Healthy Mouths for Healthy Ageing

Transcription

1 Healthy Mouths for Healthy Ageing International Federation on Ageing 10 th Global Conference Dr Matthew Hopcraft Senior Lecturer Melbourne Dental School

2 Oral Health - Community Dwelling

3 Edentulism Slade GD, Spencer AJ, Roberts-Thomson KF (Editors). Australia s dental generations: the National Survey of Adult Oral Health AIHW cat. no. DEN 165. Canberra: Australian Institute of Health and Welfare (Dental Statistics and Research Series No. 34)

4 Caries experience Slade GD, Spencer AJ, Roberts-Thomson KF (Editors). Australia s dental generations: the National Survey of Adult Oral Health AIHW cat. no. DEN 165. Canberra: Australian Institute of Health and Welfare (Dental Statistics and Research Series No. 34)

5 Periodontal (Gum) Disease Moderate/severe periodontitis years old % years old 43.6% >75 years old 60.8% Gingival inflammation years old 19.3% years old 21.0% >75 years old 23.7% Higher in people with lower education, eligible for public dental care, without dental insurance or who normally visit for a dental problem Slade GD, Spencer AJ, Roberts-Thomson KF (Editors). Australia s dental generations: the National Survey of Adult Oral Health AIHW cat. no. DEN 165. Canberra: Australian Institute of Health and Welfare (Dental Statistics and Research Series No. 34)

6 Incidence per 100,000 Incidence per 100,000 Incidence per 100,000 Incidence of Oral Cancer Lip Tongue Floor of mouth Australian Dental Journal 2002;47:(1):45-56

7 Oral Health Residential Care

8 Dentate Status 1970s % dentate 35.4% dentate 34% dentate 36.6% dentate 47% dentate 53.9% dentate 13.8 teeth 11.9 teeth 11.6 teeth 12.1 teeth 14.4 teeth (Saub, 1996; Chalmers et al, 1998; Chalmers et al, 1999; Stubbs & Riordan, 2002; Hopcraft et al, 2010)

9 Caries Status DMFT 24.9 DMFT 23.7 DMFT 24.4 DMFT 24.7 DMFT decayed teeth 1.1 decayed teeth 1.0 decayed teeth 0.8 decayed teeth 2.7 decayed teeth 1.4 teeth root caries 1.5 surfaces root caries 1.3 surfaces root caries 1.3 teeth root caries (Saub, 1996; Chalmers et al, 1998; Chalmers et al, 1999; Stubbs & Riordan, 2002; Hopcraft et al, 2010)

10 Periodontal Disease Status % with no disease mild-moderate disease common 0% with no disease 88.6% bleeding or calculus 4.4% severe disease 25.5% mild-moderate disease 3.8% mild-moderate disease (Saub, 1996; Chalmers et al, 1998; Hopcraft et al, 2010) 10.3% severe disease

11 Oral Health Trends edentulism teeth and restorations present prevalence of periodontal disease Links between oral and general health High risk groups nursing home residents physical & cognitive impairment

12 Increased Risk Medications and polypharmacy impact on saliva flow and xerostomia -> related to caries risk Salivary gland hypofunction ~ 20% of the population (12-47%) Xerostomia ~ 20% of the population (10-46%) Both SGH and xerostomia 5-10%

13 Function and Nutrition Poor nutrition and being underweight are significant problems in residential care (Kagansky et al, 2005; Bate et al, 1999) Correlation between number of teeth and BMI and number of occluding pairs and nutrition (Sheiham et al, 2002; Mojon et al, 1999)

14 Access Community Dwelling Visited dentist past 12 months (2006) >75 years old 49.4% years old 62.0% years old 62.7% Last dental visit 5+ years ago >75 years old 23.2% years old 13.2% years old 8.9%

15 Access - Residential Care Residents in care for long periods 48.4% in RACF 2yrs 31.4% in RACF 3+ yrs Time since last dental visit 10.9% < 12 mths 13.4% 1-3 yrs 17.9% 4+ yrs 57.5% don t know Location of last dental visit 39.3% dental clinic 6.0% RACF 54.7% don t know

16 Access - Residential Care Private practitioners 50% Victorian & South Australian dentists provided care in past 12mths Average time - 1 hour per month Rural dentists more likely to provide care Dentists prefer to treat patients at their own practice (only 53% provided care at RACF) Lack of portable equipment and space at RACF Royal Dental Hospital of Melbourne Domiciliary Service 1625 patients in 12mth period ~1,000 extractions, 400 restorations, 350 periodontal services

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18 Current Research Education of carers in nursing homes Investigating the changes in oral health and quality of life of nursing home residents Education program targeted at carers for practical daily oral hygiene

19 Current Research Oral health, saliva and dental caries in nursing homes 12 month longitudinal data on changes in oral health Inform decision making on treatment needs, health impacts and prevention required

20 Current Research Utilisation of dental hygienists in nursing homes Dental examination and treatment provided Focus on prevention and education

21 Gaps in Existing Knowledge No national level or representative data on oral health in nursing homes Lack of longitudinal data on oral health and ageing Multidisciplinary studies linking oral health and systemic health with ageing Oral health promotion and prevention for the ageing population

22 Thank-you

23 Acknowledgments CRC-OHS Victorian Department of Human Services Dental Health Services Victoria