Academic Clinical Fellow and Specialist Registrar in Special Care Dentistry, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW.
Consultant in Special Care Dentistry, Newcastle Dental Hospital, Richardson Road, Newcastle upon Tyne, Tyne and Wear, NE2 4AZ.
Br Dent J. 2018 Sep 14;225(5):395-399. doi: 10.1038/sj.bdj.2018.742. Epub 2018 Aug 31.
There are a growing number of older patients who are retaining their natural teeth. Though the majority of these patients remain independent, many are affected by frailty, multi-morbidity or dementia. The complexities associated with dementia have led to guidelines being produced by the FGDP, Dementia friendly dentistry, although other features of ageing can similarly increase the risk of dental disease and the consequent complexity, safety and suitability of providing treatment. Prevention of dental disease is crucial for older patients as the features of ageing may make the risk of treatment greater than that of younger patients. Conscious sedation or general anaesthesia, typically provided by a specialist dental service, may be required to facilitate treatment, though these approaches may have significant short and long-term impacts on older patients. Clinical guidelines and legislation are available to assist in decision-making for patients who may lack mental capacity, yet for patients who are able to consent for treatment, a comprehensive discussion as part of an informed consent process remains crucial to determine the most appropriate approach to care provision.
越来越多的老年患者保留了自己的天然牙齿。尽管这些患者大多数仍能独立生活，但许多人都受到体弱、多病或痴呆的影响。痴呆症的复杂性导致 FGDP 制定了“痴呆友善牙科”指南，尽管衰老的其他特征也可能同样增加患牙科疾病的风险以及治疗的复杂性、安全性和适宜性。预防牙科疾病对老年患者至关重要，因为衰老的特征可能使治疗的风险大于年轻患者。为了便于治疗，可能需要使用由专业牙科服务提供的镇静或全身麻醉，但这些方法可能会对老年患者产生重大的短期和长期影响。为可能缺乏精神能力的患者提供了临床指南和立法，但对于能够为治疗提供同意的患者，全面讨论作为知情同意过程的一部分仍然是确定最适当的护理提供方法的关键。
