A Randomized Controlled Trial

by Yuriko Komagamine, Hiroyuki Suzuki, Maiko Iwaki, Shunsuke Minakuchi and Manabu Kanazawa

J. Clin. Med. 2023, 12(14), 4709; https://doi.org/10.3390/jcm12144709 - 16 Jul 2023

Viewed by 847

Abstract

Mild cognitive impairment (MCI), including memory loss, has been attracting attention in Japan. This study assessed the effect of new complete dentures provision alone and with dietary intervention on cognitive functions assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). A randomized controlled trial was conducted with 70 older adults who required new complete dentures. The participants had new complete dentures fabricated and were randomly classified into the intervention or control group. The intervention group received simple dietary advice, and the control group only received denture care advice. Cognitive function was assessed using the MoCA-J before and at 3 and 6 months after treatment. The between-group comparison and within-group comparison were analyzed. No significant differences were reported for comparisons between the intervention and control groups. A significant increase was revealed in the within-group comparisons for the total scores between the 3- and 6-month assessments (p = 0.002) and between the baseline and 6-month assessments (p = 0.012) in the intervention group. In the control group, a significant increase in the total scores was not revealed between any of evaluation period. Complete denture replacement combined with simple dietary intervention may help improve MoCA-J scores in edentulous older adults. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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12 pages, 1311 KiB

Open AccessArticle

Early Loading of Two Implants Supporting Mandibular Overdentures in Geriatric Edentulous Patients: A 12-Year Follow-Up Study

by Eugenio Velasco-Ortega, Nuno Matos-Garrido, Alvaro Jiménez-Guerra, Ivan Ortiz-Garcia, Jesús Moreno-Muñoz, Enrique Núñez-Márquez, José Luis Rondón-Romero, Raul Ayuso-Montero, José López-López and Loreto Monsalve-Guil

J. Clin. Med. 2023, 12(11), 3825; https://doi.org/10.3390/jcm12113825 - 2 Jun 2023

Cited by 2 | Viewed by 1467

Abstract

Background: This study aims to show the clinical outcomes of implants supporting mandibular overdentures in edentulous patients. Methods: Mandibular edentulous patients were diagnosed with an oral examination, panoramic radiograph, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants. After two-stage surgery, implants were early loaded with an overdenture at 6 weeks. Results: Fifty-four patients (28 females and 24 males) were treated with 108 implants. Thirty-two patients (59.2%) had a previous history of periodontitis. Twenty-three patients (46%) were smokers. Forty patients (74.1%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 147.8 ± 10.4 months. The clinical outcomes showed a global success of 94.5% of implants. Fifty-four overdentures were placed in the patients over the implants. The mean marginal bone loss was 1.12 ± 0.34 mm. Nineteen patients (35.2%) showed some kind of mechanical prosthodontic complication. Sixteen implants (14.8%) were associated with peri-implantitis. Conclusions: Based on the clinical results obtained, we can determine that the treatment of elderly edentulous patients with mandibular overdentures through the early loading of two placed implants is a successful implant protocol. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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10 pages, 261 KiB

Open AccessArticle

by Salvatore Calderaro, Kathrin Bausch, Céline Tourbier, Christian Wetterauer, Florian M. Thieringer and Britt-Isabelle Berg

J. Clin. Med. 2023, 12(2), 638; https://doi.org/10.3390/jcm12020638 - 13 Jan 2023

Cited by 3 | Viewed by 1841

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a potentially preventable adverse side effect of mainly antiresorptive drugs. MRONJ is expected to become a growing clinical problem due to the aging population and the increasing number of patients requiring antiresorptive agents. Knowledge and awareness about MRONJ and elimination of the oral and dental risk factors before starting antiresorptive therapy (AR) are fundamental to reducing the incidence of MRONJ. In urology, ARs are used primarily in patients suffering from bone metastases due to prostate cancer and to prevent cancer-treatment-induced bone loss (CTIBL) in prostate cancer patients receiving endocrine therapy. This postal survey aimed to evaluate disease-related knowledge and awareness about implementing oral examinations for patients starting AR among Swiss, German, and Austrian urologists. A total of 176 urologists returned the completed questionnaire, yielding a response rate of 11.7%. Of the respondents, 44.9% (n = 79) and 24.4% (n = 43) stated that they give more than five first-time prescriptions of denosumab and of intravenous or oral bisphosphonates per year, respectively. Only 14.8% (n = 26) of the participating urologists had never encountered MRONJ cases related to BPs. Of the participants, 89.8% (n = 158) had implemented referrals to dentists for oral examination before initiating AR. The mean percentage of correct answers regarding the knowledge about MRONJ was 70.9% ± 11.2%. In contrast to previous surveys on MRONJ among physicians, this study showed that the participating urologists were sufficiently informed about MRONJ, as reflected by the high number of participants implementing preventive dental screenings. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

10 pages, 452 KiB

Open AccessArticle

Study of Prevalence, Severity and Risk Factors of Periodontal Disease in a Portuguese Population

by Marta Relvas, Paula López-Jarana, Luis Monteiro, José Júlio Pacheco, Ana Cristina Braga and Filomena Salazar

