J Am Dent Assoc. 2017 Apr;148(4):236-245.e3. doi: 10.1016/j.adaj.2016.12.022. Epub 2017 Feb 4.
Cognitive impairment is the gradual loss of one's ability to learn, remember, pay attention, and make decisions. Cognitively impaired elderly people are a challenging patient population for dental health care professionals and may be at higher risk of developing oral health diseases. The authors systematically reviewed interventions effective at improving dental health in patients with cognitive impairment and described research gaps remaining.
In a comprehensive search of multiple databases, the authors identified 2,255 studies published in the English language from 1995 through March 2016. The authors included studies if the investigators evaluated oral health measures after an intervention in patients 65 years or older with cognitive impairment or dementia. Nine full-text articles met the criteria for inclusion.
Only 1 study was a randomized control trial, whereas all others lacked appropriate controls. Investigators studied the effects of dental treatments, battery-powered devices for oral hygiene, and training of care staff members. Most interventions improved some aspect of the oral health of patients with dementia, and results were more pronounced when patients required assistance while performing oral hygiene tasks or had poor oral health at baseline.
A basic care plan for patients with dementia should, at the minimum, match prevention strategies recommended for healthy elderly patients. Dental health care professionals should promote oral hygiene education for caregivers for elderly patients with cognitive impairment. There is a wide gap in knowledge regarding effective methods specifically to improve oral health in patients with dementia.
认知障碍是指一个人学习、记忆、注意力和决策能力逐渐丧失的过程。认知障碍的老年人是口腔医疗保健专业人员面临的一个具有挑战性的患者群体，他们可能有更高的风险患上口腔健康疾病。作者系统地回顾了改善认知障碍患者口腔健康的有效干预措施，并描述了仍存在的研究空白。
在对多个数据库的全面搜索中，作者从 1995 年到 2016 年 3 月共检索到 2255 篇以英文发表的研究。如果研究人员在 65 岁或以上认知障碍或痴呆患者中评估了干预后的口腔健康措施，则将这些研究纳入研究。有 9 篇全文文章符合纳入标准。
只有 1 项研究是随机对照试验，而其他研究均缺乏适当的对照。研究人员研究了牙科治疗、电池供电的口腔卫生设备和护理人员培训的效果。大多数干预措施改善了痴呆症患者口腔健康的某些方面，当患者在进行口腔卫生任务时需要帮助或在基线时口腔健康状况较差时，结果更为明显。
痴呆症患者的基本护理计划至少应符合为健康老年患者推荐的预防策略。口腔卫生保健专业人员应促进对认知障碍老年患者护理人员的口腔卫生教育。在改善痴呆症患者口腔健康的有效方法方面，知识存在广泛差距。
