Ina Nitschke

Mundgesundheit, Zahnstatus und Ernährung im Alter

The loss of natural teeth impairs essentially the chewing function and can only partly be restored by the insertion of dental prostheses. Equally, xerostomia and dysphagia may aggravate the nutritional intake in older adults. Often denture wearers do subjectively not notice the adjustment of their food choice and the employment of special preparation techniques. Finally the dental state influences the nutritional intake. A reduced number of teeth correlates with the intake of less calories, proteins, fat, non-starch polysaccharides and vitamins. Often missing calories are compensated by an increased consumption of sugar and fat. Especially edentulous persons with a low level of education choose a diet which is rich in fat and sugar. Further the daily intake of fruit and vegetables diminishes along with fewer occlusal contacts in posterior teeth. The restoration of the chewing function by dental intervention does not lead to an improvement of the nutritional intake by itself and should therefore always be complemented by nutritional advice.ZusammenfassungDer Verlust natürlicher Zähne beeinträchtigt die Kaufunktion erheblich und kann durch die Eingliederung von Zahnprothesen nur teilweise ausgeglichen werden. Gleichzeitig erschweren oft Mundtrockenheit und Dysphagie die Nahrungsaufnahme bei alten Menschen. Subjektiv oft nicht wahrgenommen stellen Prothesenträger ihre Nahrungsmittelauswahl um und greifen auf spezielle Zubereitungsarten zurück. Letztendlich zeigt der Zahnstatus einen Einfluss auf die Nahrungsaufnahme. Mit abnehmender Zahnzahl werden weniger Kalorien, Proteine, Fett, nichtstärkehaltige Polysacharide und Vitamine aufgenommen. Oft werden die fehlenden Kalorien durch vermehrte Zucker und Fettaufnahme ausgeglichen. Besonders zahnlose Personen mit geringer Schulbildung greifen zu einer eher fett- und zuckerhaltigen Ernährung. Auch nimmt der tägliche Verzehr von Früchten und Gemüse mit der Anzahl der Seitenzahnkontakte ab. Eine Verbesserung der Kaufunktion durch zahnärztliche Maßnahmen geht nicht automatisch mit einer verbesserten Nahrungsaufnahme einher und sollte daher immer mit einer Ernährungsberatung kombiniert werden.SummaryThe loss of natural teeth impairs essentially the chewing function and can only partly be restored by the insertion of dental prostheses. Equally, xerostomia and dysphagia may aggravate the nutritional intake in older adults. Often denture wearers do subjectively not notice the adjustment of their food choice and the employment of special preparation techniques. Finally the dental state influences the nutritional intake. A reduced number of teeth correlates with the intake of less calories, proteins, fat, nonstarch polysaccharides and vitamins. Often missing calories are compensated by an increased consumption of sugar and fat. Especially edentulous persons with a low level of education choose a diet which is rich in fat and sugar. Further the daily intake of fruit and vegetables diminishes along with fewer occlusal contacts in posterior teeth. The restoration of the chewing function by dental intervention does not lead to an improvement of the nutritional intake by itself and should therefore always be complemented by nutritional advice.

High‐fluoride toothpaste: a multicenter randomized controlled trial in adults

Objective The aim of this single – blind, multicenter, parallel, randomized controlled trial was to evaluate the effectiveness of the application of a high-fluoride toothpaste on root caries in adults. Methods Adult patients (n = 130, ♂ = 74, ♀ = 56; mean age ± SD: 56.9 ± 12.9) from three participating centers, diagnosed with root caries, were randomly allocated into two groups: Test (n = 64, ♂ = 37, ♀ = 27; lesions = 144; mean age: 59.0 ± 12.1; intervention: high-fluoride toothpaste with 5000 ppm F), and Control (n = 66, ♂ = 37, ♀ = 29; lesions = 160; mean age: 54.8 ± 13.5; intervention: regular-fluoride toothpaste with 1350 ppm F) groups. Clinical examinations and surface hardness scoring of the carious lesions were performed for each subject at specified time intervals (T0 – at baseline before intervention, T1 – at 3 months and T2 – at 6 months after intervention). Mean surface hardness scores (HS) were calculated for each patient. Statistical analyses comprised of two-way analysis of variance and post hoc comparisons using the Bonferroni–Dunn correction. Results At T0, there was no statistical difference between the two groups with regard to gender (P = 0.0682, unpaired t-test), or age (P = 0.9786, chi-squared test), and for the overall HS (Test group: HS = 3.4 ± 0.61; Control group: HS = 3.4 ± 0.66; P = 0.8757, unpaired t-test). The anova revealed significantly better HS for the test group than for the control groups (T1: Test group: HS = 2.9 ± 0.67; Control group: HS = 3.1 ± 0.75; T2: Test group: HS = 2.4 ± 0.81; Control group: HS = 2.8 ± 0.79; P < 0.0001). However, the interaction term time-point*group was not significant. Conclusions The application of a high-fluoride containing dentifrice (5000 ppm F) in adults, twice daily, significantly improves the surface hardness of otherwise untreated root caries lesions when compared with the use of regular fluoride containing (1350 ppm F) toothpastes.

