Pilar Barahona

Introduction: Removable dental prostheses (RDPs) are essential for chewing, nutrition, and preventing geriatric syndromes in older adults. Evidence regarding their benefits varies. Objective: To compare two groups of elderly individuals aged 70 and above from public and private health systems, assessing changes in hand grip strength (HGS) adjusted for masticatory function, malnutrition risk, and body mass index (BMI) after using dental prostheses. Method: A prospective pre–post study. Between March 2020 and 2023, elderly individuals aged 70 or older who used public and private health systems and lacked molars and premolars were included. They were categorized based on chewing ability according to the Eichner index and assessed for malnutrition risk using calf circumference (CC) and BMI. HGS was measured at baseline and 15 days after prosthetic use using a hydraulic manual dynamometer (Jamar™). Differences in HGS were analyzed with a mixed linear regression model using SAS 9.4 software (p < 0.05). Results: n= 248 (124 public/124 private), sex 73/73 women (p > 0.05), ages 81.2/75.2 years (p < 0.0001), and malnutrition risk based on CC 5/31 (p < 0.0001). In a multivariate model adjusted for sex, age, BMI, and malnutrition risk, the HGS before using prostheses was 22.8 kg/11.7 kg (Δ = 11.1 kg; p < 0.0001), and afterwards it was 23.0 kg/14.2 kg (Δ = 8.8 kg; p < 0.0001). Conclusions: RDPs immediately improved HGS in older adults from both public and private health systems, with significant differences of up to 8.8 kg between the two groups.

Removable dental prostheses (RDPs) are essential for chewing, nutrition, and preventing geriatric syndromes in older adults. Evidence regarding their benefits varies. Objective: To compare two groups of elderly individuals aged 70 and above from public and private health systems, assessing changes in hand grip strength (HGS) adjusted for masticatory function, malnutrition risk, and body mass index (BMI) after using dental prostheses. Method: A prospective pre-post study. Between March 2020 and 2023, elderly individuals aged 70 or older who used public and private health systems and lacked molars and premolars were included. They were categorized based on chewing ability according to the Eichner index and assessed for malnutrition risk using calf circumference (CC) and BMI. HGS was measured at baseline and 15 days after prosthetic use using a hydraulic manual dynamometer (Jamar™). Differences in HGS were analyzed with a mixed linear regression model using SAS 9.4 software (p< 0.05). Results: N = 248 (124 public/124 private), sex 73/73 women (p>0.05), ages 81.2/75.2 years (p< 0.0001), and malnutrition risk based on CC 5/31 (p< 0.0001). In a multivariate model adjusted for sex, age, BMI, and malnutrition risk, HGS before using prostheses was 22.8 kg/11.7 kg (Δ = 11.1 kg; p< 0.0001), and after was 23.0 kg/14.2 kg (Δ = 8.8 kg; p< 0.0001). Conclusions: RDPs immediately improve HGS in older adults from both public and private health systems, with significant differences of up to 8.8 kg between the two groups.

Background/Objectives: Frailty and sarcopenia are geriatric syndromes associated with increased vulnerability to adverse health outcomes, including functional decline, disability, and mortality. Emerging evidence suggests that oral health interventions may play a role in mitigating these conditions. This systematic review aims to evaluate the impact of oral health interventions on frailty and sarcopenia in older adults. Methods: A systematic search was conducted in PubMed, Scopus, and SciELO databases for studies published up to December 2023. Inclusion criteria comprised experimental and quasi-experimental studies assessing dental interventions and their effects on frailty and sarcopenia in individuals aged 60 years and older. The primary outcomes included frailty index, grip strength, walking speed, and functional dentition. Study quality was assessed using GRADEpro. Results: Eight studies were included. Preventive oral hygiene interventions improved oral health but did not significantly impact frailty scores. Oral exercises significantly improved muscle strength and weight, leading to frailty score reductions (−1.1 points, 95% CI: −1.5 to −0.7, p < 0.01). Swallowing therapies were linked to increased grip strength (+1.8 kg, p = 0.03) and walking speed (+0.2 m/s, p = 0.04), with corresponding frailty index reductions (−0.8 points, 95% CI: −1.2 to −0.4, p = 0.01). The certainty of evidence ranged from very low to moderate. Conclusions: Oral health interventions, particularly oral exercises and swallowing therapies, show potential in reducing frailty and sarcopenia-related outcomes in older adults. However, methodological heterogeneity and low-certainty evidence highlight the need for high-quality, large-scale trials with standardized assessment measures to establish definitive clinical recommendations.

Aging is a gradual and adaptive process that entails a series of changes, leading to reduced functional and physiological capacity. Each elderly person presents heterogeneous health conditions that must be considered by the interdisciplinary team responsible for their functional maintenance and overall health. This descriptive, cross-sectional study was conducted on elderly individuals with deficient removable dental prostheses, treated at the dental prosthetic rehabilitation centre of Hospital Del Salvador, in Santiago de Chile between the years 2021 and 2023. Instruments and indices were used to record and measure muscular conditions, such as the hand grip strength measurements, the Timed Up and Go test, and the calf circumference measurement. Information on educational levels, geriatric syndromes, chronic diseases, and medication consumption was collected. Of the participants, 58.9 % were female, and 41.1 % were male, with a mean age of 84.2 years for males and 80.4 years for females. 20.8 % had access to higher education, and 22.6 % lived alone. 78.5 % had lost all posterior support zones. 81.5 % had visual impairments; 36.3 % had auditory impairments, and 31.5 % had experienced one or more falls in the last 6 months. The mean sum of medications consumed per person was 4.32. The most prevalent morbidities were arterial hypertension (66.4 %) and type II diabetes (32.7 %). Means values for male/ female were: Hand Grip Strength 27.84 Kg/17.99 kg, Timed Up and Go 14.3 sec/14.9sec, BMI 27.16/ 26.44, and calf circumference 35.5 cm /35.2cm, values were within the normal range of values. The data collected is important to consider when treatment planning and implementing actions aimed at maintaining oral and general functionality. These aspects should be addressed from a multidimensional perspective, including risk factors, in both the diagnosis and dental treatments.

The ageing population has increased globally, leading to the prevalence of geriatric syndromes, including frailty. Frailty is associated with multiple physiological system impairments, increased vulnerability to stressors, and functional disabilities. Dental problems are common among older adults and can contribute to frailty by causing chewing difficulties and malnutrition. The objective of this randomized clinical trial is to evaluate the impact of an immediate prosthetic functionalization protocol on the general functionality of patients with deficient removable prostheses in the Chilean public health system. This study protocol follows the Standard Protocol Items for Reporting in Trials (SPIRIT) guidelines. Patients aged 70 years or older, referred for prosthetic rehabilitation treatment, will be enrolled from the Eastern Metropolitan Health Service of Chile. The sample size calculation determined a sample universe of 120 individuals. The participants will be randomized into two groups: the control group will receive conventional prosthetic treatment, while the experimental group will undergo immediate prosthetic functionalization prior to conventional treatment. Various measurements will be assessed at baseline, 15 days after baseline, and at patient discharge, including hand grip strength, Timed Up and Go test, and quality of life related to oral health. Statistical analysis will be performed to compare the outcomes between the two groups, considering age, gender, and comorbidities. The findings from this trial will provide insights into the impact of immediate prosthetic functionalization on general functionality in patients with deficient removable prostheses. The results will contribute to improving the oral health and overall well-being of older adults, particularly those in the Chilean public health system. This study has received ethical approval and is registered in the U.S. National Library of Medicine Clinical Trials database (ClinicalTrials.gov Identifier: NCT05818436).