Dental treatment in the elderly

According to WHO experts, by 2005, more than 1 billion people stepped over the 60-year milestone.However, only in nursing homes in Germany in 2000, 1.56 million people were living elderly, accounting for 4.5% of the population as a whole.According to sociological studies conducted in the US, by 2030 the number of persons older than 65 years will exceed the current level of 2 times.

in Russia by 2012 the number of pensioners will exceed the level of 25% - more than 38 million people (that is, make a quarter of the country's population).Currently, the concept of "aging" is defined as a natural result of the actions of all the processes leading to a decrease in the ability to adapt.

aging react all the organs and systems of the body: is their destruction on the one hand, and adaptation to the new conditions of existence and life on the other.With age, it narrows the range of adaptive mechanisms (biological and social): difficult adaptation of an old man to the pace of life, reduced resistance to stress f

actors.

In the age group of 75 years more than 50% have a combination of three or more chronic diseases predisposing to multiple physical, mental and social problems.

With regard to dental care for patients of elderly and senile age, its effectiveness depends on the following blocks are inextricably linked, and problems.

relationship of somatic and dental diseases in elderly and senile patients is widely discussed in the literature.On average, during the examination of patients of elderly and senile diseases is determined 3-5.The flow of pathological and adaptive processes in the mouth in patients of geriatric age, burdened by chronic diseases of internal organs, and especially their combination - comorbidity, has been insufficiently studied.This makes the problem of efficiency and quality of dental treatment for patients with middle and old age is particularly important.

comorbid condition in elderly patients not only significantly affect the state of health of the body as a whole and the organs and tissues of the mouth in particular, but also to determine the prognosis of dental treatment.

Ignorance of the concept of comorbidity dentist can lead to serious medical errors causing iatrogenic disease at all stages of treatment, as well as a significant impact on its long-term results.

aggravates dental pathology system somatic diseases often nullify the hard work of dentists, surgeons, podiatrists, therapists and other related specialized professionals.

But so widespread in Soviet times, clinical examination is rarely used today by dentists, efficiency and effectiveness of its recently decreased, less share in the practical work.

Particularly affected in this aspect of dental patients are burdened by systemic somatic pathology imposes unfavorable mark on the clinical course and treatment of dental caries, pulpitis, periodontitis, periodontal disease, temporomandibular joint.Contribute to this and the lack of well-designed criteria, deadlines, the multiplicity of clinical examination, evaluation of its effectiveness, as well as the lack of dentists specialized knowledge of the clinic and diagnosis of somatic pathology.

More than 64.2% of the surveyed patients older than 60 years suffer from complete loss of teeth, 50% of surveyed patients have disturbances in chewing food, more than 70% are not satisfied with the condition of the mouth and are uncomfortable in everyday life.

That is among dental pathologies first place in patients with middle and old age takes the loss of teeth, followed by functional impairment in the dentition in the absence of timely assistance from the dentists.

patients of older age groups unevenness atrophy of the upper and lower jaw, malocclusion, there are characteristic changes in the CPU index, reduces the volume of the mouth occurs atrophy of facial and masticatory muscles, as well as the change in the position and condition of the temporomandibular joint.Active and multifaceted study of the problem of providing quality dental care for patients of elderly and senile both abroad and in the Russian Federation, provides a basis for the allocation of a special section of modern dentistry - gerontostomatologiya.

analysis of the situation of older people in Russia for socio-demographic and economic parameters allow to state their dissatisfaction with the state of their own health, including dental, needy, lonely and, as a result, social maladjustment.

In the current socio-economic conditions, needs and requirements of elderly patients are not fully accounted for by the state.Services of private dental clinics are usually inaccessible.At the state and municipal sectors of the modern health care system does not have sufficient economic motivation for dentists to assist this contingent, and operating the CHI system does not provide the solution of dental problems and does not create sufficient economic motivation of dentists working in the public health system to provide quality,individually tailored services to patients in this group.

In fact, the policy of recent years has led to discrimination more than 1/4 of the population of our country in terms of getting dental care, especially high-tech methods of prevention and treatment of dental diseases.The absence of state regulation of this area has led to a substantial backlog of domestic gerontostomatologii from existing programs providing dental care geriatric patients in other developed countries where comprehensive, adequate and most effective solution to the problems of patients with middle and old age in the co-financing of special programs involving both private and publicfunds and insurance companies, municipal authorities.

existing financial failure, especially noticeable in the surgical and orthopedic treatment, has changed significantly as the structure of dental disease among patients with middle and old age, and severely restricted the possibility of obtaining high-quality and skilled care of a dentist (general practitioner, surgeon, orthopedist).Despite the obvious connection between aging and maladjustment of the teeth-jaw system, geriatric contingent, constantly increasing, has fewer opportunities to exercise their constitutional right to affordable and sometimes free medical care, that is, to date, no state dental policies relating to suchnumerous and socially significant contingent as the elderly and the elderly.

appropriate, be increased attention to this issue leads to the creation of new educational programs for dentists, gerontostomatologii allocation of a separate discipline and the creation of specialized programs in this specialty.

Currently this section is not very promising and unattractive from a financial point of view.This situation can be changed when you create a new strategy for public financing programs for the prevention and treatment of dental diseases in elderly patients through improved by gerontostomatologii training programs for dentists, surgeons, increase competence of the clinic and diagnosis of somatic pathology, improving interaction modelsdentists with specialist general medical profile.

In connection with the above, it becomes apparent relevance, as well as great theoretical, scientific and practical significance, social significance of the creation doctrine development gerontostomatologii, in particular relating to means testing, providing scope, effectiveness and prospects for the implementation of emergency and planned surgical dental care for patients of elderly and senile agebased on a multidisciplinary approach and the integration gerontostomatologii the state funding system.

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