Revisión sistemática sobre la prevención de enfermedades bucales en adultos mayores

Norbelis Beatríz Fuentes Moreno, Jesús Alberto Coronado Cisneros

Resumen


Introducción: El envejecimiento es un proceso natural, universal e irreversible, que involucra cambios anatómicos y fisiológicos que no implican una enfermedad ni un trastorno, pero convierten a los adultos mayores en un grupo vulnerable, susceptible a enfermedades bucales prevenibles. Por lo tanto, la prevención de enfermedades y la promoción de la salud bucal es clave en esta población. Objetivo: Determinar la efectividad de los procedimientos odontológicos clínicos y educativos para la prevención de enfermedades bucales en pacientes adultos mayores. Metodología: Se realizó una revisión sistemática de la literatura publicada en los últimos 15 años en las bases de datos: Elsevier, Medline, Wiley Online Library, Europe PMC, SagePub, SpringerLink, Taylor & Francis, BVS y Google Scholar. De los 769 documentos identificados se seleccionaron 30 que cumplieron con los criterios de inclusión. Los estudios primarios fueron evaluados mediante MINORS y los estudios secundarios mediante los criterios de la Biblioteca Cochrane y PRISMA. Resultados: La evidencia respalda la efectividad de las intervenciones educativas dirigidas al personal asistencial y las intervenciones clínicas y educativas dirigidas a los pacientes para prevenir enfermedades bucales en los adultos mayores. La realización de profilaxis dental, aplicación de fluoruro diamino de plata y administración de probióticos también resultaron efectivas como procedimientos preventivos. También, se encontró que las intervenciones preventivas que combinan ambas modalidades realizadas mediante la teleodontología son igualmente efectivas. Conclusión: Las intervenciones que combinan la colaboración del odontólogo, higienistas dentales, personal asistencial y pacientes mediante modalidad presencial o virtual mejoran la salud bucal de los adultos mayores. Por lo tanto, se sugiere su implementación individual, combinada, o mediante la teleodontología en hogares de cuidado, hospitales y residencias particulares. Recibido: 20-03-2021 Aceptado: 01-06-2021


Palabras clave


Enfermedades de la boca; Ancianos; Adultos mayores; Odontología preventiva; Prevención y control

Texto completo:

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Referencias


Aagaard, K., Meléndez, G., & Overgaard, C. (2020). Improving oral health in nursing home residents: A process evaluation of a Shared Oral Care intervention. Journal of Clinical Nursing. https://doi.org/10.1111/JOCN.15373

Albrecht, M., Kupfer, R., Reissmann, D., Mühlhauser, I., & Köpke, S., (2016). Oral health educational interventions for nursing home staff and residents. Cochrane Database of Systematic Reviews, 9, CD010535. https://doi.org/10.1002/14651858.CD010535.pub2. Aquilanti, L.,

Santarelli, A., Mascitti, M., Procaccini, M., & Rappelli, G. (2020). Dental Care Access and the Elderly: What Is the Role of Teledentistry? A Systematic Review. International Journal of Environmental Research and Public Health, 17(23), 9053. https://doi.org/10.3390/ijerph17239053

Aranco, N., Stampini, M., Ibarrarán, P., & Medellín, N. (2018). Panorama de envejecimiento y dependencia en América Latina y el Caribe. División de Protección Social y Salud. Banco Interamericano de Desarrollo. Resumen de políticas NºIDB-PB-273. https://publications.iadb.org/publications/spanish/document/Panorama-de-envejecimiento-y-dependencia-en-America-Latina-y-el-Caribe.pdf

Ástvaldsdóttir, Á., Boström, A., Davidson, T., Gabre, P., Gahnberg, L., Sandborgh, G., Skott, P., Ståhlnacke, K., Tranæus, S., Wilhelmsson, H., Wårdh, I., Östlund, P., & Nilsson, M. (2018). Oral health and dental care of older persons - A systematic map of systematic reviews. Gerodontology, 35, 290–304. https://doi.org/10.1111/ger.12368

Barbe, A., Kottmann, H., Derman, S., & Noack, M. (2019). Efficacy of regular professional brushing by a dental nurse for 3 months in nursing home residents - A randomized, controlled clinical trial. International Journal of Dental Hygiene, 17, 327–335. https://doi.org/10.1111/idh.12389

Barbe, A., Küpeli, L., Hamacher, S., & Johannes, M. (2020) Impact of regular professional toothbrushing on oral health, related quality of life, and nutritional and cognitive status in nursing home residents. International Journal of Dental Hygiene, 18, 238–250. https://doi.org/10.1111/idh.12439

Blanco, F. (2017). Consideraciones actuales sobre la Estomatología Geriátrica y su importancia para una longevidad saludable. Revista Médica Electrónica, 39(1). https://www.medigraphic.com/pdfs/revmedele/me-2017/me171i.pdf

Bustillos, L. (2012). Envejecimiento bucofacial terapéuticas y conductas. Acta Bioclínica, 2(3). http://erevistas.saber.ula.ve/index.php/actabioclinica/article/view/3968/3802

Bustillos, L. (2015). Prevalencia de caries y lesiones bucales en adultos mayores institucionalizados en Mérida – Venezuela. Revista odontológica de Los Andes, 10(2), 19-24. http://erevistas.saber.ula.ve/index.php/odontoula/article/view/6916

Charadram, N., Maniewicz, S., Maggi, S., Petrovic, M., Kossioni, A., Srinivasan, M., Schimmel, M., Mojon, P., & Müller, F. (2020). Development of a European consensus from dentists, dental hygienists and physicians on a standard for oral health care in care-dependent older people: An e-Delphi study. Gerodontology, 00, 1–16. https://doi.org/10.1111/ger.12501

Cochrane Collaboration. (2011). Handbook for Systematic Reviews of Interventions 5.1.0. https://crtha.iums.ac.ir/files/crtha/files/cochrane.pdf

Croonquist, C., Dalum, J., Skott, P., Sjögren, P., Wårdh, I., & Morén, E. (2020) Effects of Domiciliary Professional Oral Care for Care-Dependent Elderly in Nursing Homes – Oral Hygiene, Gingival Bleeding, Root Caries and Nursing Staff’s Oral Health Knowledge and Attitudes. Clinical Interventions in Aging, 15, 1305-1315. https://doi.org/10.2147 / CIA.S236460

Crumley, E., Wiebe, N., Cramer, K., Klassen, T., & Hartling, L. (2005). Which resources should be used to identify RCT/CCTs for systematic reviews: a systematic review. BMC Medical Research Methodology, 5(24). https://doi.org/10.1186/1471-2288-5-24

Davalos, C., Monroy, S., Muñoz, J., Olvera, V., Sánchez, K., & Monjarás, A. (2020) Protocolo de atención odontológica para el adulto mayor. Educación y Salud: Boletín Científico Instituto de Ciencias de la Salud Universidad Autónoma del Estado de Hidalgo, 9(17), 89-95. https://doi.org/10.29057/icsa.v9i17.5811

Deutsch, A., Siegel, E., Cations, M., Wright, C., Naganathan, V., & Brodaty, H. (2017). A pilot study on the feasibility of training nurses to formulate multicomponent oral health interventions in a residential aged care facility. Gerodontology, 1–10. https://doi.org/10.1111/ger.12295

Farcuh, C., & Grasset, N. (2017). Falencias en la odontogeriatría actual. Revisión de la literature. Tesis de Grado, Facultad de Odontología de la Universidad Finis Terrae, Santiago, Chile. http://repositorio.uft.cl/bitstream/handle/20.500.12254/546/Farcuh-Grasset%20%202017.pdf?sequence=1&isAllowed=y

Grandjean, M., Maccarone, N., McKenna, G., Müller, F., & Srinivasan, M. (2021). Silver Diamine Fluoride (SDF) in the management of root caries in elders: a systematic review and meta-analysis. Swiss Dental Journal Org. https://www.swissdentaljournal.org/fr/magazine/artikel/artikel/silver-diamine-fluoride-sdf-in-the-management-of-root-caries-in-elders-a-systematic-review-and-me.html