J. Clin. Med. 2022, 11(13), 3728; https://doi.org/10.3390/jcm11133728 - 28 Jun 2022

Cited by 14 | Viewed by 3363

Abstract

Periodontal disease is a common worldwide oral inflammation/infection affecting tissues that surround and support teeth. This study aims to evaluate the prevalence, extent and severity of periodontal diseases and its risk factors, according to the most recent periodontal classification, in an adult population of Northern Portugal. This observational study collected data from clinical records of patients who attended the University Clinic of Gandra between April 2021 and April 2022. Of a total of 941 patients included, 457 (48.6%) had periodontitis, 253 (26.9%) had gingivitis and the remaining 231 (24.5%) were healthy patients. The prevalence of stage III severe periodontitis was 51.2%, more prevalent in males, and in the age group of 61–70 years. Gingivitis was more prevalent in females, and in the age group of 31–40 years; in both diseases, the most prevalent extension was the generalized one. Using a binary logistic regression, we observe a significant relation of the risk of periodontitis with age (p = 0.019; OR 1.033; 95% CI 1.005–1.062), tooth brushing (p = 0.002; OR 0.25; 95% CI 0.105–0.599) and dental flossing (p = 0.015; OR 0.63; 95% CI 0.09–0.768). This study revealed a high prevalence of periodontitis. Increased age, lack of tooth brushing and flossing were identified as potential risk factors for periodontitis in the investigated Portuguese population. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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Review

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10 pages, 415 KiB

Open AccessReview

The Relationship between Oral Health and Schizophrenia in Advanced Age—A Narrative Review in the Context of the Current Literature

by Sanjana Santhosh Kumar, Raquel Cantillo and Dongxia Ye

J. Clin. Med. 2023, 12(20), 6496; https://doi.org/10.3390/jcm12206496 - 12 Oct 2023

Cited by 1 | Viewed by 1569

Abstract

Schizophrenia is a psychiatric disorder that makes patients incompetent to perform day-to-day activities due to their progressing mental illness. In addition to disturbances with thoughts, behavioral changes, and impaired cognitive functions, oro-systemic health also becomes compromised. Even though the population with schizophrenia is primarily made up of older people, little is known about this group’s oral health treatment. The present review explores the relationship between oral healthcare and elderly patients with schizophrenia. Our literature search included databases, like PubMed, Embase, and Google Scholar, for appropriate and evidence-based information. Preventive and management strategies outlined in the included articles and future research perspectives in this field are discussed. To the best of our knowledge, this is the first review that looked at dental care and related characteristics in older schizophrenia patients. The findings highlight the necessity for targeted dental interventions to address the dental health challenges faced by this vulnerable population. Integrating dental health into the overall medical management of elderly individuals with schizophrenia is crucial. Although specific therapies remain limited, the emphasis is on preventive dentistry to reduce the occurrence and progression of oral diseases in this group. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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25 pages, 491 KiB

Open AccessEditor’s ChoiceReview

Association between Type 1 Diabetes Mellitus and Periodontal Diseases

by Rosana Costa, Blanca Ríos-Carrasco, Luís Monteiro, Paula López-Jarana, Filipa Carneiro and Marta Relvas

J. Clin. Med. 2023, 12(3), 1147; https://doi.org/10.3390/jcm12031147 - 1 Feb 2023

Cited by 6 | Viewed by 2413

Abstract

Gingivitis and periodontitis are chronic inflammatory diseases that affect the supporting tissues of the teeth. Although induced by the presence of bacterial biofilms, other factor, such as tobacco smoking, drugs, and various systemic diseases, are known to influence their pathogenesis. Diabetes mellitus and periodontal diseases correspond to inflammatory diseases that have pathogenic mechanisms in common, with the involvement of pro-inflammatory mediators. A bidirectional relationship between type 2 diabetes and periodontitis has been documented in several studies. Significantly less studies have focused on the association between periodontal disease and type 1 diabetes. The aim of the study is to analyze the association between periodontal status and type 1 diabetes mellitus. The “Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines” was used and registered at PROSPERO. The search strategy included electronic databases from 2012 to 2021 and was performed by two independent reviewers. According to our results, we found one article about the risk of periodontal diseases in type 1 diabetes mellitus subjects; four about glycemic control; two about oral hygiene; and eight about pro-inflammatory cytokines. Most of the studies confirm the association between type 1 diabetes mellitus and periodontal diseases. The prevalence and severity of PD was higher in DM1 patients when compared to healthy subjects. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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11 pages, 3555 KiB

Open AccessReview

Benefit of Hyaluronic Acid to Treat Facial Aging in Completely Edentulous Patients

by Selene Aubry, Pierre-Yves Collart-Dutilleul, Matthieu Renaud, Dominique Batifol, Sylvie Montal, Laurence Pourreyron and Delphine Carayon

J. Clin. Med. 2022, 11(19), 5874; https://doi.org/10.3390/jcm11195874 - 4 Oct 2022

Cited by 4 | Viewed by 2345

Abstract

Hyaluronic acid (HA) is widely used in aesthetic medicine for its moisturizing and anti-aging action. This molecule, which is naturally present in the body, has an interesting response to aging, accentuated in totally edentulous patients. While its aesthetic benefits for facial rejuvenation are well-documented, there is a lack of description and investigation on its therapeutic usefulness for edentulous patients. The management of completely edentulous patients is a daily reality in dental practice and requires specific attention. The aesthetic and functional challenge is considerable. The displacement of the bone base, which is often marked, and lack of soft tissue support are sometimes difficult to correct with prosthetic reconstruction. This review aims to present the physiological processes appearing in completely edentulous patients and prosthetic solutions available to recreate oral functions and counteract facial aging. As prosthetic rehabilitations are not fully satisfying for counterbalancing the impression of excessive facial aging, we investigated the applications of HA injection in the perioral area, in order to improve edentulism treatment, and discussed the advantages and disadvantages, compared to other dermal fillers and rejuvenation therapies. Considering the specific situations of edentulous patients, dermal HA injections help to correct uncompensated bone losses and mucous volume losses and appear to be a therapeutically beneficial for treating completely edentulous patients, without the requirement to full rejuvenation therapy. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Older Adults)

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