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Geriatric dentistry.

Veterinary dentistry for geriatric patients is a vital part of the health maintenance program. For detailed procedures on the many facets of veterinary dentistry, there are a number of texts and articles in journals. The practitioner who wishes to become more proficient in dentistry should take a planned approach of reading, attending seminars, and practicing. Most importantly, look. The conditions are there and they are causing problems. If we are to attend to the entire health needs of our geriatric patients, then a thorough knowledge of veterinary dentistry is absolutely necessary.

Aging↗

Using oral quality of life measures in geriatric dentistry.

OBJECTIVE: The purpose of this paper is to present potential uses of existing oral-specific quality of life (OQOL) instruments in geriatric dentistry. METHOD: Selected existing OQOL instruments were reviewed. Three examples of how such instruments have or could be used in geriatric dentistry are presented. CONTENT OF REVIEW: Nine OQOL instruments are briefly reviewed. The potential uses in geriatric dentistry include population applications and uses with individuals for political, theoretical and practical reasons. Practical uses include identification of persons needing treatment, assessing oral health needs in populations and estimating resources required to meet those needs, as endpoints in clinical trials and as measures of the impact of care provided. CONCLUSIONS: The ultimate value of OQOL measures will be measured by their usefulness in improving care of patients. The development of streamlined instruments and a core instrument which can be used in multiple populations and serve as a baseline to which other measures are added is recommended.

Activities of Daily Living↗

A compendium of objectives for geriatric dentistry.

A two-phase survey was conducted with 82 persons identified as having special knowledge in geriatric dentistry. In Phase 1, they were asked to list competencies required of the geriatric dentist. In Phase 2, they were asked to rate the relative importance of 150 competencies for five different educational settings: dental school, general practice residency, prosthodontic specialty program, geriatric fellowship program, and continuing education. The resulting compendium of objectives suggests that geriatric dentistry should become integrated into general dentistry, with relatively few competencies reserved for specialists.

Aged↗

Delphi study to identify core competencies in geriatric dentistry.

The Delphi technique and an expert panel of general practitioners were used to identify geriatric dentistry core competencies--the necessary knowledge, skills, and values of new graduates to meet the oral health needs of older patients. Of the 74 dentists solicited, 50 dentists agreed to participate, and 40 dentists returned two questionnaires. Respondents were mostly male, white, in solo practice, with a mean age of 51.6 (SD 7.4) years. The first survey asked the participants to identify at least three topics in geriatric dentistry that they believed to be essential to a dental curriculum to graduate competent practitioners who can effectively treat older patients. The 45 unique responses were used in the second questionnaire that asked the practitioners to rate the importance of each topic for inclusion in a curriculum. For the 29 items describing skills, respondents indicated how often they performed the skill in their practices. Finally, the respondents considered all 45 items, and selected the five most crucial topics. Overall, participants achieved good consensus as to core knowledge, skills, and values needed to provide general dental care to older patients.

Clinical Competence↗

Reflections on changes in geriatric dentistry.

The development of geriatric dental education programs in the United States and at the University of Iowa over the last twenty years is reviewed. The program at Iowa evolved from a didactic elective program taught by a single faculty person to required didactic and clinical programs that include a special care clinic in the dental school and a mobile unit with portable equipment serving ten area nursing homes with comprehensive care. Factors influencing the curriculum development are identified and discussed, and as no dental schools are the same, some general applications are suggested from the Iowa experience.

Aged↗

Pharmacologic considerations in geriatric dentistry.

Drug administration to geriatric patients in the dental office requires special care. The margin of safety, or therapeutic window, in which the drug is safely effective may be greatly decreased because of physiologic changes with age, and pharmacokinetic and pharmacodynamic alterations. Realizing that the elderly are, as a group, more susceptible to adverse drug reactions, the addition of new medications must be undertaken with caution. Consulting with the patient's physician and a close working relationship with clinical pharmacists specializing in geriatrics can facilitate safe and effective drug prescribing.

Aged↗

An analysis of the supply of and demand for continuing education in geriatric dentistry.

