Training of dental students in the treatment of older patients must also consider the multiple chronic medical conditions that may be present. We developed an interdisciplinary gerodontology training curriculum for dental students (GeriDent-Cologne) to investigate its influence on the attitudes and expectancies of dental students towards the treatment of older patients.The curriculum (given to fourth-year students) comprised five clinical examination stations that simulated different medical conditions affecting older people. Students were able to experience related issues first hand, express their fears and problems concerning dental treatment in older people and, through discussion with the supervisor, develop strategies to overcome these difficulties and enhance treatment. An extended version of the Los Angeles Geriatric Attitudes Scale was given to fourth- and fifth-year students (who acted as controls) over one semester.Dental students had a positive attitude towards older people, and their attitude did not change after attending the curriculum. However, participating in GeriDent-Cologne had a significant beneficial impact on the feeling of being prepared to treat older people, led to a significantly greater understanding of the impact of medical issues and resulted in a considerably higher level of geriatric clinical knowledge over time.GeriDent-Cologne led to positive and semester-long changes in awareness and knowledge of specific geriatric problems that influence dental treatment. We recommend the curriculum as a blueprint for the module of senior dentistry implemented in the new German dental licencing regulations.
Despite a high prevalence in the general practitioner (GP) and geriatric field, limitations of oral health of seniors under outpatient care in Germany are not routinely recorded. Since seniors with a high age visit GPs more often than dentists, the question arises whether an interdisciplinary screening instrument can be used to identify reduced oral health in routine practice.The aim of the work was to develop a screening tool for reduced oral health for GPs and to validate this by dental examinations.The geriatric outpatient oral health screening (GAMS) was developed as a subjective screening instrument to depict dental aspects relevant for geriatric patients, such as chewing problems, pain, periodontitis, bad breath or dry mouth in dichotomous questions. The urgency of a visit to the dentist is also assessed by the family doctor. A total of 75 patients were included and the GAMS and a dental examination were performed for validation.The subjective assessment of patients and dental findings showed reduced oral health especially with recognized risk factors for the development of systemic comorbidities, such as dysphagia and malnutrition, whereas oral health problems were underestimated by patients. Bites, chewing problems and dry mouth showed sufficient correspondence between dental findings and subjective assessment.The GAMS could help facilitate the consideration of oral health problems in geriatric patients in a GP setting and promote cooperation with dentists in the sense of European recommendations for action.HINTERGRUND: Einschränkungen der Mundgesundheit ambulant betreuter Senioren in Deutschland werden trotz hoher Prävalenz im hausärztlich-geriatrischen Bereich nicht routinemäßig erfasst. Da Senioren Hausärzte mit höherem Alter häufiger aufsuchen als Zahnärzte, stellt sich die Frage, ob reduzierte Mundgesundheit im Praxisalltag mit einem interdisziplinären Screeninginstrument identifiziert werden kann.Ziel der Arbeit ist, ein Screeninginstrument für reduzierte Mundgesundheit für Hausärzte zu entwickeln und dieses durch zahnmedizinische Befunde zu validieren.Das geriatrische ambulante Mundgesundheits-Screening (GAMS) als subjektives Screeninginstrument wurde entwickelt, um für geriatrische Patienten relevante zahnmedizinische Aspekte wie Kauprobleme, Schmerzen, Parodontitis, Mundgeruch oder Mundtrockenheit in dichotomen Fragen abzubilden. Zudem erfolgt die Einschätzung der Dringlichkeit eines Zahnarztbesuches durch den Behandler. Es wurden n = 75 Patienten eingeschlossen und der GAMS sowie eine zahnärztliche Untersuchung zur Validierung durchgeführt.Bei subjektiver Einschätzung als auch im zahnmedizinischen Befund zeigte sich reduzierte Mundgesundheit, insbesondere bei Risikofaktoren für die Entwicklung systemischer Komorbiditäten wie Dysphagie und Mangelernährung, wobei Mundgesundheitsprobleme durch die Patienten unterschätzt wurden. Einbisse, Kauschwierigkeiten und Mundtrockenheit zeigten ausreichende Übereinstimmung zwischen oralem Befund und subjektiver Einschätzung.Der GAMS könnte beitragen, die Erwägung und Berücksichtigung von Mundgesundheitsproblemen bei geriatrischen Patienten im hausärztlichen Setting zu erleichtern und die Zusammenarbeit mit Zahnmedizinern im Sinne europäischer Handlungsempfehlungen fördern.
