Dalva Maria Pereira Padilha

Oral health care in private and small long‐term care facilities: a qualitative study

OBJECTIVE Elderly people who are institutionalised receive qualified care. Among the services supplied, oral health care has not always been a priority. The aim of this study was to identify the characteristics of oral health care provided to the elderly residents in long-term care facilities (LTC) in Porto Alegre/RS city. METHODS Twelve private and small-size LTCs (less than 20 residents) participated in this study. All supervisors and 36 carers were interviewed. The data obtained were organised according to the offer of oral health under the following categories: responsibility for oral care, oral care routines, difficulties carrying out oral care routines. RESULTS The procedures used most often in order of frequency were tooth brushing, prostheses cleaning, use of mouthwashes, soaking of prostheses and cleaning of the tongue. Among the difficulties mentioned were the high cost of dental assistance, the lack of co-operation both by family members and by the elderly themselves, the oral and general health status of the elderly and the limited time available for carers to carry out the tasks. Oral care is conducted empirically, and the responsibility is left to the carers. CONCLUSIONS Analysis of the statements given reveals that oral care does not follow any kind of protocol or standardisation. The persistence of this situation could lead to unsatisfactory oral health care in private and small LTC facilities.

Morphological Changes in the Mandible of Male Mice Associated With Aging and Biomechanical Stimulus

Degenerative changes in the temporomandibular joint (TMJ) associated with aging can affect mandibular shape and reduce growth potential when stimulated by functional appliance therapy. This study was designed to evaluate the morphological changes in the mandibles of male mice associated with aging and biomechanical stimulus. Every 3 days over the course of 1 month, the lower incisors were trimmed by 1 mm to induce mandibular advancement (MA) when the animal was feeding. The left mandibles of the 23 experimental and 27 control animals were subsequently dissected, and digital images were obtained to analyze nine linear/angular measurements. Because mandibular morphology depends on the maintenance of condylar cartilage, the surfaces of the condylar cartilage and the ascending ramus of the mandible were also analyzed by scanning electron microscopy (SEM). The linear measurements of the mandible showed changes according to age in the control group and a growth response in the mandibular condyle in 7‐ and 15‐month‐old mice after MA. Moreover, SEM analysis revealed depressions in the anterior region of the condylar cartilage and inclined vascular grooves in the ascending ramus in the 7‐ and 15‐month‐old experimental mice. Although the growth potential is reduced in mice after 6 months of age, the results showed that continuous growth of the mandible occurs after maturation, except in the condyle, and that biomechanical stimulus of the TMJ of male mice leads to condylar growth. These results suggest that mature and old individuals can favorably respond to maxillary functional orthopedic therapy. Anat Rec, 292:431–438, 2009.

Mandibular advancement and morphological changes in the mandibles of female mice of different ages

Mandibular advancement (MA) by means of functional orthopedic techniques is currently used in young patients to stimulate mandibular growth. The aim of this study was to evaluate the morphological changes in the mandibles of 2-, 7-, and 16-month-old female mice after MA. Every 3 days during 1 month, the lower incisors were trimmed by 1mm to induce protrusion when the animal was feeding. The left mandibles of the 30 experimental and 28 control individuals were subsequently dissected and digital images were obtained to analyze nine linear/angular measurements. The condylar microstructure was also analyzed by scanning electron microscopy (SEM). The linear/angular measurements showed a growth response in different mandibular regions in 2- and 16-month-old individuals. SEM showed that, in the 7-month-old mice, the condylar cartilage had regenerated in the treated individuals but not in the controls. The results suggest that MA produces mandibular growth in 2- and 16-month-old female mice. Although there was no mandibular growth in 7-month-old mice, regeneration of the condylar cartilage was detected, thus demonstrating that different responses to the MA stimulus occur in female mice of different ages.

Interfaces of geriatric nursing and dental care

ealth providers have overlooked the dental health of the elderly. Interdisciplinary actions should be urgently promoted to change the current state of dental care delivery for the elderly. The purpose of this study was to analyze the content about oral health in textbooks commonly adopted in nursing graduate courses. Contents were classified into five categories: Oral health in nursing care; The aging changes and pathologies that affect oral health; Purposes of oral hygiene; Material used in dental care procedure; Dental care procedure. The analysis of these categories revealed that textbooks’ priority focus is on the procedure. Discussion of patients’ referral to dentists is rare, which shows that oral health is only partially assigned to these professionals. Geriatric nursing and dental care are faced with the challenge of working in association to review concepts and implement actions leading to more adequate dental care for the elderly.