Dental Treatment in a Nursing Home -Relationship between General Condition and Oral Status-

本研究调查了入住养老院的老年人一般状况与口腔状况的关系。大多数人患有高血压、脑血管意外、缺血性心脏病等心血管疾病，80%的人有心电图异常。日常生活活动能力(ADL)越低，口腔状态和口腔功能越差。偏瘫患者由于义齿的放置和延迟困难，义齿的局部修复率明显较低。在患有缺血性心脏病的患者中，口腔状况非常差，因为牙医在进行积极的牙科治疗时犹豫不决。痴呆症患者常因口腔疾病引起食欲不振，我们在该养老院对156例患者进行了2.5年的口腔治疗。患者平均年龄79.7岁。超过一半的患者抱怨义齿带来的麻烦。在此期间，有19名患者死于各种原因。入住养老院的患者口腔状况和一般情况普遍较差。因此，牙科服务在养老院护理中的作用非常重要，因为可以定期对患者进行随访，根据患者的一般情况和口腔状况制定牙科护理计划。对21例养老院心血管疾病患者在牙科治疗过程中进行血压和心电图监测。心律失常，如室性早搏或房性早搏，经常出现在牙科治疗期间，甚至在静息时心电图正常的患者中也是如此。血压升高倾向于在牙科治疗过程中发生。

In this study, the relationship between general condition and oral status was investigated in the geriatric subjects who were staying in a nursing home. Most of them suffered from cardiovascular disease such as hypertension, cerebrovascular accident, and ischemic heart disease and 80% of them showed abnormal electrocardiogram. It became apparent that the lower activity of daily life (ADL) was, the poor oral status and oral function were. The rate of partial denture was remarkably low in the patient with hemiplegia because of the difficulty in setting and putting off it. In the patient with ischemic heart disease, oral status was very poor because dentists hesitated to perform aggressive dental treatment. Loss of appetite was often induced by oral disease in the patient with dementia.We performed dental treatment on 156 patients in this nursing home for 2.5 years. The mean age of the patients was 79.7 years old. More than half patients complained of the trouble associated with denture. During this period, 19 patients died from various reasons. The oral status and general condition in patients staying in the nursing home is generally poor. Therefore the role of dental service in the nursing home care is very important because a patient can be followed regularly and dental care can be planed according with patients's general and oral condition.Blood pressure and electrocardiogram were monitored during dental treatment in 21 patients with cardiovascular disease in this nursing home. Arrhythmias such as premature ventricular or attrial contraction were often presented during dental treatment even in the patient who presented normal electrocardiogram at rest. The elevation of blood pressure tended to occur during dental treatment.