Foltyn P
Dental Department, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.
Aust Dent J. 2015 Mar;60 Suppl 1:86-94. doi: 10.1111/adj.12287.
Neurocognitive decline and delirium, frailty, incontinence, falls, hearing and vision impairment, medication compliance and pharmacokinetics, skin breakdown, impaired sleep and rest are regarded as geriatric giants by gerontologists, geriatricians and nursing home staff. As these are all interrelated in the elderly, failure to act on one can impact on the others. However, the implications of poor oral health have for too long been ignored and deserve equal status. Mouth pain can be devastating for the elderly, compound psychosocial problems, frustrate carers and nursing home staff and disrupt family dynamics. As appearance, function and comfort suffer, so may a person's self-esteem and confidence. The contributing factors for poor oral health such as rapid dental decay, acute and chronic periodontal infections and compromised systemic health on a background of a dry mouth, coupled with xerostomia-inducing medications, reduced fine motor function, declining cognition and motivation will not only lead to an increase in both morbidity and mortality but also impact on quality of life.
神经认知衰退与谵妄、衰弱、失禁、跌倒、听力和视力损害、药物依从性和药代动力学、皮肤破损、睡眠和休息障碍，被老年医学专家、老年病医生和养老院工作人员视为老年问题中的“巨头”。由于这些在老年人中都是相互关联的，对其中一个问题不采取行动可能会影响其他问题。然而，口腔健康不佳的影响长期以来一直被忽视，理应得到同等重视。口腔疼痛对老年人来说可能是毁灭性的，会加重心理社会问题，让护理人员和养老院工作人员感到沮丧，并扰乱家庭关系。随着外貌、功能和舒适度下降，一个人的自尊和信心也可能受到影响。口腔健康不佳的促成因素，如快速龋齿、急慢性牙周感染以及在口干背景下的全身健康受损，再加上导致口干的药物、精细运动功能下降、认知和动力减退，不仅会导致发病率和死亡率上升，还会影响生活质量。
