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Title: Selected orał health parameters and the utility of the mirror sliding test in the assessment of dry mouth on the example of a group of seniors in Municipal Health Center for Older and Dependent lndividuals in Krakow
Abstract:
Introduction: The process of ageing of the global population is growing and gaining strength, and a key parameter of this process is the quality of ageing. It leads to an increasing importance of adequate care for the aging population. The aim of this study was to com pa re selected orał health parameters of elderly people residing in the institutionalized care of Municipal Health Centre for Older and Dependent Individuals (MHCOD) and participants of a 3:..month rehabilitation program at a Daily Medical Care House (DMCH) and the utility of the mirror test in the diagnosis of orał dryness - an important risk factor for orał health deterioration. Materiał and Methods: The study involved 80 patients, 50 MHCOD residents, and 30 participants in a 3-month DMCH rehabilitation camp. The seniors were interviewed and clinically examined. The questionnaire survey was aimed to collect information abo ut sex, age, length of stay in MHCOD in Kraków and the value of the Mini Men tal State Examination. The analysis included self-care of hygiene activities and frequency of cleaning teeth and dentures. Patients were asked about orał complaints and problems related to salivary disorders on the basis of questionnaires. The correlation of the occurrence of complaints with the length of stay in MHCOD was analysed, and pain intensity was assessed using the Visual Analogue Scale (VAS). A subjective as ; sessment of dry mouth was performed using the Fox questionnaire. The number, type of medications taken and the effect of polypragmasy on the orał cavity was assessed. The clinical examination section included the characteristics of missing teeth (FDI, 1970). To assess orał hygiene, the following was used: Plaque Index (PI Silness & Loe 1964), Gingival Index (Gł, Loe & Silness 1963), and hygiene analysis of removable prosthetic restorations was performed using the Ambjornsen Index (1982). Assessment of the prevalence of denture stomatitis was performed using Newton's (1962) classification, and orał mucosal pathology was assessed using R. Górska's (2011) classification. Orał mycology samples were collected from patients for orał mucosal examination. Clinical assessment of dry mouth symptoms was performed using the Challacombe (2011) scale, on the basis of which a Clinical Orał Dryness Score was calculated. In addition, a dental mirror test was performed to assess the resistance of the buccal mucosa to sliding the mirror over its inner surface. The result obtained were evaluated for correlation with selected questionnaire parameters. Results: A. The questionnaire part The predominant group of seniors were women: 62%MHCOD, 70% DMCH. The mean age of women residing in the MHCOD was 78,2 and in the DMCH 72,9 years, while the values for men were 66,5 and 70,6 years, respectively. The a ; verage length of stay in MHCOD was approximately 3,2 years. A comparison of MHCOD residents and DMCH rehabilitation camp participants using the MMSE showed no statistically significant differences (MHCOD mean=25,0; DMCH mean=25,8). Among the seniors, 68% performed orał hygiene and dentures once a day or less frequently. A statistically significant relationship was found between place of residence and frequency of hygiene procedures in favour of DMCH patients. Dryness, impaired taste and food intake and mucosal burning were symptoms associated with seniors, and their frequency did not depend on the type of care. The frequency of mucosal burning and difficulty with the use of den tu res increased with the length of stay at MHCOD. Analysis of the Fox questionnaire results showed no statistically significant differences between the study groups. The most reported complaints in both groups were the sensation of too much or too little saliva and the need to drink fluids while chewing dry foods. Senior patients were at risk of side effects of polypharmacy, which increased the risk of dry mouth and taste disorders. Seniors with higher severity of dry mouth showed more frequent mucosal burning and difficulties with food intake. B. Clinical examination The prevalence of missing teeth was higher among MHCOD than DMCH residents. The distribution of remaining teeth in both groups correspond ; ed to the outlets of the large salivary glands. In the study group of seniors, we observed that residents with some degree of dependence on the help of others presented orał hygiene at a lower level, and the Plaque Index and Gingival Index values reached higher values among them more often. Plaque deposits were more frequently present among residents with a feeling of dry mouth. Prosthetic restorations were used by 71,2% of the patients. The most common type was removable mucosal dentures. Analysis using the Ambjornsen Index indicated that 72% of residents with a positive mycological result had inadequate denture hygiene. The predominant form of stomatopathy was stage 1 indicating pink congestion points. Among senior patients, red and white lesions were the most common lesion type, and the site of occurrence was the mucosa of the tongue and the red zone of the lips. The most frequently isolated fungal species were candida albicans (89%) and candida glabrata (39%). In more than half of the cases (51 % ), more than 1 fungal species was isolated. Fungal inf ection of the orał cavity of ten progressed without accompanying subjective symptoms, so that most patients were diagnosed at a late stage. Fungal concentrations in the mycological smear did not show statistically significant correlations with the stage of development of denture stomatitis according to Newton's classification. ; The most frequently isolated fungal species were candida albicans (89%) and candida glabrata (39%). In more than half of the cases (51 %), more than 1 fungal species were isolated. Fungal infection of the orał cavity often progressed without accompanying subjective symptoms, so that most patients were diagnosed at a late stage. Fungal concentrations in the mycological smear did not show statistically significant correlations with the stage of development of denture stomatitis according to Newton's classification. A positive mycological smear increased the risk of red lesions, and an increase in white lesions on the tongue was noticeable among patients with abundant and very abundant growth. Mucosal burning and problems with food intake were more common among seniors with higher CODS scores. The study found correlations between the mirror test score and taste disorders, problems with food intake, pain intensity and number of medications taken. Conclusions: The orał hygiene of seniors was unsatisfactory regardless of their place of residence. This indicates the need to educate seniors and their caregivers in this area. Care dependent patients deserved special attention. Saliva deficiency was the main cause of discom fort du ring food intake, use of prosthetic restorations and burning of the orał mucosa in both groups. There is a need to educate patients on how to prevent troubles ; ome dryness symptoms. The length of stay in MHCOD and multi-drug therapy increased the risk of developing dry mouth. Thus, there is a need for medical staff to analyse the medications taken and reduce them (so-called drug reviews) to avoid the side effects of polypharmacy. Patients who stay for long periods of time in MHCOD should be particularly monitored for the development of medication-induced dry mouth. The mirror test can be a simple test to detect dry mouth and take steps to eliminate its causes and consequences. Taking action to increase salivary secretion can contribute to longer preservation of the patient's own dentition (preservation of the dentition in the location of the large salivary gland mouths), improved orał hygiene and elimination of the acute subjective symptoms of salivary deficiency.
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Rada Dyscypliny Nauki medyczne
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Last modified:
Jan 16, 2025
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Jan 16, 2025
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http://dl.cm-uj.krakow.pl:8080/publication/5184
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| Edition name | Date |
|---|---|
| ZB-141627 | Jan 16, 2025 |
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