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Aspetti chiave nella cura odontoiatrica dei pazienti anziani

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Le persone anziane dovrebbero ricevere un'attenzione particolare, anche per quanto riguarda la salute orale. Scopri gli aspetti chiave qui.

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Aspetti chiave nella cura odontoiatrica dei pazienti anziani

  1. 1. Aspetti chiave nella cura odontoiatrica dei pazienti anziani Dott. Manuel Ribera Uribe Responsabile Area Geriatria e Pazienti speciali. Università Internazionale della Catalogna
  2. 2. Aspectos clave en la atención odontológica de los pacientes mayores INDICE 1. Perché Geriatria? 2. Epidemiologia della terza età 3. Il profilo del paziente anziano. Aspetti differenziali 4. Cambiamenti biologici dell’invecchiamento. Teorie 5. Trattamenti odontoiatrici. Aspetti differenziali 6. L'impegno medico e farmacologico 7. L’anziano in casa di cura. Piani d’attuazione
  3. 3. Aspectos clave en la atención odontológica de los pacientes mayores ODONTOIATRIA INFANTILE ODONTOIATRIA INFANTILE ODONTOIATRIA DELL’ADULTO ODONTOIATRIA DELL’ADULTO ODONTOIATRIA GERIATRICA ODONTOIATRIA GERIATRICA SPECIALITÀ ODONTOIATRICHESPECIALITÀ ODONTOIATRICHE 1. Perché Gerodontologia?
  4. 4. Aspectos clave en la atención odontológica de los pacientes mayoresAspetti chiave nella cura odontoiatrica dei pazienti anziani Maggiore longevità Minore natalità NOTA: L’ombreggiatura corrisponde alla posizione della generazione del baby-boom (1957-1977)NOTA: L’ombreggiatura corrisponde alla posizione della generazione del baby-boom (1957-1977) Fonte: INE: INEBASE. 2012: Anagrafe nazionale della popolazione al 1 gennaio 2012 Richiesta in aprile 2013Fonte: INE: INEBASE. 2012: Anagrafe nazionale della popolazione al 1 gennaio 2012 Richiesta in aprile 2013 2. Epidemiologia della terza età Nel 2020 il 19,8% della nostra popolazione avrà più di 65 anni Eurostat: “Statistiques sociales européennes, démographie Nel 2020 il 19,8% della nostra popolazione avrà più di 65 anni Eurostat: “Statistiques sociales européennes, démographie
  5. 5. Aspetti chiave nella cura odontoiatrica dei pazienti anziani “L’invecchiamento è un processo in cui gli adulti diventano fragili, con una riduzione dei meccanismi di riserva fisiologici e un aumento esponenziale della vulnerabilità rispetto alla malattia e alla morte” Richard A. Miller Invecchiamento 2. Epidemiologia della terza età
  6. 6. Aspetti chiave nella cura odontoiatrica dei pazienti anziani  Cambiamenti propri dell’invecchiamento  Pluripatologia sistemica  Polifarmacia  Esigenze nutrizionali  Cambiamenti sfera psicologica  Cambiamenti sfera sociale  Handicap  Mobilità ridotta In cosa si differenzia l’anziano dal resto della popolazione? 3. Il profilo del paziente anziano. Aspetti differenziali
  7. 7. Aspectos clave en la atención odontológica de los pacientes mayores Cambiamenti biologici nell'invecchiamento MUCOSA ORALE STRUTTURA DENTALE - PERDITA DEL RINNOVAMENTO CELLULARE - DIMINUZIONE DELLE FIBRE ELASTICHE E DEL COLLAGENE - DIMINUZIONE DELL’IDRATAZIONE - MODIFICA DEL COLORE - DIMINUZIONE DELLA PERMEABILITÀ - AUMENTO DELLA DENTINA SECONDARIA - DENTINA SCLEROTICA - CALCIFICAZIONI DELLA POLPA Si è osservato che con l'età vi è una riduzione del contenuto di acqua e un aumento di contenuto organico (azoto) ;ciò è attribuito a una chiusura delle fessure o crack adamantine da parte del materiale organico proveniente dalla pellicola acquisita 4. Cambiamenti biologici dell’invecchiamento. Teorie
  8. 8. Si suggerisce una riduzione dell’epitelio e un’atrofia. NonSi suggerisce una riduzione dell’epitelio e un’atrofia. Non sufficientemente chiaritosufficientemente chiarito La diminuzione della cellularità, dell’apporto di sangue e di fibreLa diminuzione della cellularità, dell’apporto di sangue e di fibre elastiche si relaziona maggiormente con la patologia o ielastiche si relaziona maggiormente con la patologia o i farmaci che con la vecchiaiafarmaci che con la vecchiaia La mucosa orale dell’anziano conserva intatte le proprie capacitàLa mucosa orale dell’anziano conserva intatte le proprie capacità Si suggerisce una riduzione dell’epitelio e un’atrofia. NonSi suggerisce una riduzione dell’epitelio e un’atrofia. Non sufficientemente chiaritosufficientemente chiarito La diminuzione della cellularità, dell’apporto di sangue e di fibreLa diminuzione della cellularità, dell’apporto di sangue e di fibre elastiche si relaziona maggiormente con la patologia o ielastiche si relaziona maggiormente con la patologia o i farmaci che con la vecchiaiafarmaci che con la vecchiaia La mucosa orale dell’anziano conserva intatte le proprie capacitàLa mucosa orale dell’anziano conserva intatte le proprie capacità Non diminuiscono le papille gustative con l'etàNon diminuiscono le papille gustative con l'età È citata una lieve riduzione della soglia del gusto perÈ citata una lieve riduzione della soglia del gusto per il salato (ClNa) e l’amaro (Chinina)il salato (ClNa) e l’amaro (Chinina) Non diminuiscono le papille gustative con l'etàNon diminuiscono le papille gustative con l'età È citata una lieve riduzione della soglia del gusto perÈ citata una lieve riduzione della soglia del gusto per il salato (ClNa) e l’amaro (Chinina)il salato (ClNa) e l’amaro (Chinina) Prolungamento del tempo diProlungamento del tempo di contrazionecontrazione Perdita di elementiPerdita di elementi contrattili e sostituzione concontrattili e sostituzione con tessuto adiposotessuto adiposo Minore forza di masticazioneMinore forza di masticazione Prolungamento del tempo diProlungamento del tempo di contrazionecontrazione Perdita di elementiPerdita di elementi contrattili e sostituzione concontrattili e sostituzione con tessuto adiposotessuto adiposo Minore forza di masticazioneMinore forza di masticazione Maggiore durata del tempo di deglutizioneMaggiore durata del tempo di deglutizione Particolarmente sensibili ai farmaci e alle patologieParticolarmente sensibili ai farmaci e alle patologie Maggiore durata del tempo di deglutizioneMaggiore durata del tempo di deglutizione Particolarmente sensibili ai farmaci e alle patologieParticolarmente sensibili ai farmaci e alle patologie La xerostomiaLa xerostomia nell’anziano richiede unanell’anziano richiede una valutazione generale oralevalutazione generale orale farmacologica che la giustifichifarmacologica che la giustifichi Non si associa la xerostomiaNon si associa la xerostomia all’etàall’età La xerostomiaLa xerostomia nell’anziano richiede unanell’anziano richiede una valutazione generale oralevalutazione generale orale farmacologica che la giustifichifarmacologica che la giustifichi Non si associa la xerostomiaNon si associa la xerostomia all’etàall’età MUCOSA ORALEMUCOSA ORALE GHIANDOLE SALIVARIGHIANDOLE SALIVARI SENSISENSI MUSCOLATURA ORALEMUSCOLATURA ORALE DEGLUTIZIONEDEGLUTIZIONE Aspetti chiave nella cura odontoiatrica dei pazienti anziani 4. Cambiamenti biologici dell’invecchiament
  9. 9. Aspetti chiave nella cura odontoiatrica dei pazienti anziani Trattamenti odontoiatrici. Aspetti differenziali 1. Protesi: Totale, Rimovibile Cura delle protesi 2. Parodontologia 3. Endodonzia 4. Chirurgia e Protesi 5. Medicina Orale: Xerostomia 6. Preventiva 7. Trattamenti conservativi 5. Trattamenti odontoiatrici. Aspetti differenziali
  10. 10. Aspectos clave en la atención odontológica de los pacientes mayores Concetto di salute Salute per tutti nell’anno 2000. OMS Alma Ata : Condizione completa di benessere fisico, mentale e sociale e non solo assenza del dolore o della patologia La salute nel contesto dell’invecchiamento sarebbe una condizione cumulativa che deve essere promossa durante tutto il ciclo di vita del soggetto per consentire che i suoi benefici possano essere goduti in età avanzata Classificazione statistica Internazionale delle patologie e dei problemi relazionati alla salute OMS .Ginevra. Htpp ://www.who.int/whosis/ icd10/glosario Aspetti chiave nella cura odontoiatrica dei pazienti anziani 6. L'impegno medico e farmacologico
  11. 11. Aspectos clave en la atención odontológica de los pacientes mayoresAspetti chiave nella cura odontoiatrica dei pazienti anziani • Conoscere il passato del paziente. – Anamnesi medica, Farmaci. – Attitudine e predisposizione del paziente e dei familiari. • Definire gli obiettivi della ricostruzione protesica con il paziente o i familiari. • Concordare le cure e la manutenzione della protesi nel contesto di un piano di controllo. • Stabilire una relazione empatica a scapito del singolo professionista. Nessuna modifica. Generalità sulle condizioni della visita 6. L'impegno medico e farmacologico
  12. 12. Aspectos clave en la atención odontológica de los pacientes mayoresAspetti chiave nella cura odontoiatrica dei pazienti anziani • Comunicazione Verbale e Non Verbale – Linguaggio semplice e diretto – Importanza dei gesti • Condizioni adeguate – Sessioni corte per quadrante – Non sdraiare il paziente – Isolamento? • Sedazione se necessaria – Interazioni farmacologiche – Emivita delle benzodiazepine diluite 6. L'impegno medico e farmacologico Generalità sulle condizioni della visita
  13. 13. Aspectos clave en la atención odontológica de los pacientes mayores Il significato della politerapia Somacarrera et al. Gerodontologia pagina 61. SEGER Aspetti chiave nella cura odontoiatrica dei pazienti anziani 6. L'impegno medico e farmacologico
  14. 14. Aspectos clave en la atención odontológica de los pacientes mayores IL PAZIENTE ANZIANO IN CASA DI CURAIL PAZIENTE ANZIANO IN CASA DI CURA Aspetti chiave nella cura odontoiatrica dei pazienti anziani 7. Anziano in casa di cura. Piani d’attuazione.
  15. 15. Aspectos clave en la atención odontológica de los pacientes mayores È necessario fornire agli assistenti: - Formazione - Motivazione - Informazioni per l'accesso ai servizi dentali La funzione dell’assistente 7. Anziano in casa di cura. Piani d’attuazione.
  16. 16. Aspectos clave en la atención odontológica de los pacientes mayores @Dentaid

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