Oral health related quality of life of the frail and dependent elderly

Abstract

Necessary approach to a patient in the 21st century understands not only analyzing physical condition, but also social and psychological aspect of an individual. In frail and dependent elderly who are residents of the long term institutions and hospitals, every aspect of health is jeopardized. Missing natural teeth and functional prosthetic constructions makes their medical condition worse, because of impossibility of adequate nutrition intake and communication. Aim of this work is to determine in what degree oral condition influence quality of life of frail and dependent elderly. Fifty patients (32 women and 18 men) were questioned in Institute for Geriatric Medicine, Hospital center 'Zvezdara'. Oral examination was done, including dental status, condition of the mucosa and periodontal tissues, and the presence of prosthetic constructions and their functionality. Quality of life was examined with questionnary OHIP (Oral Health Impact Profile) which gives information about possibility of oral functioning (speech, mastication, swallowing, presence of pain etc.) in the present condition (with or without natural teeth or prosthetic constructions). It was determined that 36 patients had score which shows high negative influence of oral condition on the quality of life. In that group of patients, dominant were women. Prosthetic care and rehabilitation is necessary in population of the frail and dependent elderly, in order to, at least maintain quality of life as it is, and to avoid more complication of the general health condition.

Neophodan pristup zdravlju u 21. veku podrazumeva obavezan osvrt ne samo u fizičko stanje nego i u socijalni i psihički aspekt svake individue. Kod pacijenata smeštenih u bolnice i staračke domove svi aspekti zdravlja su ugroženi. Nedostatak prirodnih zuba i adekvatnih zubnih nadoknada dodatno narušavaju fizičko i mentalno zdravlje ove populacije zbog nemogućnosti adekvatne ishrane ili komunikacije sa okolinom. Cilj rada je utvrđivanje stanja oralnog zdravlja kao i njegovog uticaja na kvalitet života pacijenata zavisnih od tuđe nege. U okviru Instituta za gerijatriju Kliničko Bolničkog Centra Zvezdara ispitano je 50 pacijenata (32 žene i 18 muškaraca). Stomatološkim pregledom utvrđeni su dentalni status, stanje potpornih tkiva prisutnih zuba, prisustvo zubnih nadoknada i njihova funkcionalnost. Uticaj koji stanje oralnog zdravlja ima na kvalitet života ispitan je pomoću upitnika OHIP (Oral Health Impact Profile) koji ispituje mogućnost funkcionisanja (govor, žvakanje, gutanje, prisustvo boli itd.) sa postojećim stanjem zuba i eventualno prisutnih zubnih nadokada. Utvrđeno je da 36 pacijenata ima skor koji pokazuje visok uticaj narušenog oralnog zdravlja na kvalitet života. Sa negativnim uticajem dominiraju osobe ženskog pola. Stomatološko zbrinjavanje i protetska rehabilitacija su neophodni kod pacijenata i oni se odvijaju u otežanim uslovima kako se već narušeno zdravstveno stanje i kvalitet života ne bi dodatno komplikovali.