Seniors Oral Health in Southeast Alaska

总结 寿命的增加，牙齿脱落的减少，牙周疾病的增加，冠和根 随着年龄的增长，龋齿导致需要口腔保健的老年人数量增加。 龋齿和牙周病不成比例地影响阿拉斯加土著老年人：他们是3倍 更有可能有未经治疗的龋齿和1.7倍更有可能患牙周病比 美国总人口。缺乏对这些口腔疾病预后的前瞻性研究， 特别是那些解构种族和民族差异的作品。这个研究项目的目标是 了解患有牙周病和/或龋齿的老年患者的结果， 疾病控制成功的预后因素，重点是阿拉斯加土著老年人。 我们的主要目的是分别估计牙周炎和龋齿的36个月成功率 管理老年患者的整体，和阿拉斯加原住民/美国印第安人老年人。我们的次要目标 1）确定医生、患者、口腔环境和牙齿水平的预后特征 与36个月成功的疾病控制策略相关; 2）描述初始疾病诊断 从业人员使用的管理策略，以及相关因素。 我们将通过在部落医疗保健中进行前瞻性队列预后研究来实现这些目标。 该组织服务于阿拉斯加东南部的城市和偏远农村地理位置。本观察性 在这项研究中，大约600名患有牙周炎和/或龋齿的患者将被系统地招募， 随访了三年。关于口腔健康、患者和提供者特征以及诊断和 将在基线时收集疾病管理策略，并在入组后每年收集一次，直至3年。这 这项研究是创新的，与公共卫生和临床研究高度相关，因为它解决了缺乏 严格的前瞻性美国基于实践的老年口腔健康研究，以及预后的不确定性， 在治疗口腔健康差异最大的患者的口腔疾病时， 通过预后研究，我们可以获得关于如何潜在地改善临床决策的重要知识 更好的阿拉斯加原住民老年口腔健康。

SUMMARY The increase in longevity, reduction in tooth loss, increase in periodontal diseases and coronal and root dental caries with aging are contributing to an increased number of seniors with oral health care needs. Dental caries and periodontal diseases disproportionately affect Alaska Native older adults: they are 3 times more likely to have untreated dental caries and 1.7 times more likely to have periodontal disease than the overall United States population. Prospective studies on the prognosis of these oral disorders are lacking, particularly those deconstructing racial and ethnic differences. The goal of this research project is to understand outcomes of geriatric patients with periodontal diseases and/or dental caries and identify prognostic factors for success in disease control, with a focus on Alaska Native seniors. Our primary aim is to estimate, separately, 36-month success rates for periodontitis and dental caries management for geriatric patients overall, and for Alaska Native/American Indian seniors. Our secondary aims are 1) to ascertain practitioner-, patient-, oral environment- and tooth-level prognostic characteristics associated with 36-month successful disease control strategies; and 2) to describe initial disease diagnosis and management strategies used by practitioners, and associated factors. We will accomplish these aims by conducting a prospective cohort prognosis study within a tribal healthcare organization serving urban and remote rural geographical locations in Southeast Alaska. In this observational study, approximately 600 patients with periodontitis and/or dental caries will be systematically enrolled and followed up for three years. Data on oral health, patient, and provider characteristics as well as diagnosis and disease management strategies will be collected at baseline, and yearly up to 3 years after enrollment. This study is innovative and highly relevant to public health and clinical research because it addresses the lack of rigorous prospective US practice-based geriatric oral health research, and the uncertainty in prognosis and prognostic factors when managing oral disorders in patients suffering the greatest oral health disparities. Through prognosis research, we can gain important knowledge on how to potentially improve clinical decision making for better Alaska Native geriatric oral health.