Dental care of frail older people and those caring for them

AIMS AND OBJECTIVES To describe oral health utilisation patterns of frail older people and contrast these with attitudes and utilisation patterns of nursing staff who are caring for them. BACKGROUND In view of widespread poor oral health of frail older people in long-term care, staff attitudes have been identified as an area of interest. In addition to data on attitudes, the current study contributes a description of aspects of oral health related behaviour of staff and clients. DESIGN Cross-sectional study. METHODS Structured interviews of a random selection of long-term care staff (n=320) and frail older people (n=172), within the two groups of home-care services (HCS) and long-term care facilities (LTCF). RESULTS Of staff members, 55·3% attach the same importance to their own oral health compared to that of clients and 35·7% regard their own oral health as more important; 98·4% of staff attended two or more dental examinations per year; 3·4% of HCS and 37·1% of LTCF routinely arranged oral examinations. In 81·4% HCS and in 34·4% of LTCF, there was no routine dental service available. Patterns of oral health service attendance greatly differ between staff and clients. CONCLUSION The oral health awareness of the majority of long-term care staff did not translate into adequate oral health care for clients. A gap exists between attitudes supportive of oral health, adequate and prevention driven own oral health related behaviour of staff and actual oral health care delivered to clients. RELEVANCE TO CLINICAL PRACTICE To bridge the gap identified, a concept is suggested for nursing educators and managers of LTCF targeting educational measures while taking into account individual attitudes.

Predicting tooth color from facial features and gender: Results from a white elderly cohort

STATEMENT OF PROBLEM Clinicians providing edentulous patients with complete dentures are often confronted with the problem of not knowing the patients natural tooth color. It would be valuable to be able to determine this from other facial features. PURPOSE The purpose of this study was to assess the possibility of predicting tooth color in the elderly from hair and eye color, facial skin complexion, and gender. MATERIAL AND METHODS The lightness (L*), chroma (C*), and hue (h*) of the color of 541 natural teeth were measured for a white study population (94 subjects, 75 to 77 years old, 55.3% male) by means of a single measurement with a clinically applicable spectrophotometer. Hair and eye color and facial skin complexion were recorded in categories. Mixed-effects regression models were calculated for each L*, C*, and h* value with hair and eye color, facial skin complexion, and gender as independent variables (alpha=.05). RESULTS Only gender and hair color in univariate analysis and, additionally, eye color in multivariate analysis, were significant predictors of tooth color. Higher L* values (lighter color) were associated with lighter eye color and with female gender. The C* value was lower (less saturated) for women. More yellow/green than yellow/red h* values were associated with hair colors other than black and with female gender. However, the parameter estimates of the variables were rather low. CONCLUSIONS Determination of tooth color from hair and eye color and from gender in the white elderly was only partially possible.

Mundhygiene bei Senioren — eine interdisziplinäre Aufgabe

Im Alter werden Zahnarztbesuche und die tägliche Mundhygiene immer beschwerlicher. Dadurch nimmt das Karies- und Parodontitisrisiko zu. Um Komplikationen wie Abszesse oder Zahnverlust zu vermeiden, ist der Zahnarzt auf den Hausarzt angewiesen, der Senioren zu regelmäßigen Zahnarztbesuchen und konsequenter Mundhygiene motivieren kann.Im Alter werden Zahnarztbesuche und die tagliche Mundhygiene immer beschwerlicher. Dadurch nimmt das Karies- und Parodontitisrisiko zu. Um Komplikationen wie Abszesse oder Zahnverlust zu vermeiden, ist der Zahnarzt auf den Hausarzt angewiesen, der Senioren zu regelmasigen Zahnarztbesuchen und konsequenter Mundhygiene motivieren kann.

Auch Senioren zeigen Zähne

Zahnpflege im Alter - Zuerst die gute Nachricht: Pflegebedürftige Menschen haben heute mehr Zähne als früher. Aber: Mit der Zunahme der Zahnzahlen steigt das allgemeine Erkrankungsrisiko und damit der pflegerische Aufwand. Kann man dem wirksam vorbeugen?

Zähneputzen – aber richtig

Zahn-, Mund- und Prothesenpflege - Immer mehr alte Menschen pflegen und erhalten ihre eigenen Zähne ein Leben lang. Damit ist die Pflege vermehrt gefordert, die Mund- und Zahngesundheit auch bei funktionell eingeschränkten Bewohnern zu gewährleisten. Mit gesunder Ernährung, einer exzellenten Mundhygiene und der regelmäßigen Zufuhr von Fluoriden ist dieses Ziel erreichbar.