van der Putten Gert-Jan, de Baat Cees, De Visschere Luc, Schols Jos
BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium/Nijmegen, The Netherlands; Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; University of Applied Sciences, Utrecht, The Netherlands; The Opbouw Foundation, Birkhoven Zorggoed, Amersfoort, The Netherlands; Department of Community Dentistry and Oral Public Health, University Ghent, Ghent, Belgium.
Gerodontology. 2014 Feb;31 Suppl 1:17-24. doi: 10.1111/ger.12086.
This article presents a brief introduction to the medical aspects of ageing and age-related diseases, and to some geriatric syndromes, followed by a discussion on their impact on general and oral healthcare provision to community-dwelling older people. Recent investigations suggest that inflammation constitutes a biological foundation of ageing and the onset of age-related diseases. Multimorbidity and polypharmacy, together with alterations in pharmacokinetics and pharmacodynamics, make older people at risk of adverse medication reactions. A side effect of several medications is causing xerostomia and hyposalivation, and both the type and number of medications used are relevant. New options of general healthcare provision to community-dwelling older people are the use of mobility aids and assistive technology devices, domiciliary health care, respite care and telecare. Their oral health status may be jeopardised by frailty, disability, care dependency and limited access to professional oral health care. Recommendations for improvement are the following: better integrating oral health care into general health care, developing and implementing an oral healthcare guideline, providing customised oral hygiene care aids, domiciliary oral healthcare provision, visiting dental hygienists and/or nurses, oral hygiene telecare, easily and safely accessible dental offices, transforming dentistry into medical oral health care and upgrading dentists to oral physicians. In case oral healthcare providers do not take the responsibility of persuading society of the importance of adequate oral health, weakened oral health of community-dwelling older people will become a potential new geriatric syndrome.
本文简要介绍衰老及与年龄相关疾病的医学方面，以及一些老年综合征，随后讨论它们对为社区居住老年人提供的一般医疗和口腔保健的影响。最近的研究表明，炎症构成衰老和与年龄相关疾病发病的生物学基础。多种疾病并存和多种药物治疗，以及药代动力学和药效学的改变，使老年人面临药物不良反应的风险。几种药物的一个副作用是导致口干和唾液分泌减少，所使用药物的类型和数量都与此相关。为社区居住老年人提供一般医疗保健的新选择包括使用移动辅助设备和辅助技术设备、居家医疗保健、临时护理和远程护理。他们的口腔健康状况可能会因身体虚弱、残疾、护理依赖以及获得专业口腔保健的机会有限而受到损害。改进建议如下：将口腔保健更好地融入一般医疗保健，制定并实施口腔保健指南，提供定制的口腔卫生护理辅助工具，提供居家口腔保健服务，拜访口腔保健员和/或护士，开展口腔卫生远程护理，设立方便且安全可达的牙科诊所，将牙科转变为医疗口腔保健，并将牙医提升为口腔医师。如果口腔保健提供者不承担起说服社会认识到充足口腔健康重要性的责任，那么社区居住老年人日益衰弱的口腔健康将成为一种潜在的新老年综合征。
