The purpose of this study has been to assess the prevalence of denture stomatitis and candida infection in an elderly Danish population. Ten percent of the population above the age of 65 in a Danish community was selected randomly. The study group consisted of 465 persons wearing a removable maxillary denture, who were examined in their homes. Yeasts were isolated by oral swabs for cultivation and by mucosal and denture scrapings for microscopy. The prevalence of denture stomatitis was 65%. Yeasts, especially C. albicans, were cultivated in most denture wearers with denture stomatitis (Group 1) or with clinically normal palatal mucosa (Group 2). However, large accumulations of hyphae were present in 77% of the patients in Group 1 compared with 47% in Group 2; both hyphae and inflammatory cells were seen in smears in 65% of Group 1 but only in 14% of Group 2. On the other hand, bacterial contamination of the smears was more pronounced in Group 2 than in Group 1. The study has revealed that candida infection and poor denture cleanliness are very common in elderly denture wearers.
It is interesting and often useful to compare and contrast individuals from different countries who decide on careers in dentistry. Such data can help provide a broadened perspective from which inferences about future patterns of specialization and distribution of manpower in America may be made. This study compares the backgrounds and plans for dental practice of dental students in the United States and Sweden. The similarities that American and Swedish dental students share relate to strong parental influence, time of decision to attend dental school, origins in urbanized areas, interest in direct patient care, uncertainty about specialty training, and a lack of prior health-related experience among males in both countries. The differences in the dental students of the two nations are more pervasive and may be explained in part by the ways the two countries have organized and financed dental education and dental care.
Ontario's Geriatric Preventive Dentistry Program (mandated under the Health Protection and Promotion Act) is assessed using the rational comprehensive approach. Policy options are examined, taking into account population characteristics, the nature of the health problem, current service delivery policy and resources, and barriers to access. Examining the 1974 Task Force recommendations, sets of draft guidelines issued in 1982, 1983, and 1984, and the revised 1985 guidelines as implemented, one can note changes in the benefits offered and in eligibility for coverage. The final program appears to be largely a symbolic policy response, which is unlikely to have major implications for either efficiency or community effectiveness. Implications of the current program, including the possibility it may be a precursor to more effective policies, are noted.
Comment In: Can J Public Health. 1989 Jul-Aug;80(4):3062790641
This article reviews access to and financing of dental care for aging populations in selected nations in Europe. Old age per se does not seem to be a major factor in determining the use of dental services. Dentition status, on the other hand, is a major determinant of dental attendance. In addition to perceived need, a variety of social and behavioral factors as well as general health factors have been identified as determinants of dental service use. Frail and functionally dependent elderly have special difficulties in accessing dental care; private dental practitioners are hesitant to provide dental care to these patients. One reason may be that the fee for treating these patients is too low, considering high dental office expenses. Another reason may be problems related to management of medically compromised patients. This raises an important question: does inadequate training in geriatric dentistry discourage dentists from seeking opportunities to treat geriatric patients? Overall, the availability of dental services, the organization of the dental health care delivery system, and price subsidy for dental treatment are important factors influencing access to dental care among older people in Europe as well as in the United States.