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Oral health in old age

Today we keep our own teeth or sophisticated fixed tooth replacements high up in ages. A well preserved chewing function is both correlated to good oral health related quality of life, a good general health and well preserved cognitive functions. Chewing function is therefore one of our focus research areas.

We also study other relations between general and oral health, as the health situation in an elderly individual is very complex.

A special focus area is the increased amount and changed composition of oral bacteria that follows with oral dryness. Elderly people have a high medication usage that causes oral dryness, which in turn increases the risk for caries and mucosal infections but also the risk to receive aspiration pneumonia.

Oral dryness, eye and motor difficulties, decreases the elderly’s ability to perform oral hygiene. The oral detoriation often goes fast. The Swedish system of oral care to dependent elderly works rather well in special facilities but not for those who still live in their own homes, while domestic dental care also is a focus area.

Oral Health in Elderly

Principal Investigator

Objective and subjective masticatory ability in older individuals

This project has been run for several years in collaboration with the public dental care Folktandvården Stockholm Region. It consists of both quantitative and qualitative studies with a systematic literature review as a start. It aims to sort out the concept of chewing and how a relevant chewing function best should be preserved in elderly patients.

Group members

Per Stjernfeldt Elgestad, DDS and PhD-student; Associate professor Anne-Marie Boström and PhD Gerd Faxén Irving, both at Karolinska Institutet, Stockholm, Sweden, Norrbotten Region.

Financing

Stockholm Region, ACT

Dental anxiety in adults from the dental personnel’s perspective, a PhD-project

Generally the assessment of the patient’s anxiety level is done by the gut feeling of the dental personnel but it is important that the assessment is accurate to enable the correct treatment to the patient. This is further accentuated when it comes to the elderly patient, where sight and hearing problems as well as both functional and cognitive limitations are obstacles for mutual conversation and understanding. By tradition or other non-known reasons, dental personnel seldom consider that an elderly patient’s behavior, lack of cooperation or lost dental contacts may originate from dental anxiety.

The project aims to evaluate dental personnel´s ability to assess dental anxiety, to determine which factors affect the assessment and to evaluate a new system for measuring dental anxiety in the clinical setting.

Group members

Markus Höglund, DDS and PhD-student; Shervin Shahnavaz, psychologist and PhD, Mats Bågesund, associate professor

Financing

Region Östergötland

Domiciliary professional oral care for dependent elderly, a PhD-project

Elderly patients with functional limitations and care dependency present many obstacles to this traditional dental care. The result will be dental visits only in emergency case and prophylactic care will not be performed. The Swedish dental remuneration from 1999 includs a possibility for home visits to dependent patients by a dental hygienist to perform an oral health care assessment. Professional oral care is often not included, even if it can be conducted with rather simple dental equipments with high quality in a home environment. County councils or regions have also applied restrictions regarding the annual number of subsidized prophylactic oral care treatments. The rationale for this is probably tradition and economy due to absence of scientific evidence of benefits.

The project has already been performed in nursing homes, with good effects but now we focus on home living dependent elderly, an expanding group in the society.

The project aims to evaluate the effect of domiciliary prophylactic professional oral care interventions for care dependent home living elderly, and to establish evidence based recommendations for domiciliary prophylactic professional oral care in this patient group.

Group members

Elisabeth Morén, dental hygienist, DDS and PhD-student; Pia Skott, DDS and PhD; Petteri Sjögren, DDS and PhD, Georgios Belibasakis, Professor  

Financing

Stockholm Region