Number of teeth and myocardial infarction and stroke among elderly never smokers

<p>Abstract</p> <p>Background</p> <p>In most previous studies the association between number of teeth and cardiovascular diseases has been found to be stronger among younger age groups than in older age groups, which indicates that age may modify the association between number of teeth and cardiovascular diseases.</p> <p>We investigated the association between tooth loss and atherosclerotic vascular diseases such as myocardial infarction and stroke in a homogeneous elderly population.</p> <p>The study population was comprised of a subpopulation of 392 community-living elderly people who participated in the population-based Kuopio 75+ study. The data were collected through an interview, a structured clinical health examination and from patient records. The main outcome measures were a history of diagnosed myocardial infarction and diagnosed ischemic stroke. Prevalence proportion ratios (PPR) were estimated using generalised linear models.</p> <p>Results</p> <p>Edentate subjects had a weakly, statistically non-significantly increased likelihood of a history of myocardial infarction and ischemic stroke compared with dentate subjects. Those with a large number of teeth had a slightly, but not statistically significantly increased likelihood of a history of myocardial infarction and ischemic stroke compared with those with a small number of teeth.</p> <p>Conclusion</p> <p>These data did not show evidence that total or partial tooth loss would be associated with atherosclerotic vascular diseases such as myocardial infarction and ischemic stroke among an elderly population aged 75 years or older.</p

Implementation of oral hygiene practices in nursing homes:the view of supervisor nurses

Abstract Objectives: The aim of our study was to analyse the implementation of oral health-related practices in private enhanced service housing units and nursing homes in Finland reported by supervisor nurses. Methods: We sent an anonymous, voluntary Webropol-questionnaire to the supervisor nurses of private enhanced service housing units and nursing homes (N= 245). The questionnaire included items about the implementation of oral healthcare-related practices in the care units and items based on the Nursing Dental Coping Beliefs index (DCBS index). Five dimensions of the implementation of oral healthcare-related practices, Oral hygiene practices and Favourable diet for oral health, Oral hygiene equipment, Professional dental services, and Knowledge and opinions were used as outcomes. The factors in the nursing DCBS index and background variables were used as explanatory variables. Results: Our main results showed that in care units, Oral hygiene practices, Favourable diet for oral health, Oral hygiene equipment, and Professional dental services were partly implemented. Furthermore, according to Knowledge and opinions supervisor nurses had challenges in oral health-related knowledge and difficulties in managing oral care. In the DCBS index, better self-efficacy in “Managing bleeding gums” was associated with better implementation of oral health practices. Furthermore, supervisor nurses’ better own oral health habits were associated with better implementation of oral health-related practices. Conclusions: It can be concluded that based on the responses of the supervisor nurses, oral health-related practices were partly implemented in private enhanced service housing units and nursing homes in Finland

Anticholinergic burden and dry mouth in middle-aged people

Abstract Introduction: Anticholinergic burden refers to the cumulative effect of taking 1 or more drugs with anticholinergic properties. At the moment, little is known about the association between the anticholinergic burden and dry mouth. Objectives: The objective of this article was to study, whether an anticholinergic burden is associated with dry mouth among middle-aged people. Methods: The study population included 1,345 people aged 46 y from the Northern Finland Birth Cohort 1966 (NFBC1966) study, who took part in a clinical medical and dental examination during 2012–2013. Medication data comprised both self-reported drug use and information obtained from the national register. Anticholinergic burden was measured using 10 different anticholinergic scales. Dry mouth was defined on the basis of having either a subjective feeling of dry mouth (xerostomia) or objectively measured low unstimulated or stimulated whole salivary flow rates (hyposalivation). Poisson regression models with robust error variance were used to estimate relative risk (RR). Regression models were adjusted for sex, smoking, diabetes, rheumatoid diseases, depressive symptoms, anxiety, total number of drugs, and antihypertensive drugs. Results: Approximately 14% of the participants reported having xerostomia and about 2% had hyposalivation. The RRs of different anticholinergic scales for xerostomia varied from 1.05 to 1.68. The scales’ RRs were between 0.89 and 2.03 for low unstimulated whole salivary flow (&lt;0.1 mL/min) and between 0.59 and 1.80 for low stimulated whole salivary flow (&lt;0.7 mL/min). Seven of 10 studied anticholinergic scales associated statistically significantly with dry mouth, either with xerostomia or hyposalivation. Conclusion: Most of the anticholinergic scales were associated with dry mouth, either with xerostomia or hyposalivation. There was considerable variation in the strength of the associations between anticholinergic scales and dry mouth. Knowledge Transfer Statement: The findings of this study suggest that dentists should take notice of the use of drugs with anticholinergic properties and their harmful effects among middle-aged people. Dentists should provide these patients with necessary guidance on how to cope with dry mouth and give them prophylactic measures against oral diseases associated with dry mouth

Developing an instrument to measure self-efficacy, challenges and knowledge in oral care among geriatric home care nurses:a pilot study

Abstract The role of geriatric nurses is essential in preventing oral health problems of older people with impaired daily functioning. Nurses have reported low self-efficacy with regard to oral health care practices and wish to receive more information on the topic. The main aim of this pilot study was to develop an instrument to measure the self-efficacy beliefs, challenges and knowledge of geriatric home care nurses with regard to the oral health care of older. A questionnaire was developed to evaluate geriatric home care nurses’ self-efficacy beliefs, challenges and knowledge regarding the oral health care of the older people. In this case, 18 nurses participated in a one-day intervention and filled in the questionnaire before and after the intervention. The comments and questions of the nurses were analysed utilising the principles of inductive content analysis. Cronbach’s alpha for the scales varied between 0.69–0.79. The interactive intervention improved both nurses’ self-efficacy beliefs and oral health-related knowledge, and most of the challenges faced by nurses in older people’s oral health care were diminished. Financial resources and older people’s self-determination were the most common limitations to oral care. In this pilot study, we developed an instrument to measure geriatric home care nurses’ self-efficacy beliefs, challenges and knowledge regarding older people’s oral health care. In the future, this instrument can be validated with a larger study population

Waist circumference and waist-to-height ratio are associated with periodontal pocketing:results of the Health 2000 Survey

Abstract Background: Body mass index (BMI) has been found to associate with different parameters of chronic periodontal disease in previous studies. It is reasonable to expect that central adiposity measures, such as waist circumference and waist-to-height ratio, which indirectly takes into account visceral fat, are more accurate measures of obesity-related oral health risks than BMI. The aim of this study was to examine whether central obesity is associated with periodontal pocketing, an indication of infectious chronic periodontal disease. Methods: The study was based on a subpopulation from the national Health 2000 Survey in Finland. It included dentate, non-diabetic, never-smoking subjects aged 30–49 (n = 1287). The outcome variable was the number of teeth with deepened periodontal pockets (4 mm or more) and the number of teeth with deep periodontal pockets (6 mm or more). Central obesity was measured by means of waist circumference (WC) and waist-to-height ratio (WHtR). Poisson regression models were used to estimate prevalence rate ratios (PRR) and their 95% confidence intervals. Results: Our main finding was that both WC and WHtR were associated with the number of teeth with deeper (4 mm or more) periodontal pockets; the PRR for the fifth quintile in WC was 1.5, CI: 1.2–1.9 and in WHtR 1.4, CI: 1.1–1.7, when compared to the lowest quintile. Corresponding figures for deep (6 mm or more) periodontal pockets were 2.3, CI: 0.9–6.1 for WC and 1.9, CI: 0.8–4.4 for WHtR. There were no essential differences in the strengths of the associations between WC and WHtR and the number of teeth with deepened periodontal pockets. Conclusion: Both central adipose measures—WC and WHtR—seem to be associated with periodontal pocketing in non-diabetic, never-smoking subjects aged 30–49 years old

Sedative load, carious teeth and infection in the periodontium among community-dwelling older people

Abstract Objective: To study the relation of sedative load to carious teeth and periodontal pocketing — indication of infectious periodontal disease — among older people. Materials and methods: This cross‐sectional study was based on a subpopulation of 158 community‐dwelling, dentate, non‐smoking, 75‐year‐old or older people from the Oral Health Geriatric Multidisciplinary Strategy study. The data were collected by interviews and clinical oral examinations during 2004–2005. Sedative load was measured by means of the sedative load model, and Poisson multivariate regression models were used to estimate relative risk (RR) with 95% confidence intervals (CI). Results: Participants with a sedative load of either 1–2 (n = 31) or ≥3 (n = 12) had an increased likelihood of having carious teeth (RR: 1.8, CI: 1.2–2.6 and RR: 2.4, CI: 1.4–4.1, respectively) compared to participants without a sedative load. There was an inverse association between sedative load and the number of teeth with periodontal pockets. Conclusions: Presence of dental caries was associated with the use of drugs with sedative properties. The use of drugs with sedative properties was not associated with the presence of periodontal pockets

Sedative load and salivary secretion and xerostomia in community-dwelling older people

Abstract Objective: The aim was to investigate how sedative load and the total number of drugs used are related to hyposalivation and xerostomia among 75‐year‐old or older dentate, non‐smoking, community‐dwelling people. Materials and Methods: The study population consisted of 152 older people from the Oral Health GeMS study. The data were collected by interviews and clinical examinations during 2004–2005. Sedative load, which measures the cumulative effect of taking multiple drugs with sedative properties, was calculated using the Sedative Load Model. Results: The results showed that participants with a sedative load of either 1–2 or ≥3 had an increased likelihood of having low stimulated salivary flow (&lt;0.7 ml/min; OR: 2.4; CI: 0.6–8.6 and OR: 11; CI: 2.2–59; respectively) and low unstimulated salivary flow (&lt;0.1 ml/min; OR: 2.7, CI: 1.0–7.4 and OR: 4.5, CI: 1.0–20, respectively) compared with participants without a sedative load. Participants with a sedative load ≥3 had an increased likelihood of having xerostomia (OR: 2.5, CI: 0.5–12) compared with participants without a sedative load. The results showed that the association between the total number of drugs and hyposalivation was weaker than the association between sedative load and hyposalivation. Conclusion: Sedative load is strongly related to hyposalivation and to a lesser extent with xerostomia. The adverse effects of drugs on saliva secretion are specifically related to drugs with sedative properties

Anticholinergic burden and dry mouth among Finnish, community-dwelling older adults

Abstract Objective: The aim was to study whether the anticholinergic burden of drugs is related to xerostomia and salivary secretion among community‐dwelling elderly people. Background: Anticholinergic drugs have been shown to be a risk factor for dry mouth, but little is known about the effects of cumulative exposure to anticholinergic drugs measured by anticholinergic burden on salivary secretion or xerostomia. Methods: The study population consisted of 152 community‐dwelling, dentate, non‐smoking, older people from the Oral Health GeMS study. The data were collected by interviews and clinical examinations. Anticholinergic burden was determined using the Anticholinergic Drug Scale (ADS). A Poisson regression model with robust error variance was used to estimate relative risks (RR) with 95% confidence intervals (CI 95%). Results: Participants with a high‐anticholinergic burden (ADS ≥ 3) were more likely to have xerostomia (RR: 3.17; CI: 1.44–6.96), low‐unstimulated salivary flow (&lt;0.1 mL/min; RR: 2.31, CI: 1.22–4.43) and low‐stimulated salivary flow (&lt;1.0 mL/min; RR: 1.50, CI: 0.80–2.81) compared to reference group (ADS 0). In participants with a moderate anticholinergic burden (ADS 1–2), all the risk estimates for xerostomia, unstimulated and stimulated salivary secretion varied between 0.55 and 3.13. Additional adjustment for the total number of drugs, antihypertensives and sedative load caused only slight attenuation of the risk estimates. Conclusion: A high‐anticholinergic burden was associated with low‐unstimulated salivary secretion and xerostomia