高齢者に対する地域歯科医療と歯科臨床判断 [in Japanese] Community Dental Care and Decision-Making of the Elderly Patient [in Japanese]
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The policy to promote retention of at least 20 teeth in 80-year-old presents substantial challenges to a changing health care system. Community based dental health services data demonstrate that greater numbers of natural teeth are being retained by older adults due to higher dental service utilization, effective caries prevention strategies, and a dramatic decreasing prevalence of periodontal disease.“Older-old”elderly, however, are becoming more frail and functionally dependent. Their oral health status is typically compromised and poor oral hygiene is promoting high dental caries rates and extensive periodontal diseases. Dental care providers must assume greater leadership and become more active participants in providing oral care for these “at-risk” elderly including domiciliary dental services.<BR>As older patients are retaining more natural teeth, their dental status is becoming increasingly complex. The delivery of dental care to “older” elderly patients can present tremendous challenges with clinical decision-making as well as overcoming barriers associated with treating the disabled elderly patient. In an effort to maintain and/or improve function and esthetics as well as treat symptoms and pathology, the dentist should consider: 1) patient desires and expectations; 2) type and severity of dental need; 3) impact on quality of life; 4) probability of positive outcome; 5) reasonable treatment alternatives; 6) ability to tolerate stress of treatment; 7) capability to maintain oral health; 8) financial and other resources; 9) dentist capabilities; and 10) other issues. These determining factors will help the dentist decide the appropriate extent of care to be provided.
- Nihon Hotetsu Shika Gakkai Zasshi
Nihon Hotetsu Shika Gakkai Zasshi 42(2), 201-206, 1998-04-10
Japan Prosthodontic Society