TREATMENT FOR FRAIL ELDERLY – A CHALLENGE FOR ALL DENTAL CARE
The importance of oral health for well-being and quality of life is described in several studies as very high, but is dependent on several factors. The older we get, the more the conditions vary. Oral health varies with socioeconomics and sometimes geography, but the inequality becomes particularly clear when the number of teeth in healthy independent elderly people is compared to the number of teeth in care-dependent elderly people. It shows the importance of regular dental care and that oral health deteriorates when disability and the need for care increase. Contact with dental care throughout life is often of decisive importance. Older generations have many restorations and constructions that require maintenance, both by the individual and the dental care. The demand for advanced dental care has increased among the aging population who often had teeth extracted at a young age. The proportion of patients with dental implants in Sweden has nearly doubled in eight years for the age group 80 years and older. If contact with dental care is lost, oral health can quickly deteriorate. This usually happens in a fragile period of life when even daily oral hygiene becomes increasingly difficult to perform. Frailty is an expression of general increased sensitivity to suffering from various diseases and loss of function, but there are some conditions that are often noted in connection with deteriorating oral health and lost dental contact. Parkinson's disease, stroke and cognitive impairment/dementia have strong links to oral health, as does dry mouth, which occurs in many different diseases and conditions, not least due to pharmacological reasons. The article provides a background to this and examples of three different patient categories and the care related to care ambition levels, a concept that has been created to describe the balance between what dental care can achieve and what conditions the patient in question has to undergo and receive the treatment. It is based on Swedish circumstances but to important parts suitable even for other Nordic countries.