Health Evidence. (2016). Quality Assessment Tool – Review Articles. Health Evidence. https://healthevidence.org/documents/our-appraisal-tools/QATool&Dictionary_01Jun16.pdf

Hoben, M., Kent, A., Kobagi, N., Huynh, K., Clarke, A., & Yoon, M. (2017). Effective strategies to motivate nursing home residents in oral care and to prevent or reduce responsive behaviors to oral care: A systematic review. PLoS ONE, 12(6), e0178913. https://doi.org/10.1371/journal.pone.0178913

Hoben, M., Clarke, A., Tu Huynh, K., Kobagi, N., Kent, A., Hu, H., Pereira, R., Xiong, T., Yu, K., Xiang, H., & Yoon, M. (2017). Barriers and facilitators in providing oral care to nursing home residents, from the perspective of care aides: A systematic review and meta-analysis. International Journal of Nursing Studies, 73, 34-51. https://doi.org/10.1016/j.ijnurstu.2017.05.003

Joanna Briggs Institute. (2016). Checklist for systematic reviews and Research syntheses. Joanna Briggs, Inst. https://joannabriggs.org/sites/default/files/2019-05/JBI_Critical_Appraisal-Checklist_for_Systematic_Reviews2017_0.pdf

Johansson, I., Joy, C., & Lindmark, U. (2020). Is an oral health coaching programme a way to sustain oral health for elderly people in nursing homes? A feasibility study. International Journal of Dental Hygiene, 18, 107–115. https://doi.org/10.1111/idh.12421

Koistinen, S. (2020). Oral health, experiences of oral care, associated factors, and mortality among older people in short-term care. Tesis Doctoral., Facultad de Educación, Salud y Estudios Sociales, Ciencias del Cuidado de la Universidad de Dalarna, Falun, Suecia. https://www.diva-portal.org/smash/get/diva2:1447104/FULLTEXT01.pdf

Konstantopoulou, K., Kossioni, A., Karkazis, H., & Polyzois, G. (2020). Implementation and evaluation of an oral health education programme for caregivers in nursing homes. Special Care Dentistry, 41(2), 154-163. https://doi.org/10.1111/scd.12558

Konstantopoulou, K., Kossioni, A., Karkazis, H., & Polyzois, G. (2020). Barriers to good oral health for nursing home residents: a literature review. Stomatology Edu Journal, 7(2), 131-137. https://doi.org/10.25241/stomaeduj.2020.7(2).art.7

Kossiono, A., Hajto-Bryk, J., Janssens, B., Maggi, S., Marchini, L., McKenna, G., Muller, F., Petrovic, M., Roller-Wirnsberger, R., Schimmel, M., Van der Putten, G., Vanobbergen, J., & Zarzecka, J. (2018). Practical guidelines for physicians in promoting oral health in frail older adults. Journal of the American Medical Directors Association, 19(12), 1039-1046. https://doi.org/10.1016/j.jamda.2018.10.007

Kraft-Bodi, E., Jørgensen, M., Keller, M., Kragelund, C., & Twetman, S. (2015). Effect of Probiotic Bacteria on Oral Candida in Frail Elderly. JDR Clinical Research Supplement, 2(94), 181S-186S. https://doi.org/10.1177/0022034515595950.

Latapiat, A. (2016). Existencia de protocolos de higiene bucal en los establecimientos de larga estadía para adultos mayores (eleam) y caracterización de sus directores técnicos. Trabajo de investigación, Universidad de Chile Adscrito a PRI-ODO N° 15/008: “Servicios y cuidados odontológicos para personas mayores institucionalizadas en establecimientos de larga estancia”. http://repositorio.uchile.cl/bitstream/handle/2250/142506/Existencia-de-protocolos-de-higiene-bucal-en-los-establecimientos-de-larga-estad%C3%ADa.pdf?sequence=1&isAllowed=y

Lewis, A., Wallace, J., Deutsch, A., & King, P. (2015). Improving the oral health of frail and functionally dependent elderly. Australian Dental Journal, 60(1), 95–105. https://doi.org/10.1111/adj.12288

