Dairo Javier Marín Zuluaga

Oral health in institutionalised elderly people in Oslo, Norway and its relationship with dependence and cognitive impairment.

OBJECTIVE Investigating oral healths relationship with dependency and cognitive state. BACKGROUND Oral hygiene is poor in the institutionalised elderly. There are problems regarding the oral care of residents having poor mobility or cognitive impairment. MATERIAL AND METHODS Cross-sectional study involving 135 participants (mean age 85.7, SD 8.8 years) in two categories: nurses doing tooth cleaning and residents doing tooth cleaning. Those cleaned by nurses were categorised as co-operative or unco-operative. The oral hygiene status, presence of caries, retained roots and denture-related stomatitis were recorded. RESULTS Of the participants, 70% had only natural teeth. The prevalence of caries was 28%. A significant correlation showed that having more teeth gave a poorer Simplified Oral Hygiene Index (OHI-S) (p = 0.018). The number of retained roots increased with the severity of cognitive impairment (p < 0.05). Significant differences were found between nurses or residents doing the tooth cleaning on the OHI-S (p = 0.05) and percentage of dental plaque (p = 0.003). Unco-operative residents had poorer oral hygiene (p = 0.028), more caries (p = 0.008) and were more often moderate-severe cognitive impaired (p = 0.016). CONCLUSIONS A high percentage of participants had unacceptable oral hygiene. Residents whose teeth were cleaned by the nurses had poorer oral hygiene. Unco-operative residents had the worst oral hygiene and more caries.

Association between oral health, cognitive impairment and oral health–related quality of life

OBJECTIVE Investigating oral health-related quality of lifes (OH-QoL) relationship with cognitive state. BACKGROUND Oral health affects OH-QoL and is poor in institutionalised and cognitively impaired people. MATERIAL AND METHODS This was a cross-sectional study involving 215 institutionalised elderly (82.9 mean age), who were interviewed, examined and cognitively screened using the Pfeiffer test. RESULTS Mean GOHAI score was 53.1; only 43.7% of the participants reported having a good OH-QoL. Needing help with dressing or washing (OR 2.14; p = 0.004), having one to nine teeth (OR 4.65; p ≥ 0.001), eight or less occluding pairs (OR 2.74; p = 0.002), one to three caries (OR 1.85; p = 0.005) and being cognitive impaired (OR 0.54; p = 0.034) were significantly associated with altered OH-QoL in bi-variate analysis. Being edentulous (OR 3.18; p = 0.0046), having 1-9 teeth (OR 2.62; p = 0.056) and presenting mild cognitive impairment (MCI) (OR 0.32; p = 0.016) appeared as predictive variables in logistic regression for having an altered OH-QoL. CONCLUSIONS Participants having MCI had significantly better GOHAI score than cognitively normal residents. Performing cognitive screening parallel to applying any OH-QoL instrument would make the results more reliable and would benefit cognitively impaired people.

Denture-related stomatitis managed with tissue conditioner and hard autopolymerising reline material

OBJECTIVE To compare the response of denture-related stomatitis (DS) under management with a tissue conditioner (TC) and autopolymerising hard reline material (AHRM). BACKGROUND DATA Denture-related stomatitis affects up to 75% of denture wearers; not wearing the denture at night, using TC or prescribing topical or systemic antifungal agents could reduce its incidence. MATERIALS AND METHODS This was a double-blind study consisting of 44 participants with DS who wear denture; they were randomly divided into two unmatched groups according to the material used for the management of DS. The TC was replaced weekly, and the AHRM was placed at the beginning of the study and was not changed for 4 weeks. A dentist performed an initial and a weekly clinical diagnosis for DS; the clinical situation was recorded by means of photographs for each week. RESULTS Both TC and AHRM were effective in the management of DS. Significant differences were found in the DS resolution time (p < 0.001), taking longer for the TC. CONCLUSIONS Both the tissue conditioner and AHRM are effective for the management of DS, but AHRM requires less time for recovery and as a result fewer appointments are required for the patient.

Denture-related stomatitis managed with tissue conditioner and hard autopolymerising reline material: DS managed with TC and AHRM

OBJECTIVE To compare the response of denture-related stomatitis (DS) under management with a tissue conditioner (TC) and autopolymerising hard reline material (AHRM). BACKGROUND DATA Denture-related stomatitis affects up to 75% of denture wearers; not wearing the denture at night, using TC or prescribing topical or systemic antifungal agents could reduce its incidence. MATERIALS AND METHODS This was a double-blind study consisting of 44 participants with DS who wear denture; they were randomly divided into two unmatched groups according to the material used for the management of DS. The TC was replaced weekly, and the AHRM was placed at the beginning of the study and was not changed for 4 weeks. A dentist performed an initial and a weekly clinical diagnosis for DS; the clinical situation was recorded by means of photographs for each week. RESULTS Both TC and AHRM were effective in the management of DS. Significant differences were found in the DS resolution time (p < 0.001), taking longer for the TC. CONCLUSIONS Both the tissue conditioner and AHRM are effective for the management of DS, but AHRM requires less time for recovery and as a result fewer appointments are required for the patient.