JDE
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Dent Educ. 70(12): 1261-1262 2006
© 2006 American Dental Education Association
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Montandon, A. A.B.
Right arrow Articles by Fais, L. M.G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Montandon, A. A.B.
Right arrow Articles by Fais, L. M.G.

Quality of Life and Oral Hygiene in Older People with Manual Functional Limitations

Andréia A.B. Montandon, Ph.D., Associate Professor of General Clinic  ; Lígia A.P. Pinelli, Ph.D., Associate Professor of Fixed Prosthodontics  ; Laiza M.G. Fais, Postgraduate Student (Ms.D.) in Oral Rehabilitation  

Dear Dr. Alvares:

As life expectancy has increased, the proportion of older people has grown faster than that of any other segment in the world population.1 With aging, the physical incapacities associated with chronic diseases increasingly render the elderly more susceptible to stress and infections and less capable of performing daily activities.2 One of the main systemic alterations that can cause incapacities is rheumatoid arthritis (RA). One problem associated with RA is the reduction of the manual ability necessary to efficiently perform a complete oral cleaning.

Since there is a need for these patients to be independent in their daily life activities, the dentist must encourage their active participation in the oral hygiene process by promoting awareness and stimulus and providing mechanical assistance that takes into account their reduced motor skill and ability to grip objects. In effect, dentists should use the basic concepts of occupational therapy in a multidisciplinary manner for patients with RA.

In order to increase the gripping strength of patients with RA to the palms of their hands, it is necessary to thicken the toothbrush handle. This can be done by adapting bicycle handle sleeves to the toothbrush handle with the aid of condensation silicone (putty consistency) (see Figure 1Go). The sleeve can be used to improve the older person’s grip strength on the toothbrush, frequently with reduced grip force.


Figure 1
View larger version (37K):
[in this window]
[in a new window]

  		Figure 1. Toothbrush with thickened handle

 
The toothbrush handle may also be individualized with a mold of the patient’s hand made with condensation silicone. The mold can be separated into two parts and pressed in acrylic resin; then, the toothbrush handle is inserted between the two parts, which are held together with acrylic resin (see Figure 2Go).


Figure 2
View larger version (42K):
[in this window]
[in a new window]

  		Figure 2. Acrylic resin device made from the mold

 
Patients with RA may also use an electric toothbrush, but if the patients’ condition allows it, cleaning with a manual toothbrush and opting for smooth circular movements could allow the patient to have better joint and muscle stimulation.

The use of a bicycle handle sleeve on a toothbrush handle for patients with RA, together with reduced grip force, is a simple procedure that not only improves patients’ integration in the oral hygiene treatment process, but also contributes to the multidisciplinary therapy of joint and muscular stimulation, thereby promoting greater independence and better emotional conditions.

The dentist must make a complete assessment of elderly patients’ degree of dependence and their motor conditions for performing oral hygiene, so that caregivers can be taught to respect their limitations and provide ways to overcome these limitations. In addition, caregivers must encourage the elderly person to be as independent as possible.

Footnotes

Department of Social Dentistry, andreiam{at}foar.unesp.br

Department of Dental Materials and Prosthesis, ligia{at}foar.unesp.br

Department of Dental Materials and Prosthesis, lamgf_2005{at}yahoo.com

All at Araraquara Faculty of Dentistry-UNESP, Araraquara-SP, Brazil.

REFERENCES

  1. Petersen PE, Yamamoto T. Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2005; 33(2):81–92.[Medline]
  2. DeBiase CB, Austin SL. Oral health and older adults. J Dent Hyg 2003; 77(2):125–45.[Medline]



This article has been cited by other articles:


Home page
 Journal of the American Dental AssociationHome page
C. Scully and R. L. Ettinger
The Influence of Systemic Diseases on Oral Health Care in Older Adults
J Am Dent Assoc, September 1, 2007; 138(suppl_1): 7S - 14S.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Montandon, A. A.B.
Right arrow Articles by Fais, L. M.G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Montandon, A. A.B.
Right arrow Articles by Fais, L. M.G.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS