GERONTOLOGY IN DENTISTRY
- Authors: Shabanov D.1
-
Affiliations:
- Воронежский государственный медицинский университет имени Н.Н. Бурденко
- Issue: Vol 11 (2022): Materials of the XVIII International Burdenkov Scientific Conference on April 14-16, 2022
- Pages: 453-456
- Section: Стоматология
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/7290
Cite item
Full Text
Abstract
The increase in life expectancy of the population of Russia implies an increase in the number of gerontological patients at a dental appointment. For successful treatment of this category of patients, it is necessary to know the psychological, physiological and, most importantly, dental features associated with age.
Relevance: At the dental appointment there is a special category of patients - gerontostomatological. The reality is that the state of the oral cavity in recent years, according to statistics, has been deteriorating significantly due to a significant change in the environmental situation and the quality of life in general. Aging patients a priori need all specialized types of dental care: therapeutic, surgical, orthopedic. An important problem is the treatment of diseases of the oral mucosa.
Purpose: This study is to analyze the features of dental care for the elderly.
Materials and methods: the analysis of primary medical documentation of age patients who applied for help to the dental clinic of the Voronezh State Medical University named after V.I. N.N. Burdenko for one reporting year (in the period from 12/21/20 to 12/20/21 with diseases of the oral mucosa)
Results: An analysis of the appealability of gerontostomatological patients with diseases of the oral mucosa is presented;
This problem was previously dealt with by E.V. Sidova, F.N. Paleev, O.N. Startseva M. (educational manual "Fundamentals of Geriatrics for Primary Care Physicians", 2019), O.I. Doroshina, Yu.V. Lebedev, L.V. Tokarskaya. Yekaterinburg (textbook "Gerontopsychology" 2020).
The dental portrait of elderly patients is described in detail in the work of the same name by Cheremnykh A.I., Russkikh I.S.
When writing this article, scientific and methodological literature was used, as well as the actual data of polyclinic case histories.
Conclusion: Analyzing the presented data, it should be noted that the appeal of age patients for dental care is significant. This applies to all narrow specialties of the dental profile. Oral mucosal diseases are no exception. The basic requirements for a primary care physician are still the same: correctly diagnose, adequately treat: if necessary, involve relevant narrow specialists.
Age patients with diseases of the oral mucosa make up the vast majority of those who seek medical help. It should be noted that patients belonging to the group "Elderly" aged 55-74 years prevail among other groups. Patients from the "long-livers" group are rare.
When analyzing the appealability of gerontostomatological patients according to the nosological forms of mucosal diseases, it should be noted that oral candidiasis is the leader among other diseases of this group, and in two age groups: “Elderly” and “Old”. According to the frequency of referral, patients with glossalgia phenomena take the second place, and with manifestations of lichen planus of the oral cavity, the third.
Precancerous conditions of the oral mucosa occur in various diseases (lichen planus, leukoplakia); from the doctor require special attention.
Keywords
Full Text
Gerontology in dentistry
Author: D.M. Shabanov
Scientific supervisors: I.A. Belenova, O.A. Azarova.
Organizations: Burdenko State Medical University, Department of Training of Highly qualified Personnel in Dentistry.
Structured summary: An increase in the life expectancy of the Russian population implies an increase in the number of gerontological patients at dental appointments. For the successful treatment of this category of patients, it is necessary to know the psychological, physiological and, most importantly, dental features associated with age.
Keywords: Gerontostomatology, elderly and senile age, centenarians, dental features.
Relevance: At the dental reception there is a special category of patients - gerontostomatological. The reality is that the condition of the oral cavity in recent years, according to statistics, has deteriorated significantly due to significant changes in the environmental situation and the quality of life in general. Age-related a priori patients need all specialized types of dental care: therapeutic, surgical, orthopedic. An important problem is the treatment of diseases of the oral mucosa.
The purpose of this study is to analyze the features of dental care for elderly people.
Materials and methods: the analysis of primary medical documentation of age-related patients who sought help at the dental polyclinic of the Burdenko State Medical University for one reporting year (in the period from 12/21/20 to 12/20/21 with diseases of the oral mucosa) was carried out
Results: The analysis of the treatment of gerontostomatological patients with diseases of the oral mucosa is presented;
This problem was previously dealt with by E. V. Sidova, F.N. Paleev, O.N. Startseva M. (training manual "Fundamentals of geriatrics for primary care physicians", 2019), O.I. Doroshina, Yu.V. Lebedev, L.V. Tokarskaya. Yekaterinburg (textbook "Gerontopsychology" 2020).
The dental portrait of elderly patients is described in detail in the work of the same name by Cheremnykh A.I., Russian I.S.
When writing this article, scientific and methodological literature was used, as well as the actual data of polyclinic medical histories.
Discussion: The goals and objectives of medical care for age-related patients are clearly presented in: The Strategy of Actions in the Interests of Older Citizens in the Russian Federation until 2025", approved on 05.02 2016. Old age is a period of life with constantly slowing development.[1] Aging is a natural process that occurs with physiological and psychological changes. The UN recommendations are well-known: consider elderly people over 60 years old. WHO suggests that men 61-74 years old, women 55-74 years old should be considered elderly, people aged 75-89 years old should be considered old, and people over 90 years old should be considered centenarians. Consequently, age-related patients live for a long period of time with great changes in all respects: social, psychological, physiological. The natural tasks of an elderly person: adaptation to the deterioration of health, a decrease in the standard of living, rethinking the past, summing up life. The main thing during this period is the preservation of psychological activity, a positive attitude towards yourself and the life you have lived. The physiological characteristic of this age is a decrease in vital functions: aging of the musculoskeletal system, changes in the respiratory, digestive, genitourinary systems, skin. The central nervous and cardiovascular systems undergo significant involutive processes. Metabolic processes in the body slow down. Visual and auditory analyzer perception acuity decreases.[2]
Psychological features of this age: reduced learning speed, adherence to familiar stereotypes, reduced mechanical and semantic memory retention. Depressive-anxious mood in emotions.[4]
The oral cavity of age-related patients is also subject to changes: there are changes in the masticatory and mimic muscles, loss of tone, atrophy of muscle fibers and their replacement with connective tissue. Changes also occur in the temporomandibular joint: changes in the topography of the joint elements and the quality of the articular surfaces. The gum thickens with age, loses elasticity; the non-horny epithelium becomes thinner, and the keratinized one grows. There is a gum recession with an increase in the clinical crown of the tooth, a shift of the center of gravity towards the apex; the circular ligament stretches, weakly fixes the tooth in the hole. The oral mucosa older than 60 years undergoes atrophy, changes color to whitish. The mucous membrane of the hard palate thickens, becomes loose. Papillae atrophy is possible on the back of the tongue with a decrease in taste sensitivity to sweet, sour, bitter. The protective function of saliva, its volume, biochemical and immunological parameters, volume, and the rate of excretion are reduced. A feeling of dryness in the oral cavity occurs when saliva secretion decreases by 50% from normal. This is facilitated by continuous (according to vital indications) drug therapy, a decrease in chewing load, 40% of gerontological patients complain of a feeling of dryness in the oral cavity. More than 14% of patients have complete secondary adentia at the age of 65-74. And 30% of patients have 20 or more preserved teeth. More than 60% of patients have pronounced pathological erasability. [5] The architectonics of the oral cavity changes: the lower jaw, salivary glands, and tongue, which lengthens and flattens, are displaced; the anterior palatine arch and tongue are lowered. Pronounced decrease in bite. When assessing the dental status of an elderly patient, it is necessary to take into account: age-related changes, somatic diseases, taking pharmaceuticals, bad habits, hygiene level, presence of orthopedic structures, presence of xerostomia, frequency and quality of dental treatment. [3]
The patients' medical records were divided into three groups, according to age. Gender and diagnosis were taken into account. The first group consisted of "elderly" patients aged: men 61-74 years - 58 people; Women aged 55-74 years - 153 people; In total, representatives of the first group were 211 people.
The second group consisted of "old" patients aged 75-89 years; among them there were 15 men and 20-29 women. In total, the second group included 34 people.
The third group represented "centenarians" aged more than 90 years. Only one 93-year-old patient entered it.
