Clinical evaluation for a successful root canal treatment is assessed by various criteria, which are clinical, histopathological, and radiographical criteria. Therefore, failure of endodontic treatment can be described as a recurrence of clinical symptoms, with the presence of a periapical radiolucency or both. Failure factors in the treatment are frequently related to persistent infection. Conventional endodontic retreatment is indicated for symptomatic previously treated teeth or asymptomatic teeth with inadequately done initial endodontic treatment to avoid potential recurrence. Endodontic retreatment in elderly patients is a great challenge because the clinician has to reassure both the physical and psychological factors of the patient to determine whether to save a tooth or perform an extraction. Some difficulties may also be found in root canal retreatment, including finding the root canal hole or root canal blockage found in parts of the root canal that have not been repaired in the previous treatment. A 60-year-old female patient came with the chief complaint of recurrent pain, and subjective discomfort in the maxillary left central incisor. The patient had anxiety about the dental treatment. The tooth had a history of root canal treatment four months ago. The clinical examination showed a positive response to the percussion test. The radiographical analysis showed a root canal underfilling, 2-3 mm short of length from the apex. The tooth was diagnosed as a previously treated tooth with symptomatic apical periodontitis. Endodontic retreatment was performed based on the patient’s clinical condition and consent, followed by composite restoration. The clinical and radiographic re-evaluation after four weeks of follow-up revealed an excellent condition. This favorable result showed that a conventional retreatment plan of persistent pain on the previously treated tooth in an elderly patient led to progressive healing, and a longer follow-up was advised.
Dental Care ; Retreatment ; Aged

Fall is the most common cause of trauma in the elderly and a major reason of dental injury. Maxillary anterior region is the most vulnerable area to the traumatic fall. Loss of teeth and adjacent tissue in this area results in maxillofacial defects and inappropriate maxillomandibular relationship. Reconstruction of the loss requires comprehensive and careful planning to fulfill not only functional but also esthetic demand. Prosthetic approach can avoid surgically extensive intervention, reducing both treatment cost and time. This clinical report describes a 78-year-old woman with the loss of teeth and alveolar bone in maxillary anterior region due to a traumatic fall, rehabilitated with a metal-ceramic fixed dental prosthesis using gingival porcelain.
Aged* ; Dental Porcelain ; Dental Prosthesis ; Female ; Health Care Costs ; Humans ; Tooth

BACKGROUND: Dementia is a condition in which a person who has been living a normal life suffers from various cognitive impairments in memory, words, and judgment that considerably disrupt daily life. The oral care ability and subjective oral status of elderly individuals with dementia are lower than those of a healthy person. The oral health care of individuals admitted to nursing homes inevitably falls to nursing assistants and nursing care staff. This study aimed to investigate the need for oral health management items of and to provide basic direction for the future of the Dementia National Responsibility System. METHODS: Elders aged 65 years and over were selected from a comprehensive welfare center. A total of 155 questionnaires were analyzed. The questionnaire consisted of 15 items about general status, 9 items about recognition of the Dementia National Responsibility System, 5 items of the subjective recognition of oral health, and 6 items of the correlation between oral health and dementia. RESULTS: Among our subjects, 71.0% answered that they did not know about the Dementia National Responsibility System, 78.7% answered that they think they need the system, and 81.9% think that they should add dental health items to the Dementia National Responsibility System. The response to the need for dementia national responsibility, oral health items in the Dementia National Responsibility System, and oral specialists all showed scores of >4 points. The need for the Dementia National Responsibility System, oral health items, and specialists were found. CONCLUSION: It is necessary to include oral health care items in the Dementia National Responsibility System so that elderly individuals with dementia can receive the needed oral health care.
Accidental Falls ; Aged ; Cognition Disorders ; Dementia ; Dental Care ; Humans ; Judgment ; Memory ; Nursing ; Nursing Care ; Nursing Homes ; Oral Health ; Specialization