Lewis, A., Kitson, A., & Harvey, G. (2016). Improving oral health for older people in the home care setting: An exploratory implementation study. Australasian Journal on Ageing, 35(4), 273–280. https://doi.org/10.1111/ajag.12326

Lowe, C., Blinkhorn, A., Worthington, H., & Craven, R. (2007). Testing the effect of including oral health in general health checks for elderly patients in medical practice – a randomized controlled trial. Community Dent Oral Epidemiol, 35, 12–17. https://doi.org/10.1111/j.1600-0528.2007.00360.x

Manchery, N., Kumar, G., Nagappan, N., & Premnath, P. (2020). Are oral health education for careers effective in the oral hygiene management of elderly with dementia? A systematic review. Dental Research Journal (Isfahan), 17(1), 1-9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001561/

Marín, D., Gil, J., & Willumsen, T. (2019). Effectiveness of a training program for the nursing staff on the oral health of institutionalised aged. Randomised trial. Acta Odontológica Colombiana, 9(1), 58-70. https://doi.org/10.15446/aoc.v9n1.76124

Martínez, D., Guanche, A., & Reyes, A. (2018). La Odontogeriatría en Cuba. Actualidad y perspectivas. Convención Internacional de Salud, Cuba Salud. http://www.convencionsalud2018.sld.cu/index.php/connvencionsalud/2018/paper/view/11

Mohammadi, J., Franks, K., & Hines, S. (2015). Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol. JBI Database of Systematic Reviews & Implementation Reports, 13(10), 110–122. https://doi.org/10.11124/jbisrir-2015-2330

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine, 151(4), 264-269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L., & PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1-9. https://doi.org/10.1186/2046-4053-4-1

Nihtilä, A., Tuuliainen, E., Komulainen, K., Autonen-Honkonen, K., Nykänen, I., Hartikainen, S., Ahonen, R., Tiihonen, M., & Suominen, A. (2017). Preventive oral health intervention among older home care clients. Age and Ageing, 46, 846–851. https://doi.org/10.1093/ageing/afx020

Paris, S., Banerjee, A., Bottenberg, P., Breschi, L., Campus, G., Doméjean, S., Ekstrand, K., Giacaman, R., Haak, R., Hannig, M., Hickel R., Juric, H., Lussi, A., Machiulskiene, V., Manton, D., Jablonski-Momeni, A., Santamaria, R., Schwendicke, F., Splieth, C., Tassery, H., Zandona, A., Zero, D., Zimmer, S., & Opdam, N. (2020). How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement. Caries Research, 5-6 (54), 459–465. https://doi.org/10.1159/000510843

Patel, R., Fitzgerald, R., Warburton, F., Robertson, C., Pitts, N., & Gallagher, J. (2021). Refocusing dental care: A risk-based preventative oral health programme for dentate older people in UK care homes. Gerodontology, 00, 1–8. https://doi.org/10.1111/ger.12543

Pawluk, D., Dale, C., Yuan, J., Villacorta, N., Smith, J., Joseph, K., & Lawrence, H. (2021). The impact of oral health education taken by personal support workers caring for a geriatric population in a long-term care facility: A mixed-methods study. Gerodontology, 00, 1–14. https://doi.org/10.1111/ger.12532

Prayoonwong, T., Wiwatkhunupakan, T., Lasuka, D., & Srisilapanan, P. (2016). Development of a community-based oral healthcare model for Thai dependent older people. Gerodontology, 33, 545–553. https://doi.org/10.1111/ger.12208

Ramos, R., López, A., & Vázquez, J. (2018). Enfermedades bucales y factores de riesgo de los adultos mayores de Centro Habana. GeroInfo Publicación Periódica de Gerontología y Geriatría, 13(3). https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=86535

Red Transdisciplinaria sobre Envejecimiento, Unidad de Redes Transdisciplinarias, Vicerrectoría de Investigación y Desarrollo. (2019). Salud oral en personas mayores: un desafío multidimensional para Chile. Universidad de Chile Policy Papers, 2.

