高齡者與住院病患的口腔照護

Oral care in the elderly and hospitalized Inpatients

牙齒與口腔的照護在營造健康的生活上扮演重要角色。許多報告提出高齡者的口腔健康與生活品質之相關性，因此近年來高齡者的口腔照護成為關心的話題。但是，由於無自顧能力的高齡者無法自己清潔牙齒，加上照顧者要幫他們清潔牙齒也不是件容易的事，因此他們的口腔大都處於不乾淨的狀況。腦血管及神經退化疾病隨著年齡增高而發生率上升，而這些問題常伴隨攝食困難及咳反射不良等口腔功能障礙，進而容易引起吸入性肺炎。經過近年來的研究與報告，已釐清口腔內的細菌與吸入性肺炎及心內膜炎之間的關係，也瞭解咀嚼功能好壞對衰老及失智的影響。高齡者口腔問題引發的吸入性肺炎有可能成為死亡的原因。因此健康照顧者必須理解口腔照護的重要性，並且藉由適當的口腔照護來避免相關疾病的發生。Daily care of the teeth and mouth is important for a healthy life. Many reports reveal that proper oral health is significantly related to the overall quality of life for older individuals. Recently, oral health care for the elderly has become a topic of increasing interest. However, many dependent elderly patients who need special care have difficulty brushing their own teeth. Moreover, since it is not easy for family members or caregivers to do it for them, the teeth of dependents who cannot brush themselves are often left unclean. The incidence of cerebrovascular and degenerative neurologic diseases increase with aging, and these disorders are associated with dysphagia and an impaired cough reflex with the increased likelihood of oropharyngeal aspiration. Recently, we are coming to a better understanding of how bacteria in the mouth are related to aspiration pneumonia and endocarditis, as well as the effects of mastication on senility and dementia. Aspiration pneumonia, the leading direct cause of death among the elderly, can be prevented by proper oral care. Preventing the development of these diseases through appropriate oral care are primary goals for all of us involved in the health care profession.