D'Alessandro Giovanni, Costi Tommaso, Alkhamis Nadia, Bagattoni Simone, Sadotti Agnese, Piana Gabriela
Department of Biomedical and Neuromotor Sciences Dental School, Alma Mater Studiorum, Universita di Bologna Bologna, Italy, Phone: +390512088150, e-mail:
Department of Biomedical and Neuromotor Sciences Dental School, Alma Mater Studiorum, Universita di Bologna Bologna, Italy.
J Contemp Dent Pract. 2018 May 1;19(5):483-489.
To evaluate the oral health status in Alzheimer's disease (AD) patients.
A descriptive study was performed on 120 AD patients (60 institutionalized in a public institute and 60 attended a daytime center), from September 2013 to January 2014. About 103 subjects formed the control group. The following medical and dental data were collected: dementia severity, pharmacological therapy, physical status (American Society of Anesthesiologists [ASA]), decayed (D), filled (F), and remaining natural teeth (T), DF/T ratio, community periodontal index (CPI), and gingival index (GI). A t-test for independent samples and the Spearman's correlation test were used to evaluate all variables. The significance level was set at 0.05.
Statistically more AD patients (91.7%) were under pharmacological therapy and their physical status was more severe (ASA 2, ASA 3) compared with control subjects (p < 0.001). Moreover, they presented numbers of D, CPI, and GI significantly higher (p ≤ 0.005). In the institutionalized subgroup, statistically more moderate and severe AD cases were detected and more patients were edentulous (p < 0.001). Noninstitutionalized patients presented DF/T ratio, CPI, and GI significantly lower (p ≤ 0.024). A significant weak negative correlation (r = -0.121 to -0.372) between epidemiologic indices and AD severity was observed.
Alzheimer's disease patients show a low oral health status that decreases progressively as the disease severity aggravates. Therefore, further studies are necessary to investigate oral health care interventions for AD patients.
It would be beneficial to introduce trained professional figures in specialized elderly institutions for regular follow-up visits and professional oral hygiene procedures. This task has to be coordinated with the treating physician, family members, and/or caregivers. Knowing that the severity of AD has a negative effect on the oral health status and the type of institutionalization exacerbates it.
评估阿尔茨海默病（AD）患者的口腔健康状况。
2013年9月至2014年1月，对120例AD患者（60例入住公立机构，60例参加日间护理中心）进行了描述性研究。约103名受试者组成对照组。收集了以下医学和牙科数据：痴呆严重程度、药物治疗、身体状况（美国麻醉医师协会[ASA]分级）、龋坏牙数（D）、充填牙数（F）和剩余天然牙数（T）、DF/T比值、社区牙周指数（CPI）和牙龈指数（GI）。采用独立样本t检验和Spearman相关性检验对所有变量进行评估。显著性水平设定为0.05。
与对照组相比，统计学上更多的AD患者（91.7%）接受药物治疗，且其身体状况更严重（ASA 2级、ASA 3级）（p < 0.001）。此外，他们的龋坏牙数、CPI和GI显著更高（p≤0.005）。在入住机构的亚组中，统计学上检测到更多中度和重度AD病例，且无牙患者更多（p < 0.001）。非入住机构的患者DF/T比值、CPI和GI显著更低（p≤0.024）。观察到流行病学指标与AD严重程度之间存在显著的弱负相关（r = -0.121至-0.372）。
阿尔茨海默病患者口腔健康状况较差，且随着疾病严重程度加重而逐渐下降。因此，有必要进一步研究针对AD患者的口腔保健干预措施。
在专业老年机构引入经过培训的专业人员进行定期随访和专业口腔卫生程序将是有益的。这项任务必须与治疗医生、家庭成员和/或护理人员协调。要知道AD的严重程度对口腔健康状况有负面影响，而机构化类型会加剧这种影响。
