OBJECTIVES: To examine the current knowledge on oral health status and dental care of older persons through a systematic mapping of systematic reviews of low or moderate risk of bias.
BACKGROUND: Geriatric dentistry covers all aspects of oral health and oral care of older persons. Oral health is part of general health and contributes to a person's physical, psychological and social wellbeing.
METHODS: A literature search was performed in three different databases (PubMed, The Cochrane Library and Cinahl) within 12 domains: Dental caries, periodontitis, Orofacial pain and temporomandibular joint (TMJ) pain, mucosal lesions, oral motor function, dry mouth, halitosis, interaction between oral status and other medical conditions, ability to interrelate and communicate, quality of life, ethics and organisation of dental care for older persons. Systematic reviews were identified and scrutinised, highlighting scientific knowledge and knowledge gaps.
RESULTS: We included 32 systematic reviews of which 14 were judged to be of low/moderate risk of bias. Most of the domains lack systematic reviews with low or moderate risk of bias. In two of the domains evidence was identified; in institutionalised people aged 65 or older, effective oral hygiene can prevent pneumonia. Furthermore, there is an evidence of a relationship between malnutrition (protein energy-related malnutrition, PEM) and poor appetite and edentulousness.
CONCLUSIONS: There is an urgent need for further research and evidence-based knowledge within most domains in geriatric dentistry and in other fields related to oral health and dental care for older persons striving for multi-disciplinary research programmes.
Síntesis amplia/ Revisión panorámica de revisiones sistemáticas
OBJETIVO: Una "revisión de los exámenes" se realizó para evaluar las cuestiones metodológicas en los estudios de evaluación de las intervenciones no farmacológicas de rehabilitación en pacientes con accidente cerebrovascular.
ESTUDIO DE DISEÑO Y AJUSTE: MEDLINE, CINAHL, PsycINFO, y la Base de Datos Cochrane de Revisiones Sistemáticas se realizaron búsquedas de enero 2000 a enero 2008 en el ajuste de rehabilitación del accidente cerebrovascular. Las búsquedas electrónicas se complementan con las revisiones de las listas de referencias y citas identificadas por los expertos. Los estudios elegibles eran revisiones sistemáticas; citas excluidos eran revisiones narrativas o revisiones de exámenes. Revisión de las características y criterios para evaluar la calidad metodológica de los estudios primarios en su interior se extrajeron.
RESULTADOS: La búsqueda arrojó 949 Inglés-idioma citas. Se incluyeron un conjunto final de 38 revisiones sistemáticas. Las revisiones Cochrane, que tienen una metodología estandarizada, fueron en general de mayor calidad metodológica que los no-Cochrane. La mayoría de las revisiones sistemáticas utiliza criterios estandarizados de evaluación de la calidad de los estudios primarios, pero no todos eran completas. Opiniones de los estudios primarios mostraron que tenía problemas con la asignación al azar, ocultamiento de la asignación y el cegamiento. Comparabilidad inicial, los eventos adversos, y cointervención o la contaminación no se evaluaron de forma coherente. El cegamiento de los pacientes y los proveedores a menudo no era factible y no se evaluó como una fuente de sesgo.
CONCLUSIONES: Las revisiones sistemáticas elegibles identificó importantes deficiencias metodológicas en los estudios evaluados de primaria, lo que sugiere la necesidad de mejora de los métodos de investigación y presentación de informes.
To examine the current knowledge on oral health status and dental care of older persons through a systematic mapping of systematic reviews of low or moderate risk of bias.
BACKGROUND:
Geriatric dentistry covers all aspects of oral health and oral care of older persons. Oral health is part of general health and contributes to a person's physical, psychological and social wellbeing.
METHODS:
A literature search was performed in three different databases (PubMed, The Cochrane Library and Cinahl) within 12 domains: Dental caries, periodontitis, Orofacial pain and temporomandibular joint (TMJ) pain, mucosal lesions, oral motor function, dry mouth, halitosis, interaction between oral status and other medical conditions, ability to interrelate and communicate, quality of life, ethics and organisation of dental care for older persons. Systematic reviews were identified and scrutinised, highlighting scientific knowledge and knowledge gaps.
RESULTS:
We included 32 systematic reviews of which 14 were judged to be of low/moderate risk of bias. Most of the domains lack systematic reviews with low or moderate risk of bias. In two of the domains evidence was identified; in institutionalised people aged 65 or older, effective oral hygiene can prevent pneumonia. Furthermore, there is an evidence of a relationship between malnutrition (protein energy-related malnutrition, PEM) and poor appetite and edentulousness.
CONCLUSIONS:
There is an urgent need for further research and evidence-based knowledge within most domains in geriatric dentistry and in other fields related to oral health and dental care for older persons striving for multi-disciplinary research programmes.
Síntesis amplia»Revisión panorámica de revisiones sistemáticas