The distribution of age-related patients by disease is as follows:
Patients with candidiasis are in the lead. In the first group of applicants, there were 13 men, and 45 women, which is almost 3.5 times more. In the second group, 5 men applied, and 12 women, which is 2.4 times more.
The next most common disease was lichen planus. A total of 40 people applied. In the first group, there are 10 men and 27 women. There are 37 patients in total. There are three age-related patients in the second group, all men.
35 people turned to glossalgia phenomena. The first group included 4 men and 28 women. The second group included 1 man and two women.
30 people applied with leukoplakia problems of various localization. The first group included 18 men and 11 women. There is one woman in the second group.
Allergic stomatitis was detected in 13 patients. Moreover, the first group included 8 women, the second group - 4 women, the third group - 1 woman diagnosed with allergic stomatitis, erosive and ulcerative form. An allergic reaction occurred to a complete removable upper jaw prosthesis used for more than 10 years.
The diagnosis: "black hairy tongue" was made to 6 patients who applied for various reasons unrelated to this condition. The first age group included: one man and 4 women; the second group - 1 man
Patients with chronic recurrent aphthous stomatitis were 18 people. The groups are distributed as follows: 1 group of 16 women and the second - 2 women.
25 people were treated with the phenomenon of acute and chronic mechanical trauma of various parts of the oral mucosa. The first group included 5 men and 11 women. The second group includes 2 men and 7 women.
Special attention was paid to patients with precancerous conditions, where an oncologist's consultation was required. The first group included 10 people, 7 men and 3 women. The second group consists of 4 people: 3 men and 1 woman.
Conclusion: Analyzing the presented data, it should be noted that the appeal of age-related patients for dental care is significant. This applies to all narrow specialties of the dental profile. Diseases of the oral mucosa are no exception. The basic requirements for a primary care doctor are still the same: to diagnose correctly, to treat adequately: if necessary, to attract the appropriate narrow specialists.
Age-related patients with diseases of the oral mucosa make up the vast majority of those who seek medical help. It should be noted that patients belonging to the "Elderly" group aged 55-74 years prevail among other groups. Patients from the "Long-livers" group are rare.
When analyzing the treatment of gerontostomatological patients for nosological forms of mucosal diseases, it should be noted that candidiasis of the oral cavity is the leader among other diseases of this group, and in two age groups: "Elderly" and "Old". According to the frequency of treatment, patients with glossalgia phenomena occupy the second place, and with manifestations of lichen planus of the oral cavity - the third.
Precancerous conditions of the oral mucosa occur in various diseases (Lichen planus, leukoplakia); special attention is required from the doctor.
List of literature:
1. Fundamentals of geriatrics for primary care physicians. The study method. Manual E. V. Sidova, F.N. Paleev, O.N. Startseva M., 2019
2. Gerontopsychology. Studies. Manual. O.I. Doroshina, Yu.V. Lebedev, L.V. Tokarskaya. Yekaterinburg, 2020- 131c.
About the authors
Dmitriy Shabanov
Воронежский государственный медицинский университет имени Н.Н. Бурденко
Author for correspondence.
Email: Shabanov.dmitriy97@yandex.ru
ORCID iD: 0000-0003-1054-2359
SPIN-code: 1111-1111
Врач- стоматолог
Russian Federation, 394036 Voronezh, central district, student street, 10References
- Основы гериатрии для врачей первичного звена. Учеб-метод. Пособие Е. В. Сидова, Ф.Н. Палеев, О.Н. Старцева М., 2019 год
- Геронтопсихология. Учеб. Пособие. О.И. Дорошина, Ю.В. Лебедев, Л.В. Токарская. Екатеринбург, 2020г.- 131с.
- Основы геронтологии (антропологические аспекты) Е.Н. Хрисанфова М.
- Стоматологический портрет пожилых пациентов. Черемных А.И., Русских И.С Международный студенческий научный вестник. -2020. - №3.
- Особенности стоматологического статуса и методы лечебно- профилактической помощи населению пожилого возраста. Учеб-метод Пособие / Л.Г. Борисенко. Минск: БГМУ, 2005. – 56с.
Supplementary files
There are no supplementary files to display.