Envelhecimento populacional: Desafios e estratégias na integração da geriatria com a saúde coletiva

Introduction: The phenomenon of population aging has emerged as a striking feature of contemporary societies, representing a significant shift in the age structure of populations worldwide. The increase in life expectancy and the decrease in birth rates are determining factors in this scenario, contributing to a progressive rise in the proportion of elderly individuals compared to other age groups. Methodology: To identify existing literature, specific MESH descriptors were chosen, encompassing key areas of research, including "Geriatrics," "Public Health," "Aging," and "Obesity." These terms were selected due to their relevance in analyzing challenges and strategies related to population aging. Results: Accessibility to quality healthcare services, suitable housing conditions, and financial resources are determining elements for the well-being of this population. Therefore, intervention strategies should address not only clinical issues but also the social and economic dimensions influencing the health of the elderly. Conclusion: Attention to the specific needs of geriatrics is crucial to ensure that the growing elderly population receives healthcare tailored to their unique characteristics. Recognizing clinical conditions, addressing obesity in the elderly, promoting mental health, and considering socio-economic disparities are critical elements for effective and compassionate practice in geriatrics.Introdução: O fenômeno do envelhecimento populacional tem se manifestado como uma marcante característica das sociedades contemporâneas, representando uma mudança significativa na estrutura etária das populações ao redor do mundo. O aumento da expectativa de vida e a diminuição das taxas de natalidade são fatores determinantes desse cenário, contribuindo para um aumento progressivo da proporção de idosos em relação aos demais grupos etários. Metodologia: Para identificar a literatura existente, foram escolhidos descritores MESH específicos que abrangem as áreas-chave da pesquisa, incluindo "Geriatrics", "Public Health", "Aging" e "Obesity". Esses termos foram selecionados devido à sua pertinência na análise dos desafios e estratégias relacionados ao envelhecimento populacional. Resultado: . A acessibilidade a serviços de saúde de qualidade, condições de moradia adequadas e recursos financeiros são elementos determinantes para o bem-estar dessa população. Portanto, estratégias de intervenção devem abordar não apenas as questões clínicas, mas também as dimensões sociais e econômicas que influenciam a saúde dos idosos. Conclusão: A atenção às necessidades específicas da geriatria é fundamental para garantir que a crescente população idosa receba cuidados de saúde adequados e adaptados às suas particularidades. O reconhecimento das condições clínicas, a abordagem da obesidade na terceira idade, a promoção da saúde mental e a consideração das disparidades socioeconômicas são elementos cruciais para uma prática eficaz e compassiva na geriatria

In situ effect of a sodium bicarbonate solution on enamel after simulation of endogenous dental erosion.

