Geriatric Oral Health: The Role of Oral Disease Prevention in Vulnerable Patients

Abstract

Prevention of oral diseases plays a crucial role in maintaining the health of vulnerable patients. In this context, vulnerable patients include the adults with no or restricted access to dental treatments, adults above the age of 65 years, and adults residing in Établissement d’hébergement pour personnes âgées dépendantes (EHPADs), which is a type of nursing home for dependent elderly people in France. These vulnerable patients display frailty and/or may need specialized treatment. In addition, oral disease prevention of those living in economically weak countries is equally important. As the global population is increasing at an annual rate of 1.7% while the population of those over 65 years rises at a rate of 2.5%, it is expected that the adults older than 80 years will make up of nearly 20% of the world population in the near future. Therefore, it is without a doubt that early prevention is an important and effective approach to minimize the prevalence of oral disease in the aged population, thereby reducing the related economic repercussions. In general, four levels of prevention have been defined [1,2]. The four levels of prevention are as follows: • Primary prevention aims to prevent the occurrence of a disease or an injury. • Secondary prevention aims to reduce the spread of an already established disease or a progressing disease in a population. It should reduce the impact of a disease or injury that has already occurred or abrogate the progression of a disease and deterioration. • Tertiary prevention aims to reduce the symptoms and complications of a disease and impact of an ongoing illness to improve patient’s functional abilities, quality of life, and life expectancy. Despite that, there is still a risk of recurrence of the disease. Tertiary prevention focuses on the prevention of an already established disease or a progressing disease. • Quaternary prevention aims to identify patients at risk of over-medicalization and suggest interventions that are ethically acceptable, thereby protecting patients from unnecessary medical interventions.