As the elderly population increases, they are increasingly affected by oral health problems. Therefore, efforts are being made to improve the oral health of older people, alleviate mental discomfort, and reduce unmet dental needs. This study was conducted to confirm the relationship between the National Health Insurance Elderly Denture Coverage and the unmet dental need for the edentulous elderly, as part of the protection policy. We analyzed the 2011 and 2013 Community Health Survey data of the edentulous elderly, aged 75 years or older, before 2012. In order to more precisely confirm the effects of the denture donation policy on unmet dental care, basic life recipients who were subject to the free elderly prosthetic project were excluded from the analysis. The final analysis included 20,400 subjects. According to our investigation of the factors that affect the unmet dental needs of the elderly, the National Health Insurance Elderly Denture Coverage did not affect unmet dental needs. The statistically significant variables that affected the unmet dental needs of the elderly were education and income levels, which are representative socioeconomic status variables. The lower the level of education, the unhealthier the dental care experience, and income levels showed a similar tendency. The elderly who have a low socioeconomic status are more likely to experience unmet dental needs because they lack the knowledge and socioeconomic ability to pay for dental care. Therefore, the policy for health protection of the entire elderly population should be continuously expanded. In addition, the socioeconomically vulnerable groups may have health problems due to the restriction of medical use, which may lead to quality of life deterioration.
Aged* ; Dental Care ; Dentures* ; Education ; Health Surveys ; Humans ; National Health Programs* ; Oral Health ; Quality of Life ; Social Class

In accordance with the aged society, oral health care for the elderly is considered important to maintain general health. Although the role of dental hygienists is essential for proper health management of the oral cavity, research on the care system for the elderly people's oral health and on the role of dental hygienists in the field of elderly welfare is still insufficient. Hence, the aim of this study is to investigate the status of Korean elderly welfare system and dental hygienists by comparing them with those in Japan, a precedent of aged society. First, we compared and investigated the Japanese long-term insurance system, which provides an institutional basis for a long-term care system for the elderly in Korea. Second, the elderly welfare law and care system, focusing on oral care, were examined. Lastly, in elderly care, we analyzed the distinctions between Korea and Japan regarding dental hygienists' role and scope of work. Taken together, as a precedent of aged society, Japan has shown well-specialized and systematic welfare for the elderly compared with Korea. With the development of the welfare system for the elderly in Japan, the role and the workscope of dental hygienists have been expanded to improve quality of life of elderly people, as a key professional for elderly oral care. Therefore, we should perceive the need for improvement of long-term care insurance and the expansion of dental hygienists' work in Korea. In conclusion, these results could be used as basic data for improving the elderly welfare system and developing dental hygienists in Korea.
Aged* ; Asian Continental Ancestry Group ; Dental Hygienists* ; Humans ; Insurance ; Insurance, Long-Term Care ; Japan* ; Jurisprudence ; Korea* ; Long-Term Care ; Mouth ; Oral Health ; Quality of Life

OBJECTIVES: This study was conducted to identify the demand and willingness to pay for oral hygiene services among elderly people with long-term care insurance. METHODS: Our study was a cross-sectional analysis. Subjects comprised 126 elderly individuals from long-term home-care centers. A total of 28 centers were selected through convenience sampling from among 78 centers in ○○. For analysis, semi-structured questionnaires that required about 20–30 minutes to complete were used. Analysis was performed using SPSS 23.0 software. RESULTS: The overall demand for oral hygiene services was 44.4%, and willingness to pay was 31.0%. Thirty-three people (58.9%) of elderly those who have demand for an oral hygiene service were willing to pay for the service, and 64 people (91.4%) who did not have a demand were not willing to pay for it. Among those with partial dependence on brushing, 65.6% had demand for oral hygiene services and 50.0% were willing to pay costs. Among basic livelihood beneficiaries, 69.6% were willing to pay for oral hygiene services; general subjects and relievers were less willing to pay. CONCLUSIONS: The overall demand for oral hygiene services among elderly people was 44.4%, and the willingness to pay was as low as 31.0%.
Aged ; Cross-Sectional Studies ; Dental Hygienists ; Humans ; Insurance, Long-Term Care ; Long-Term Care ; Oral Hygiene

