摘要:

The papers in this collection address geriatric dentistry at a time when society is rapidly becoming older. More than ever before, all dental care providers must understand the special needs of elderly patients and the unique biological features of the aged person that affect the diagnosis and prognosis of oral pathology. Attitudes about aging in the elderly must be discussed within the context of the health care setting so we can address the needs for social change, particularly in the dental and medical professions. This symposium brings together a series of papers on topics that are being researched in geriatric dentistry. The topics are diverse, including methods to finance dental care, psychiatric considerations, temporomandibular joint dysfunction, prosthodontics, artificial saliva and nutritional factors, immunology and the new frontiers in dental science, periodontal disease and oral cancer. And as an epilogue to our theme, a dentist with a primarily geriatric practice reflects on the difficulties and the rewards of the elderly patient. Improving the quality of life is the goal of aging research and to investigate aging legitimately we must ask in a systematic manner, what is aging? In this introduction, we discuss briefly the several theories of aging that are guiding research efforts.

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00044.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Developing dental benefit programs for the expanding ambulatory geriatric population represents an important challenge for dentistry. This paper describes Blue Cross of California's experience in developing and providing a dental benefit as part of a HMO. supplement to the Medicare program. A study of a randomly selected sample of 133 Ultra Care enrollees was conducted in a small California city. A dental record review was performed on those individuals who accessed dental care. Patterns of utilization, distribution of planned and rendered treatment, and level of care achieved are presented. The experience of those patients compared to another sample of Ultra Care patients in a California city of comparable size, had similar care patterns. The major difference between the two patient populations was the tendency of one practice to repair existing prosthetic appliances, while the other practice tended to replace the existing appliances. The method of determining a capitation rate for these geriatric enrollees, using this data, is presented.

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00045.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The author reviews the major psychiatric disorders that can affect the dental care of the aged. Depression and dementia are the most common problems in the upper age groups. Other less frequent disorders include paranoid states, anxiety states, and alcohol abuse. All of these illnesses have both symptomatic and specific treatments so that a thorough evaluation and aggressive treatment plan should be pursued when psychiatric symptoms present in any elderly patient. Their treatment can have a considerable influence on the patient's dental care. Ageism, orality, preventive dentistry, xerostomia and periodontal disease are discussed in the context of these psychiatric illnesses of the aged.

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00046.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The prevalence of five representative signs and symptoms of temporomandibular pain and dysfunction were evaluated with respect to the age of several different populations. For each of the five signs and symptoms (mouth opening, joint noises, presence of degenerative joint disease, subjectively reported symptoms, and pain on function) no increase was found in the older age group over the middle‐age group. In one category (joint sounds), the prevalence decreased in the older age group when compared to the middle‐age group. When asked by questionnaire if there was pain on function, the oldest age groups had the lowest proportion of positive responses. As a result of this information it is suggested that the prevalence of temporomandibular disorders diminishes in the elderly population, although not as much as the very few numbers of elderly actually seeking treatment for this disease would sugg

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00047.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The geriatric population is increasing and dentists are needed who are sensitive its problems and technically competent to provide a full rante og complete, fixed, and removable prostheses as well as preventive prosthodontics. The dental profession and schools must prepare today's graduates to meet the dental needs of tomorrow's elderly population including prosthodontic therapy.

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00048.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Hyposalivation results in the sensation of a dry mouth “subjective xerostomia.” Besides the sensation of a dry mouth in serious conditions, distressing clinical symptoms are observed, e.g. difficulties in oral functioning, mucositis, progressive dental caries and nocturnal oral discomfort. A mucin‐containing artificial saliva to relieve patients'complaints from xerostomia has been developed. Its chemical and physical properties are demonstrated. In a 3‐year retrospective study the efficacy of this substitute and a CMC‐containing saliva has been evaluated for a total of 137 patients. Patients were free in choosing a mucin‐ or CMC preparation. Ninety‐six patients reported a considerable relief of their complaints with mucin‐saliva, one patient wished to continue using the CMC product. To increase efficacy of the saliva substitute on intra‐oral saliva reservoir has been developed for dentate and e

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00049.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The oral tissues like all the tissues in the body change with age. Dehydration results from negative water balance and is almost inevitable, with drying of secretions, skin, eyes and in the oral cavity (xerostomia). Osteoporosis results from negative calcium balance and affects the entire bony skeleton. This is seen in fractures, the vertebrae and alveolar process. Correction of nutritional deficiences may slow down the rate of dehydration and osteoporosis.

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00050.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The elderly population is rapidly increasing, reflecting the fact that better pre‐ and post‐natal care, better nutrition, immunizations, antibiotics, and better general hygiene have reduced infant, childhood and young adulthood mortality. There are now more of us around to live longer. It is therefore important to develop gerontologic research programs aimed at understanding the normal aging process. We need to know what age‐related changes are irreversible concomitants of the passage of time and what age‐related changes are associated with various diseases, life‐styles and cultures. It is possible that life‐style, diet and genetic characteristics, which retard or accelerate aging, can be identified and thus have major public health implications. Aging brings about an unusual immunologic situation that has not yet been thoroughly explained. The primary effect of normal aging on the immune system appears to be a decrease in thymus derived or T‐cell functional capacity, especially in the suppressor subpopulation of T‐cells. There is also an age associated hyperglobulinemia with an increase in normal autoantibody titer. Thus, one can propose that the T supressor inhibition of B lymphocytes is released in older individuals, allowing B cells an increase in functional response, especially to “slightly altered” self. The implications of these changes to the processes of chronic destructive periodontitis and oral cancer must be explained and eventually understood if we are to prevent and/or succ

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00051.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

An interpretative discussion on the cellular basis of the association between immunosenescence and loss of immunologic homeostasis was developed from results of studies performed to resolve the issues (a) of whether cells in certain stages of differentiation are more vulnerable to aging than those in other stages and (b) whether the regulatory cells participating in modulating immune responses are prime targets of aging. Young and old mice were exposed to (1) 6‐thioguanine (6‐TG) to study the activity of their mitotically active and inactive cells and (2) 500R of irradiation to study regeneration of their immune cells. Many alterations were detected in old mice including the existence of a relatively large pool of mitotically inactive pluripotent stem cells in the bone marrow, heightened stem cell regenerative activity, and altered patterns of immunologic regeneration. These kinetic abnormalities reflect age‐related changes in stem cells and their progenies, and in the lymphohematopoietic stromal

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00052.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

A private practioner presents misconceptions of the relationship between aging dental patients and dentists which he has observed in his experience. Many dentists have accepted some of the stereotypes of the aging and it affects the treatment they offer these patients. Geriatric dental patients have often developed generalizations about dental treatments based on earlier periods in dentistry and on economic limitations sometimes encountered in their life state. Several different dental care delivery systems have come into existence in recent years. It is sometimes difficult for the aging patient to choose among these systems because of the misconceptions previously mentioned. Both the dentist and the aging patient must recognize the existence of individuality in the other. The key to this recognition and to better understanding is communication.

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00053.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY