Community coordination of dental care needs in a home medical care support ward and at home

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  • Sumi Yasunori
    Department for Advanced Dental Research, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology Division of Oral and Dental Surgery, Department of Advanced Medicine, National Center for Geriatrics and Gerontology
  • Ozawa Nobuyoshi
    Division of Oral and Dental Surgery, Department of Advanced Medicine, National Center for Geriatrics and Gerontology
  • Miura Hiroko
    Department of Oral Health, National Institute of Public Health
  • Miura Hisayuki
    Department of Home Medical Care Support, National Center for Geriatrics and Gerontology
  • Toba Kenji
    National Hospital for Geriatric Medicine, National Center for Geriatrics and Gerontology

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Other Title
  • 当センター在宅医療支援病棟における歯科診療の必要性と地域連携に関する研究
  • 当センター[国立長寿医療研究センター]在宅医療支援病棟における歯科診療の必要性と地域連携に関する研究
  • トウ センター コクリツ チョウジュ イリョウ ケンキュウ センター ザイタク イリョウ シエン ビョウトウ ニ オケル シカ シンリョウ ノ ヒツヨウセイ ト チイキ レンケイ ニ カンスル ケンキュウ

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Abstract

Aim: The purpose of this study was to ascertain the current statuses and problems of dental home care patients by surveying the oral care status and needs of patients in the home medical care support ward at the National Center for Geriatrics and Gerontology. Patients that required continuous oral management even after discharge from the hospital were referred to local dental clinics to receive home dental care. We investigated the suitability and problems associated with such care, and identified the dental care needs of home patients and the status of local care coordination, including those in hospitals.<br> Methods: The subjects were 82 patients. We ascertained their general condition and oral status, and also investigated the problems associated with patients judged to need specialized oral care by a dentist during oral treatment. Patients who required continuous specialized oral care after discharge from hospital were referred to dental clinics that could provide regular care, and the problems at the time of referral were identified.<br> Results: Dry mouth was reported by many patients. A large number of patients also needed specialized dental treatment such as the removal of dental calculus or tooth extraction. Problems were seen in oral function, with 38 of the patients (46%) unable to gargle and 23 (28%) unable to hold their mouths open. About half of the patients also had dementia, and communication with these patients was difficult. Of the 43 patients who were judged to need continuing oral care after discharge from hospital, their referral to a dental clinic for regular care was successful for 22 (51%) patients and unsuccessful for 21 (49%) patients. The reasons for unsuccessful referrals included the fact that the family, patient, nurse, or caregiver did not understand the need for specialized oral care.<br> Conclusion: The present results suggest the need for specialized oral treatment in home medical care. These findings also suggest that coordinating seamless dental care among primary physicians, intermediates, and transferring care after hospital discharge to regular dentists is difficult.<br>

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