PURPOSE: To report a case of candida endogenous endophthalmitis in healthy women who had received extraction of wisdom tooth. CASE SUMMARY: A 65-year-old medically healthy woman who had received extraction of wisdom tooth two weeks ago, presented with floater symptoms in her left eye. Best-corrected visual acuity was 20/40 and intraocular pressure was 17 mmHg in her left eye. Inflammatory cells were found in the anterior chamber and vitreous. Fluorescein angiography showed multiple hypofluorescence without vascular leakage. With provisional diagnosis of intermediate uveitis, she was prescribed oral steroid for two weeks. After that, inflammatory cells in anterior chamber was reduced but vitreous imflammatory cell was increased and fundus examination detected newly developed infiltrated lesion at superotemporal area. The patient was presumed to have fungal endophthalmitis and immediate intravitreal voriconazole injection was performed. Three days after intravitreal voriconazole injection, diagnostic vitrectomy and intravitreal voriconazole injection were performed. Vitreous cultures revealed the growth of Candida albicans. Despite the treatment, inflammatory response in anterior chamber and vitreous rapidly increased and visual acuity was decreased to hand movement. We changed anti-fungal agent, voriconazole to Amphotericin B. Additional three-time intravitreal injection was done and therapeutic vitrectomy with oil injection were performed. After treatment, the patient's fundus markedly improved and inflammatory response was decreased. CONCLUSIONS: This case report shows candida endophthalmitis in healthy woman who had received extraction of wisdom tooth. So to diagnose endophthalmitis, patient's medical history should carefully be checked including dental care history who presented with vitreous inflammation and inflammatory infiltrated lesion at fundus.
Aged ; Amphotericin B ; Anterior Chamber ; Candida ; Candida albicans ; Dental Care ; Diagnosis ; Endophthalmitis ; Female ; Fluorescein Angiography ; Hand ; Humans ; Inflammation ; Intraocular Pressure ; Intravitreal Injections ; Molar, Third ; Uveitis, Intermediate ; Visual Acuity ; Vitrectomy ; Voriconazole

BACKGROUND: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. METHODS: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. RESULTS: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. CONCLUSION: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.
Aged* ; Cardiovascular Diseases ; Delivery of Health Care* ; Dental Implants* ; Emergencies ; Female ; Humans ; Hypertension ; Immunosuppressive Agents ; Insurance* ; Korea* ; Male ; Medical History Taking ; Medical Records ; National Health Programs ; Osteoporosis ; Postoperative Complications ; Sex Distribution

Tooth wear, one of the physiological changes in the elderly patient's mouth, generally does not require treatment, but requires prosthodontic restoration when occlusal disharmony, poor masticatory function, pulp exposure occurs. One of the primary considerations in prosthodontic restoration for tooth wear is vertical dimension. It is necessary to make an accurate diagnosis and analysis, correct judgement of the interdental relationship for predictive treatment plan. A step-by-step approach considering dental care for aged is also required. In this case, a 93-year-old male patient presented with worn dentition and mobility of existing fixed dental prosthesis. After diagnosis and evaluation, maxillary rehabilitation without any change in the occlusal vertical dimension was performed and this shows satisfactory results both functionally and morphologically.
Aged* ; Dental Care for Aged ; Dental Prosthesis* ; Dentition* ; Diagnosis ; Humans ; Male ; Mouth ; Rehabilitation ; Tooth Wear ; Vertical Dimension

This study was conducted to investigate the effects of professional oral healthcare program in eldery residents long-term care facilities. Ninety-four elderly residents from 5 different facilities in Asan participated in this study. The subjects were divided into 3 groups, with 32 in experimental group I, 30 in experimental group II, and 32 in the control group. Subjects in experimental group I were treated by a dental hygienist with professional oral healthcare and received daily oral care from caregivers who had completed elderly oral healthcare course. Subjects in experimental group II received daily oral care from caregivers who had completed elderly oral healthcare course. Control group received daily oral care from caregivers. These 3 groups were tested for dental plaque, halitosis, tongue coating, and salivary flow at baseline, and after 4 and 12 weeks of treatment. There were significant differences in the dental plaque index between the groups, mediate times, and mediate methods, in halitosis between the mediate methods, and in tongue coating between the mediate times, as well as the mediate methods. Finally, salivary flow was significantly different with regard to mediate methods between experimental group II and the control group. Therefore, to improve the oral health condition of elderly residents, involvement of a part-time dentist and scheduled professional oral healthcare are necessary. Furthermore, elderly oral healthcare education for nursing staff, including managers, should be provided.
Aged* ; Caregivers ; Chungcheongnam-do ; Delivery of Health Care* ; Dental Hygienists ; Dental Plaque ; Dental Plaque Index ; Dentists ; Education ; Halitosis ; Humans ; Long-Term Care* ; Nursing Staff ; Oral Health ; Tongue