预防性和治疗性口腔保健计划对养老院居民口腔健康问题的患病率和发生率的影响。
The impact of a preventive and curative oral healthcare program on the prevalence and incidence of oral health problems in nursing home residents.
机构信息
Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium.
Department of Geriatrics, Ghent University Hospital, C.Heymanslaan 10, Ghent, Belgium.
出版信息
PLoS One. 2018 Jun 12;13(6):e0198910. doi: 10.1371/journal.pone.0198910. eCollection 2018.
AIMS
To assess the impact of an oral healthcare program in nursing homes on the initial treatment backlog and residents' oral health stability.
MATERIALS AND METHODS
The study is a longitudinal cohort study in nursing home residents in Flanders, Belgium, to evaluate the oral healthcare programme Gerodent. The program consisted of: (1) the introduction of an oral healthcare team, (2) oral health education, (3) the implementation of oral health guidelines and protocols, and (4) regular visits of a mobile dental team. Data were extracted from the oral health records of 381 residents from 21 nursing homes who received treatments from the mobile dental team between October 2010 and March 2014 (mean follow-up period of 22.5 months). Oral health and treatment need between baseline and follow-up were compared.
RESULTS
The mean age at baseline was 82.4 years and the mean number of consultations per resident was 3.61 during the follow-up period. The proportion of residents with an oral treatment need was reduced from 65.9% to 31.3%. Among residents with natural teeth, there was significantly lower prevalence of caries (from 70.5% at baseline to 36.5% at follow-up; p<0.001), residual roots (from 54.2% to 25.1%; p<0.001), and need for fillings (from 31.9% to 17.1%; p<0.001) or extractions (from 64.3% to 31.6%; p<0.001). In the group with partial or full dentures (n = 223), 38.1% needed a repair, rebasing or renewal of their existing dentures at baseline and the respective figure at follow-up was 9.0% (p<0.001). In terms of oral health stability, 53% of the residents had no incident restorative and prosthetic treatment need throughout the follow-up period. A lower number of natural teeth at baseline (p<0.001) and a shorter follow-up period (p = 0.002) were associated with higher chances of oral health stability.
CONCLUSION
The oral healthcare program Gerodent significantly reduced the treatment backlog and contributed to a considerable proportion of residents being stable in terms of oral health without any incident treatment needs.
目的
评估养老院口腔保健计划对初始治疗积压和居民口腔健康稳定性的影响。
材料和方法
这是一项在比利时佛兰德斯养老院居民中进行的纵向队列研究，旨在评估口腔保健计划 Gerodent。该计划包括：（1）引入口腔保健团队，（2）口腔健康教育，（3）实施口腔保健指南和方案，以及（4）移动牙科团队的定期访问。从 2010 年 10 月至 2014 年 3 月期间接受移动牙科团队治疗的 21 家养老院的 381 名居民的口腔健康记录中提取数据（平均随访期为 22.5 个月）。比较基线和随访时的口腔健康和治疗需求。
结果
基线时的平均年龄为 82.4 岁，每位居民的平均就诊次数为 3.61 次。有口腔治疗需求的居民比例从 65.9%降至 31.3%。在有天然牙齿的居民中，龋齿的患病率显著降低（从基线时的 70.5%降至随访时的 36.5%；p<0.001），残根的患病率（从 54.2%降至 25.1%；p<0.001），以及需要填充（从 31.9%降至 17.1%；p<0.001）或拔牙（从 64.3%降至 31.6%；p<0.001）的比例也降低。在部分或全口义齿组（n=223）中，38.1%的人在基线时需要修复、重新基托或更换现有的义齿，而在随访时这一比例为 9.0%（p<0.001）。在口腔健康稳定性方面，53%的居民在整个随访期间没有发生新的修复和修复治疗需求。基线时的天然牙齿数量较少（p<0.001）和随访时间较短（p=0.002）与口腔健康稳定性较高的机会相关。
结论
口腔保健计划 Gerodent 显著减少了治疗积压，并有助于相当一部分居民的口腔健康保持稳定，没有任何新的治疗需求。
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