Continuing education directors at 158 sites were surveyed regarding their recent experience with geriatric dentistry courses. Of the 116 returns cited, 86 recorded offering courses with a total enrollment of 4,559 students. The courses tended to be of the survey type using a lecture format. Most directors thought that practitioner demand for such courses fell short of their need for education. Several suggestions emanated from this project for improving course attendance. They included: targeting courses to specific clinical areas; providing separate courses for each segment of the geriatric population; and educating both elders and dentists regarding the appropriateness of dental care for the elderly patient.

Curriculum↗

Geriatric dentistry in the predoctoral curriculum.

A survey was conducted among U.S. dental schools to determine the status of geriatric dentistry in the curriculum. Since a comparable, independent study was done in 1979, there has been significant growth in formalized didactic courses and less reliance on incorporating geriatric content as lectures or other components of existing courses. The growth in specialized courses was accompanied by an increased tendency to supplement the clinical topics with others relating to social and behavioral aspects of treating geriatric patients.

Curriculum↗

[Community aspects of geriatric dentistry--a literature review: 1975-2000].

The world's population is in transition, but there is an inevitable move in all societies towards an aging population. There is an agreement that the ability of the geriatric population to adjust to the "third age" depends on the will of the society and the community to provide services and to support this vulnerable and dependent population. The preponderance of oral health issues and their impact upon general health and quality of life have prompted a variety of geriatric related efforts over the last 20 years. Predoctoral and postdoctoral education and training efforts have been initiated, geriatric research agendas have started to yield important findings, and a few service programs have marginally helped improve dental care access for the geriatric population. Past discoveries have enabled large portions of the world's population to enjoy far better oral health than their forebears a century ago. Although different patterns of dental needs emerge throughout the world, the "silent epidemic" of oral diseases is affecting the most vulnerable parts of the population: the poor children, the elderly and many members of racial and ethnic minority groups. The review of the literature of community aspects of geriatric dentistry in the past twenty-five years will be introduced in two articles. The first article summarizes the important issues of demography, oral health condition, changes in attitude towards oral health of the geriatric population, oral health services given in geriatric institutions and mobile dentistry. The issues of law and ethics, development of public and community oral health programs for the geriatric population and plans as well as trends for the future will be discussed in the second article. Setting goals and presenting data are steps in the right direction but are not enough; the success will be measured by the ability to make things happen. The continuing anticipated growth of the geriatric population will, hopefully, be translated into a rising political power and to fruitful and practical health outcomes.

Aged↗

[Geriatric dentistry introduction].

The increasing number of old people in today's society is a reality. They are a group, whose special needs and medical problems are dealt in Geriatrics. Geriatric dentistry is the branch of Dentistry concerned with their dentical problems. In this article we discuss some of these special problems as an attempt to make this subject more comprehensible to the general practionner.

Aged↗

[Community aspects of geriatric dentistry--a literature review: 1975 - 2000].

The world's population is in transition, but there is an inevitable move in all societies towards an aging population. There is an agreement that the ability of the geriatric population to adjust to the "third age" depends on the will of the society and the community to provide services and to support this vulnerable and dependent population. The preponderance of oral health issues and their impact upon general health and quality of life have prompted a variety of geriatric related efforts over the last 20 years. Predoctoral and postdoctoral education and training efforts have been initiated, geriatric research agendas have started to yield important findings, and a few service programs have marginally helped improve dental care access for the geriatric population. Past discoveries have enabled large portions of the world's population to enjoy far better oral health than their forebears a century ago. Although different patterns of dental needs emerge throughout the world, the" silent epidemic" of oral diseases is affecting the most vulnerable parts of the population: the poor children, the elderly and many members of racial and ethnic minority groups. The review of the literature of community aspects of geriatric dentistry in the past twenty five years will be introduced in two articles. The first article summarizes the important issues of demography, oral health condition, changes in attitude towards oral health of the geriatric population, oral health services given in geriatric institutions and mobile dentistry. The issues of law and ethics, development of public and community oral health programs for the geriatric population and plans as well as trends for the future will be discussed in the second article. Setting goals and presenting data are steps in the right direction but are not enough; the success will be measured by the ability to make things happen. The continuing anticipated growth of the geriatric population will, hopefully, be translated into a rising political power and to fruitful and practical health outcomes.

Aged↗