Abstract
The rapid aging of the Japanese population as well as advances in medical technology allowing pa-tients with cerebro-vascular disease to rehabilitate into society increase our opportunities to meet such elderly patients in our dental offices, because of the increasing incidence of cerebro-vascular disease later in life. Much attention has been paid to the dependent or bedridden elderly with cerebro-vascular disease. In contrast, there are few studies of elderly outpatients with cerebro-vascular disease. The goal of this study was to clarify the medical and dental conditions of the aged patients with cerebro-vascular disease who can visit dental offices. The subjects of the present study were 282 outpatients who visited the rehabilitation clinic in Seirei Mikatahara Hospital after the acute stage of stroke. They were divided into two groups: the elderly group (E-group) aged over 65 (155 patients) and the non-eldery group (N-group) aged less than 65 (127 patients). We examined their activity of daily living (ADL) and func-tional independence measure (FIM) in addition to their medical history. We also investigated their den-tal conditions including the number of present, sound, treated, untreated, and missing teeth, and the re-maining roots, as well as their gingival index (GI) and plaque index (PLI), in addition to the condition of their dentures. We then consulted them about the dental treatment that they required, before asking whether they wished to receive dental treatment or not. The results were as follows: 1) the outpa-tients included 159 patients with cerebral infarction (56.4%), 116 with cerebral hemorrhage (41.1%), and 19 with subarachnoid hemorrhage (6.7%); 2) the main complications included 163 patients with hypertension (57.8%), 33 with diabetes mellitus (11.7%), 12 with atrial fibrillation (4.3%) and 4 with chronic renal failure (1.4%); 3) the major symptoms of these patients consisted of paralysis including hemiplegia (220, 78.0%), aphasia (77, 27.3%), articulation disorder (70, 24.8%) and ataxia (28, 9.9%); 4) the mean scores of the ADL, FIM in the E-group were lower than those in the N-group; 5) the average number of present, sound and treated teeth decreased with age, while the average number of missing teeth as well as the mean score of GI and PLI increased; 6) the number of pa-tients who required removable dentures exceeded the number of patient who required restorative den-tistry; 7) the mean ADL and FIM scores in the E-group with ariculation disorder were lower than those in the E-group without articulation disorder, and also those in the E-group with paralysis were lower than those in the E-group without paralysis. Accordingly, in treating elderly patients with cerebro-vascular disease-associated risk factors, such as hypertension or diabetes mellitus, the dentist should carefully evaluate these patients' medical condition, and manage their treatment properly. In ad-dition, the patients, even though they can visit a dental office, are often debilitated to some degree in motor function or speech, so that dentist must take care of them when they visit the office, especially the patients with hemiplegia or articulation disorder. Furthermore, the goal of dental care for them should be to fit adequate removable dentures in order to improve their quality of life.
