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Necessidade de execução de tratamentos de saúde oral em idosos institucionalizados

Authors: Cardoso, Ricardo José da Silva;

Necessidade de execução de tratamentos de saúde oral em idosos institucionalizados

Abstract

Introdução: o impacto da ausência de saúde oral é profundo quando relacionado com a Qualidade de Vida (QdV). Nos idosos, as manifestações mais comuns são: cárie radicular, xerostomia, lesões dos tecidos moles, doença periodontal, edentulismo, abrasão/erosão dentária, halitose, dificuldade de mastigação e deglutição, algumas delas associadas à polimedicação e doenças sistémicas, que vão influenciar a dificuldade de higienização da boca, necessidade de prótese e crescente dependência de terceiros. Objetivos: verificar prevalência da necessidade de tratamentos orais em idosos institucionalizados e verificar a eficiência dos cuidados orais pelos auxiliares geriátricos. Métodos: Efetuou-se um estudo transversal, baseado em duas amostras randomizadas - idosos institucionalizados em Viseu e funcionários da instituição. Nos idosos, recolheram-se informações sociodemográficas e económicas, contextos medicamentosos e clínicos, de condição (Índice CPO) e higienização orais, grau de autonomia (Índice de Barthel), estado nutricional com o Mini Nutritional Assessment (MNA®), auto-perceção da saúde (SF-36v2™) e relação entre a saúde oral e a qualidade de vida com o Oral Heath Impact Profile (OHIP-14), tendo-se apurado no final as necessidades de execução de tratamentos dentários. Nos funcionários, para alem dos dados sociodemográficos, verificou-se a sua condição oral com o Oral Health Assessment Tool (OHAT) e a atitude cuidadora e promotora dos cuidados bucais para com os utentes do lar. Resultados: amostra de idosos maioritariamente feminina, idade média de 79,6 anos, sobretudo viúva ou solteira; medicação associada especialmente a patologias dos sistemas cardiovascular e nervoso central; elevado edentulismo; níveis de halitose baixos, alguma auto-perceção de boca seca (42,8%), dificuldade em mastigar alimentos duros; maioria da amostra com falta de hábitos de higienização e de consulta em dentária, cujo principal motivo se referiu a próteses; número de funcionalmente independentes reduzido (16,9%); valores de Índice de Massa Corporal (IMC) equilibrados e presença de risco de desnutrição para 50,7% da amostra; desconforto frequente na alimentação devido a problemas orais; 23.6% relatam saúde fraca e 2,9% dores corporais fortes; 79% necessitam de execução cuidados orais, em que protéticos (78.8%), exodontias (12.4%), dentisteria (24.8%), Periodontologia (10.6%). Dos funcionários, a maioria assume que o lar promove a higiene oral, que as próteses são limpas, que os idosos têm boa saúde oral. Conclusões: há elevada necessidade de intervenção na saúde oral dos idosos institucionalizados, embora isso não se reflita diretamente na QdV, exceto na alimentação; e os cuidadores na sua maioria demostrou assertividade nos cuidados orais aos residentes.

Introduction: the impact of the absence of oral health is profound when related with Quality of Life. In the elderly, the most common manifestations are root decay, dry-mouth, soft tissue injuries, periodontal disease, tooth loss, abrasion / erosion on tooth, halitosis, difficulty chewing and swallowing, some of them associated with polypharmacy and systemic diseases, which will influence the difficulty of oral hygiene, the need for prostheses and a growing dependence on third parties. Objectives: verify the prevalence of need for oral treatment among institutionalized elderly and verify the effectiveness of oral care by geriatric aides. Methods: it has been conducted a cross-sectional study, based on two random samples - institutionalized elderly in Viseu and employees of the same institution. In the elderly, it has been collected sociodemographic and economic information, pharmacological and clinical settings, oral condition (CPO Index) and oral hygiene, degree of autonomy (Barthel Index), nutritional status with the MNA®, self-perception health test(SF-36v2 ™) and the relationship between oral health and quality of life with the OHIP-14 test; and at the end enumerated the needs of dental treatments. In employees, beyond the demographic data, it has been measured their oral condition with the OHAT and their attitude and promotion of oral care for the home users as a caregiver. Results: mostly female sample, average age of 79.6 years, mostly widowed or single; medication especially associated with the cardiovascular and central nervous systems disease’s; high edentulism; low levels of halitosis, some self-perception of dry mouth (42.8%), difficulty in chewing hard food; most of the sample with lack of hygiene habits and dental consultation, the main reason referred to prostheses; reduced number of functionally independent (16.9%); balanced values of body mass index and the presence of risk of malnutrition for 50.7% of the sample; discomfort due to frequent oral feeding problems; 23.6% reported poor health and 2.9% stronger body aches; 79% require implementing oral care, in which prosthetic (78.8%), extractions (12.4%), dentistry (24.8%) and periodontology (10.6%). Employees, the majority assumes that the institution promotes oral hygiene, that dentures are clean, that the elderly have good oral health. Conclusions: There is high need for intervention in the oral health of institutionalized elderly, although this is not reflected directly in Quality of Life, except for nourishing; and caregivers mostly demonstrated assertiveness in oral care for residents.

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Portugal
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Keywords

Idosos, Elderly, Oral health, Institucionalizados, Cuidados da cavidade oral, Saúde oral, Institutionalized, Domínio/Área Científica::Ciências Médicas::Ciências da Saúde, Oral cavity care

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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