Uma das medidas recomendadas para o controle da progressão de lesões de erosão dental de origem intrínseca é o enxágüe bucal com solução de bicarbonato de sódio, visando à neutralização de ácidos gástricos presentes na boca. Contudo, a prescrição de tal solução faz-se em bases empíricas. Assim, este estudo avaliou, através de um modelo in situ, o efeito de uma solução de bicarbonato de sódio no controle da erosão dental causada por desafios ácidos endógenos. Este estudo caracterizou-se por um experimento do tipo cross-over 2x2, composto por duas fases experimentais de 5 dias cada. Após um período de lead-in de 2 dias, quatorze voluntários utilizaram dispositivos intrabucais contendo, em cada lado (direito e esquerdo), um fragmento de esmalte bovino polido, esterilizado e delimitado de modo a obter áreas hígidas de referência. Duas vezes ao dia, um dos espécimes foi exposto, ex-vivo, à solução de ácido clorídrico (0,01 M, pH = 2) por 2 min. Imediatamente após, os aparelhos foram reinseridos na boca e os voluntários realizaram enxágüe bucal com solução de bicarbonato de sódio ou água deionizada por 1 min. Após um período de wash-out de 2 dias, os voluntários iniciaram a segunda fase empregando a substância alternativa para o enxágüe bucal. Ao término das duas etapas, foram avaliadas a profundidade de desgaste através de perfilometria ótica e a microdureza Knoop. ANOVA e o teste de Tukey demonstraram que o desgaste do esmalte foi significativamente reduzido quando se empregou a solução de bicarbonato de sódio para o enxágüe bucal. Para a microdureza, ANOVA demonstrou apenas presença de diferença significativa em função da condição do substrato (p < 0,0001). Os espécimes erodidos apresentaram valores de microdureza significativamente menores do que o grupo não submetido ao desafio ácido. O enxágüe bucal com solução de bicarbonato de sódio controlou a erosão no esmalte submetido a simulações de episódios erosivos endógenos.One of the recommended measures to control dental erosion of intrinsic origin is the oral rinse with sodium bicarbonate solution, which has been suggested to neutralize the gastric acid regurgitated into the oral cavity. However, the efficacy of this prescription has not yet been proved. Therefore, the aim of this study was to evaluate in situ the effect of a sodium bicarbonate rinse in the control of dental erosion in enamel exposed to gastric acid-like solution. This study comprised two experimental legs. After a 2-day lead-in period, fourteen volunteers wore palatal devices containing two polished, sterilized enamel slabs. Throughout the experimental period of 5-d, one of the two specimens was exposed twice daily extra-orally to hydrochloric acid solution (0,01 M, pH=2) for 2 min. Immediately after, devices were reinserted in the mouth and volunteers rinsed their oral cavity with a sodium bicarbonate solution or deionized water for 60s. In the second leg of this study, after a 2-day washout period, appliances were refilled with a new set of enamel specimens and participants were crossed over to receive the alternate rinse. The wear depth accessed using optical profilometry and Knoop surface microhardness were evaluated. Analysis of Variance (ANOVA) and Tukey\'s test demonstrated that wear of enamel was significantly reduced when a sodium bicarbonate solution was used to rinse the oral cavity following erosive episodes. For microhardness, ANOVA demonstrated only significant differences in function of the enamel condition (p < 0,0001). The eroded specimens presented microhardness values significantly lower than the group not submitted to the acid challenge. Sodium bicarbonate rinse controlled erosion of enamel caused by gastric acid-like solution

Potential effect of sodium bicarbonate-containing dentifrice in controlling enamel erosion in situ

Purpose: To assess, by a crossover 2 x 2 in situ study, the speculated protective role of a sodium bicarbonate-containing toothpaste in controlling erosive lesions. Methods: Bovine enamel slabs were sterilized, and submitted to baseline Knoop microhardness measurements. After a 3-day lead-in period, 14 volunteers wore palatal acrylic appliances containing six enamel slabs (three on each side), for 4 consecutive days. On the first day, appliances with contained specimens were placed in the oral cavity to allow salivary pellicle formation. On the subsequent days, half of the enamel slabs were immersed extraorally in a lemonade-like soft drink for 90 seconds, twice daily. On both of these occasions, the appliance was dipped in toothpaste slurry of either a sodium bicarbonate-containing toothpaste or a regular counterpart for 60 seconds. Following a 3-day washout period, a new set of enamel slabs were mounted and the volunteers started the second period using the alternate dentifrice. Results: ANOVA (alpha = 0.05) showed no statistically significant difference between enamel treated with regular and sodium bicarbonate-based dentifrices, regardless of whether specimens were eroded or not (P=0.8430). Acid-challenged specimens revealed lower microhardness values than uneroded samples. (Am J Dent 2008;21:300-302).CAPESCNPqFAPESP[#2006104550-1

Impact of chemical agents for surface treatments on microhardness and flexural strength of root dentin

This study assessed the cross-sectional Knoop microhardness and flexural strength of root dentin exposed to different surface treatments with chemical agents after biomechanical preparation. Root canals from human canines were biomechanically treated and divided into eight groups (n=10) to receive one of the following dentin treatments: I. Deionized water (control); II. 5.25% Sodium hypochlorite (NaOCl); III. NaOCl + 10% Sodium ascorbate (SA); IV. SA; V. 2% Chlorhexidine gel (CHX); VI. 37% Phosphoric acid gel (PA) + CHX; VII. PA; and VIII. PA + NaOCl. The roots were sectioned to obtain specimens that were evaluated for cross-sectional Knoop microhardness and flexural strength using a three-point bending test. ANOVA and Tukey’s test were performed. The microhardness in the control group was significantly higher (p 0.05) to each other. Regarding flexural strength, PA+NaOCl provided statistical higher values than PA+CHX and CHX. However, there was no significant difference between the control group and those groups subjected to surface treatment (p > 0.05). Dentin microhardness was reduced after exposure to NaOCl, CHX, PA, SA and their associations and the flexural strength of radicular dentin was not affected by the chemical agents.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq