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Oral Health Problem of the Elderly

Oral Health Problem of the Elderly. Narumanas Korwanich Department of Community Dentistry Chiangmai University. WHO, 2002. UN, 2001. Thailand age pyramid 2004. Male. Female. โครงสร้างประชากรอ.ลอง จ.แพร่ 2550. โครงสร้างประชากร ต.เกาะลันตาน้อย อ.เกาะลันตา 2549. Thailand Projection.

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Oral Health Problem of the Elderly

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  1. Oral Health Problem of the Elderly Narumanas Korwanich Department of Community Dentistry Chiangmai University

  2. WHO, 2002

  3. UN, 2001

  4. Thailand age pyramid 2004 Male Female

  5. โครงสร้างประชากรอ.ลอง จ.แพร่ 2550

  6. โครงสร้างประชากร ต.เกาะลันตาน้อย อ.เกาะลันตา 2549

  7. Thailand Projection

  8. WHO, 2002

  9. When the risk factors for chronic diseases and functional decline are kept low while the protective factors are kept high, people will enjoy both a longer quantity and quality of life Health When labor market, employment, education, health and social policies and programs support their full participation in socio-economic, cultural and spiritual activities, people will continue to make a productive contribution to society Participation When policies and program address the social, financial and physical security needs and rights of people as they age, elderly are ensured of protection, dignity and care in the event that they are no longer able to support and protect themselves Security Active Ageing

  10. Oral health is an important component of ‘Active Ageing’ and is included in policy proposals related to health, one of the three basic pillars. Petersen & Yamamoto, 2005

  11. Reduce risk factors associated with major diseases and increase factors that protect health throughout the life course - Tobacco - Physical activity - Nutrition - Healthy eating - Oral Health - Psychological factors - Alcohol and drugs - Medication

  12. WHO, 2002

  13. Oral Health Problem in Elderly Tooth loss Xerostomia 1 5 Denture related condition Cancer and precancer 2 6 Coronal and root caries 3 Periodontal disease 4 Petersen & Yamamoto, 2005

  14. Tooth Loss

  15. Epidemiology of Edentulousness WHO, 2005

  16. National Oral Health Survey กรมอนามัย 2551

  17. Tooth Loss Predictors • 201 participants (104 edentulous) in the Healthy Old People in Edinburg (HOPE) study • Age • Social Class • National Adult Reading Test IQ • Self Esteem Score • Dietary Assessment Score • Cognitive testing score Starr et al., 2009

  18. Association with Chewing Ability Sarita et al., 2003

  19. Association with Chewing Ability Sarita et al., 2003

  20. Association with Chewing Ability • Shortened dental arched with intact premolar regions and at least one occluding pair of molars provide sufficient chewing ability • Shortened dental arched with 3-4 pairs of occluding premolars and asymmetric arches with a long side result in impairment of chewing ability, especially of hard food • In extremely shortened dental arches comprising 0-2 occluding premolars, chewing ability is severe impaired Sarita et al., 2003

  21. Cognitive Impairment • 5 extracted molar versus 5 non-extracted molar rats were compared to each other in learning ability and acetylcholine release in parietal lobe brain • To examine the effects of tooth loss on the central nervous system Kato et al., 1997

  22. 5 Rats aged 11 weeks old kept in 23c, 50%humidity, 12 h light/dark Extract all maxillary and mandibular molars 135 weeks Test in radial arm maze 9 weeks Test of Acetyl-choline releasing from parietal cortex

  23. It has been demonstrated that the neuronal activity in the brain and the cerebral blood flow were increased by mastication • Thus, one possible explanation may be that the dysfunction of cholinergic neuronal system in the teethless aged rats is caused by the long term decrease of neuron activity of the brain and/or the cerebral blood flow by the loss of teeth

  24. Tooth Loss and Quality of Life OIDP index

  25. Tooth Loss and Quality of Life

  26. Denture Related Condition

  27. Denture Related problems • Plaque • Stomatitis and Oral Candidiasis • Malodor • Reservoir of Infection • Hygiene • Denture • Denture Hyperplasia • Traumatic Ulcer

  28. Denture Stomatitis • 11-67% prevalence • Correlate with • Amount of denture plaque • Use of denture at night • Neglect of denture cleaning • Use of defective or unsuitable denture

  29. Denture Hyperplasia • 4-26% prevalence of complete denture users • Frequently in • Ill fitting denture • Unretentive denture

  30. Dental Caries

  31. Dental Caries • Dental caries is an infectious, communicable disease resulting in destruction of tooth structure by acid-forming bacteria found in dental plaque, in the presence of sugar • During the past few decades, changes have been observed not only in the prevalence of dental caries, but also in the distribution and pattern of the disease in the population NIH, 2001

  32. Dental Caries • It is identified a shift toward improved diagnosis of noncavitated, incipient lesions and treatment for prevention and arrest of such lesions • Restorations repair the tooth structure, do not stop caries, have a finite life span and are susceptible to disease Fontana and Zero, 2006

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