在宅寝たきり高齢者の口腔健康状態と治療必要性に関する研究

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  • Oral Health Status and Treatment Needs for Bedridden Elderly People Living at Home in Kitakyushu City

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A survey of the oral health conditions and treatment needs of dental diseases was conducted among 181 bedridden elderly people living at home in Kitakyushu City, Japan. The purpose of this study was to provide baseline data before the planning and implementation of a dental program for bedridden elderly people in Japan. Dentition and periodontal status, wearing of and need for dentures, and the condition of the temporomandibular joint were assessed according to the WHO guidelines (Oral Health Surveys-Basic Method, 3rd Ed., 1987). Interviews were also conducted and data on the general diseases was obtained from the subjects' medical histories. The most frequent causes of being bedridden were cerebrovascular diseases followed by cardiovascular diseases and senility. Mental status was also surveyed. The percentage of the subjects in good, fair and poor mental condition was 29%, 50% and 20%, respectively. Forty-three percent of all persons were edentulous and the mean number of present teeth, DF teeth, D (dacayed) teeth and F (filled) teeth among dentate persons was 9.6, 7.0, 3.9 and 3.1, respectively. The average number of teeth requiring filling, pulp care, crown or bridge abutment and extraction among dentate persons was 1.0, 0.6, 0.1 and 2.4, respectively. The percentage of dentate persons with healthy, bleeding on probing, calculus, shallow pocketing of 4 or 5 mm, and deep pocketing of 6 mm or more was 3%, 4%, 23%, 59% and 11%, respectively. The mean number of sextants with healthy, bleeding, calculus, shallow pockets and deep pockets was 0.1, 0.3, 1.0, 1.3 and 0.1, respectively. Sixty-nine percent of the subjects had dentures and 60% of the denture wearers wore them day and night. Denture treatment was needed by 85% of all persons : new dentures were needed by 40% and denture repairs by 45%. Ninety percent of those interviewed had no unusual symptoms in their temporomandibular joint. Oral and denture hygiene were poor. Only 2% of the subjects were plaque-free and 20% of the denture wearers use their dentures with no visible plaque. Fifty-six percent of those interviewed had some dental complaints ; most frequently reported were difficulties with dentures and chewing. In contrast with this, 46% of the interviewed persons had a subjective need for treatment. Analysis of the results showed poor dental health in this survey group and emphasizes the necessity of improving the dental health service programs for the bedridden elderly people and also the importance of preventive programs for dental diseases in the younger generations.

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