[ISY-4] The Role of Gerodontolgy in the Centenarian-Era: toward the International Consensus, - “the inductive perspective of Taiwan” -
【略歴】Andy Y-T. Teng, DDS., MS., Ph.D., is President of Taiwan Academy of Geriatric Dentistry (TAGD) and has held full-time academic professorial positions in North America (Univ. of Toronto & Western Ontario, Canada & Univ. of Rochester, NY, USA) and Taiwan in the past 30-years, where he presently serves as Professor/Director at Center for Osteo-immunology & Biotechnology Research (COBR), College of Dental Medicine, Kaohsiung Medical University & affiliated Hospital, Taiwan. Teng has actively continued to disseminating and dedicatedly promoting to pioneer & explore the research field of osteo-immunology internationally, regarding the molecular/cellular signaling mechanisms on periodontal disease, arthritis, MRONJ & osteoporosis for potential applications via clinical vs. basic/translational sciences, including the oral-systemic medical links of modern gerodontology and novel psychomotor innervations onto developing early childhood caries (ECC) in his recent elaborations/endeavors.
Background: The traditional medical and oral health-care systems & services have been challenged by ongoing epidemic in the frail elderly carrying complex systemic disorders and the dilemmas of multi-comorbidity associated with ageing (i.e., geriatric syndrome) intertwined with mental deficits in the ageing population world-wide, whose mounting scientific evidence vary considerably in recent decays.
Methods: The materials to be presented will uncover the mixes of evidence-based databases (>26 regional/national reports, robust literature searches, the concerned issues: i.e., cardiovascular disorders, diabetes, strokes & dementia, cancers/oncologic therapies & drugs, and selected clinical targets) employed to address and sum-up the enhanced risks analyzed upon dealing with oral-systemic medical links in the frail geriatrics over the comorbidities vs. mortalities in general, thereby revealing such “silent-epidemic” factual. In Taiwan, the frail elderly have been impeded by significant burdens of systemic illnesses with high prevalence/incidences, as £12% reported being completely healthy only (~2016-2020); in parallel to top-rated diabetes-associated renal dialyses, G-I cancers (e.g., colon, breast, lung), naso-gastric tubing in long-term care facilities and the psychiatric/stress medications, etc., where they have collectively signified the worsening rates of oral health issues (i.e., caries>90%, periodontal diseases>80%, missing teeth/mixed edentulism >86% and dysphagia/chewing difficulty >30%, etc.).
Results: Herein, it is summarized to address: i) the clinical manifests and medications associated with systemic disorders, osteoporosis, heart diseases and strokes & DM (i.e., 85% taking >5 prescribed drugs), ii) notably, 1/4~1/3 vs. 30~40% of the frail elderly carried high rates of edentulism vs. untreated oral diseases, respectively, regardless their socio-economic status, iii) the prevalence of root caries and untreated caries in the elderly is a significant oral health concern, which underlines a potential threat, esp., to the frail ones with multi-comorbidities. It is suggested that (pre)-frailty, oral hypo-function, difficult in chewing & swallowing, the conditional uses of dental prostheses, dysphagia, malnutrition, dementia, multi-comorbidity & poly- pharmacy, progressive geriatric syndrome, etc., interactively contribute to the poorer quality of oral health, thus leading subsequently to systemic losses of functions and survival capacity, gradually rendering the outcomes through dental treatments being ineffective.
Summary: There is “ongoing” silent-epidemic among the frail elderly involving concerned matters described above, in Taiwan; when delivering the modern therapies for oral and medical health- care services. Importantly, we must systematically incorporate the risk assessments for the frail elderly with the sustainable evidence to ensuring the elder subject’s capacity upon engaging the stress/distress produced from dental/medical procedures; esp. how to prevent and manage the critical life-endangering situations, so that the long-term prognoses and outcomes become more favorable. This presentation will also touch-up some key issues and the challenges involved in her educational, academic vs. professional training courses to producing mature geriatric specialists leading towards a humane society with modern gerodontology for the coming years in Taiwan.
Methods: The materials to be presented will uncover the mixes of evidence-based databases (>26 regional/national reports, robust literature searches, the concerned issues: i.e., cardiovascular disorders, diabetes, strokes & dementia, cancers/oncologic therapies & drugs, and selected clinical targets) employed to address and sum-up the enhanced risks analyzed upon dealing with oral-systemic medical links in the frail geriatrics over the comorbidities vs. mortalities in general, thereby revealing such “silent-epidemic” factual. In Taiwan, the frail elderly have been impeded by significant burdens of systemic illnesses with high prevalence/incidences, as £12% reported being completely healthy only (~2016-2020); in parallel to top-rated diabetes-associated renal dialyses, G-I cancers (e.g., colon, breast, lung), naso-gastric tubing in long-term care facilities and the psychiatric/stress medications, etc., where they have collectively signified the worsening rates of oral health issues (i.e., caries>90%, periodontal diseases>80%, missing teeth/mixed edentulism >86% and dysphagia/chewing difficulty >30%, etc.).
Results: Herein, it is summarized to address: i) the clinical manifests and medications associated with systemic disorders, osteoporosis, heart diseases and strokes & DM (i.e., 85% taking >5 prescribed drugs), ii) notably, 1/4~1/3 vs. 30~40% of the frail elderly carried high rates of edentulism vs. untreated oral diseases, respectively, regardless their socio-economic status, iii) the prevalence of root caries and untreated caries in the elderly is a significant oral health concern, which underlines a potential threat, esp., to the frail ones with multi-comorbidities. It is suggested that (pre)-frailty, oral hypo-function, difficult in chewing & swallowing, the conditional uses of dental prostheses, dysphagia, malnutrition, dementia, multi-comorbidity & poly- pharmacy, progressive geriatric syndrome, etc., interactively contribute to the poorer quality of oral health, thus leading subsequently to systemic losses of functions and survival capacity, gradually rendering the outcomes through dental treatments being ineffective.
Summary: There is “ongoing” silent-epidemic among the frail elderly involving concerned matters described above, in Taiwan; when delivering the modern therapies for oral and medical health- care services. Importantly, we must systematically incorporate the risk assessments for the frail elderly with the sustainable evidence to ensuring the elder subject’s capacity upon engaging the stress/distress produced from dental/medical procedures; esp. how to prevent and manage the critical life-endangering situations, so that the long-term prognoses and outcomes become more favorable. This presentation will also touch-up some key issues and the challenges involved in her educational, academic vs. professional training courses to producing mature geriatric specialists leading towards a humane society with modern gerodontology for the coming years in Taiwan.