Robaina, E., Mora, E., Blanco, F., Fleitas, D. (2021). Intervención educativa sobre salud bucal en adulto mayor institucionalizado portador de prótesis. Revista Ciencia Digital, 4(1). https://doi.org/10.33262/anatomiadigital.v4i1.1482

Schulz, K., Altman, D., & Moher, D. (2010). CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine, 8(1), 18-27. https://annals.org/data/journals/aim/20207/0000605-201006010-00007.pdf

Schwindling, F., Krisam, J., Hassel, A., Rammelsberg, P., & Zenthofer, A. (2017). Long-term success of oral health intervention among care-dependent institutionalized seniors: Findings from a controlled clinical trial. Community Dent Oral Epidemiol, 1(9). https://doi.org/10.1111/cdoe.12335

Sjögren, P., Croonquist, C., Skott, P., Marsson, N., Nova, R., Zimmerman, M., & Wårdh, I. (2016). Professional Domiciliary Oral Care for Elderly in Nursing Homes—A Randomized Controlled Pilot Trial. Health, 8, 1112-1119. http://dx.doi.org/10.4236/health.2016.811116

Slim, K., Nini, E., Forestier, D., Kwiatkowski, F., Panis, Y., & Chipponi, J. (2003) Methodological index for non‐randomized studies (MINORS): development and validation of a new instrument. ANZ Journal of Surgery, 73(9), 712-716. https://doi.org/10.1046/j.1445-2197.2003.02748.x

Tonetti, M., Bottenberg, P., Conrads, G., Eickholz, P., Heasman, P., Huysmans, M., López, R., Madianos, P., Muller, F., Needleman, I., Nyvad, B., Preshaw, P., Pretty, I., Renvert, S., Schwendicke, F., Trombelli, L., Van der Putten, G., Vanobbergen, J., West, N., Young, A., & Paris, S. (2017). Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing-Consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. Journal Clinical Periodontology, 44(18), S135–S144. https://doi.org/10.1111/jcpe.12681

Tran, J., Wright, F., Takara, S., Shu, C., Chu, S., Naganathan, V., Hirani, V., Blyth, F., Le Couteur, D., Waite, L., Handelsman, D., Seibel, M., Milledge, K., & Cumming, R. (2019). Oral health behaviours of older Australian men: the Concord Health and Ageing in Men Project. Australian Dental Journal, 0, 1–10. https://doi.org/10.1111/adj.12694

Tuuliainen, E., Autonen-Honkonen, K., Nihtilä, A., Komulainen, K., Nykänen, I., Hartikainen, S., Ahonen, R., Tiihonen, M., & Suominen, A. (2020) Oral Health and Hygiene and Association of Functional Ability: A Cross-Sectional Study Among Old Home Care Clients. Oral Health Prev Dent, 18, 253-262. https://doi.org/10.3290/j.ohpd.a43353

Tynan, A., Deeth, L., & McKenzie, D. (2018). An integrated oral health program for rural residential aged care facilities: a mixed methods comparative study. BMC Health Services Research, 18, 515. https://doi.org/10.1186/s12913-018-3321-5

Tynan, A., Deeth, L., McKenzie, D., Bourke, C., Stenhouse, S., Pitt, J., Linneman, H. (2018). Quality Improvement Report Integrated approach to oral health in aged care facilities using oral health practitioners and teledentistry in rural Queensland. Aust. J. Rural Health. https://doi.org/10.1111/ajr.12410

Von Elm, E., Altman, D., Egger, M., Pocock, S., Gøtzsche, P., & Vandenbroucke, J. (2014). Strobe Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International Journal of Surgery, 12(12), 1495-1499. https://doi.org/10.1016/j.ijsu.2014.07.013

Wallace, J., Mohammadi, J., Wallace, L., & Taylor, J. (2016). Senior Smiles: preliminary results for a new model of oral health care utilizing the dental hygienist in residential aged care facilities. International Journal of Dental Hygiene. https://doi.org/10.1111/idh.12187

Walsh, L. (2017). Minimal intervention management of the older patient. British Dental Journal., 223(3). https://doi.org/10.1038/sj.bdj.2017.660




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