Petersen Poul Erik, Ogawa Hiroshi
Oral Health Prev Dent. 2018;16(2):113-124. doi: 10.3290/j.ohpd.a40309.
This report intends to review the global burden of oral disease among older people and to examine their oral health needs. The evidence on the inter-relationships between poor oral health conditions of older people, general health and quality of life is highlighted. Finally, WHO strategies to improve oral health of older people are reviewed.
The information relevant to this review was extracted from the WHO Global Oral Health Data Bank, the PubMed database, and the Cochrane Library. Surveys were carried out according to the criteria recommended by the WHO epidemiological manual Oral Health Surveys - Basic Methods. In addition, global data were sought on coverage of oral health care among older people. Finally, WHO policy documents on health care for aged people were gathered through the WHO website.
Across the globe, many older people suffer from oral pain or discomfort. Poor oral health during old age is mostly manifest in high caries experience, high prevalence rates of advanced periodontal disease, severe tooth loss, dry mouth, and oral pre-cancer/cancer. In both developing and developed countries, the burden of disease is particularly high among underprivileged and disadvantaged older people. In numerous countries, high proportions of the aged population are not covered by primary oral health care; this is mainly the case in low and middle income countries due to a critical shortage of dentists.
In 2015, the WHO published the World Report on Ageing and Health, which outlines a framework for action to foster healthy ageing. The policies are highly relevant to the improvement of oral health. Transformation of oral health systems away from a disease-based curative model and towards disease prevention, as well as the provision of older-person-centred integrated care are required. Moreover, wide-ranging public health action on ageing is urgently needed.
本报告旨在回顾老年人口腔疾病的全球负担，并审视他们的口腔健康需求。着重阐述老年人不良口腔健康状况、总体健康和生活质量之间相互关系的证据。最后，对世界卫生组织改善老年人口腔健康的策略进行回顾。
与本综述相关的信息取自世界卫生组织全球口腔健康数据库、PubMed数据库和考克兰图书馆。调查按照世界卫生组织流行病学手册《口腔健康调查——基本方法》推荐的标准进行。此外，还收集了关于老年人口腔保健覆盖范围的全球数据。最后，通过世界卫生组织网站收集了世界卫生组织关于老年人保健的政策文件。
在全球范围内，许多老年人遭受口腔疼痛或不适。老年时期的不良口腔健康主要表现为高龋齿发生率、晚期牙周病高患病率、严重牙齿缺失、口干以及口腔癌前病变/癌症。在发展中国家和发达国家，贫困和弱势老年人的疾病负担都特别高。在许多国家，很大比例的老年人口未得到初级口腔保健覆盖；在低收入和中等收入国家，由于牙医严重短缺，情况尤其如此。
2015年，世界卫生组织发布了《世界老龄化与健康报告》，其中概述了促进健康老龄化的行动框架。这些政策与改善口腔健康高度相关。需要将口腔健康系统从基于疾病的治疗模式转变为疾病预防模式，并提供以老年人为中心的综合护理。此外，迫切需要针对老龄化开展广泛的公共卫生行动。
