ความจำเป็นในการรับบริการทางทันตกรรมป้องกันรายบุคคลโดยทันตบุคลากรสำหรับผู้สูงอายุในพื้นที่ตำบลชัยนาม อำเภอวังทอง จังหวัดพิษณุโลก

Abstract

This study was a cross sectional study aimed to finding the individual oral preventive needs by dental professional for older people so that information could be used in preparing plans for oral health intervention in Thai aging society. The study was conducted in Chai Nam Subdistrict, Wang Thong District, Phitsanulok Province during October 2018 to February 2019.The study sample was 370 elderly people aged 60 years old and over. Data was collected by examining oral conditions and interviewing personal information related tot oral health. The study results showed that the sample mean age was 70.2 ± 7.1 years. Accoriding to activities of daily living (ADL) index, 85.4% were social-bound, 10.8% were bed-bound and 3.8% were home-bound. Among all participants, 67.6% had underlying disease. The average number of functional teeth was 12.5 ± 7.9 teeth/person. The mean of DMFT was 18.7 ± 7.8 teeth/person. There were 10.5% of participants who were reported as total tooth loss. The mean of sextant with teeth is 4.4 ± 2.0. 87.8% of participants had gingivitis and 74.3% had periodontitis. Oral hygiene of samples at low, fair and good levels was 62.7%, 22.1% and 4.8%, respectively. The mean of tooth wear at the incisal, occlusal and cervical area were 4.3 ± 3.8, 3.0 ± 3.5 and 2.1 ± 2.5 teeth/person respectively. Oral tissue abnormalities were found in 9.7% of the participants. Positive mouth mirrors stuck test was 6.8%. The sample group reported sufficient medical history to plan a dental treatment and did not demonstrate legal or ethical barriers. In detail, samples with ability to cooperate fully were 95.9%, have sufficient communication ability 94.6%, no restrictions on access to services 85.4 % and severe oral risk factors 61.4%. Number of underlying disease, average number of functional teeth, mean DMFT, number of total tooth loss, mean oral sextant with teeth, number of periodontal disease, tissue abnormalities and mouth mirrors stuck test, complexity, including ability to cooperate, communication, access to services, oral risk factors in each category of the elderly, was statistically different (P-value <0.05) among types of geriatric population. In the caries prevention, participants who show condition with most suitable for fluoride varnish fluoride was 81.9%. The mean number of crown and root to be filled is 0.7 ± 1.1 and 0.3 ± 0.6 teeth/person respectively. Subjects who need dental care from dental nurse and dentist were 66.2% and 18.4%, respectively. Proportion of service locations appropriate for dental needs and condition of study subjects, including hospital and homes, were 82.4% and 2.2%, respectively. For periodontal care, subjects who need periodontitis prevention, including dental polishing, scaling, root planing and periodontal surgery were 4.1%, 20.8%, 14.1% and 43.5% respectively. Proportions of participants who need dental care from dentist and dental nurse was 71.5% and 17.1%, respectively. 82.4% of participants required their periodontal care in hospital. Samples who needed oral cleaning assistance were 6.2%. Dental health personnel suitable to provide oral cleaning assistance was dental nurses and setting suitable for this type of care was at the home of themselves. There were statistically significant differences among elderly groups (P-value <0.05) on the type of preventive care required, as well as service providers and place of service. The bed-bound group had a high level of complexity in receiving dental care, and tended to have a greater need for care than other elderly groups. There were significant differences between complexity in bed-bound group with those in social-bound and home-bound group. Therefore, different dental service models should be developed, such as providing home dental services for the elderly if necessary, preliminary screening from a multidisciplinary team of family doctors. In addition to treatment planning among the elderly, preventive measures for oral diseases should be emphasized to the pre-aging group, both providing knowledge on the routine practice to reduce the risk factors of disease and receiving preventive dental services by dental personnel in conjunction with oral health promotion activities in the same time