F OGORVOSI SZEMLE n 101. évf. 5. sz. 2008.
interest in taking care of oral health or may lose dexterity to perform oral health measures. They may need to use multiple medications which may affect salivary flow, may suffer from chronic diseases which are related to oral health or may develop cognitive problems. Reduced oral health in elderly may subsequently result in malnutrition, pneumonia, infections elsewhere in the body, pain, bad breath, candidiasis, problems with taste and burning mouth syndrome. These problems can obviously not all be prevented or solved by the dentist or the dental team. But the dental profession should play a key role in finding ways how to deliver daily oral care and dental care to all elderly. After having identified persons that are involved in the daily care of elderly, these care-takers should be convinced of their responsibility for oral health as well. Then protocols can be designed how to deliver care effectively. In the Netherlands nursing homes may have appointed a coordinator for oral care, who supervises the execution of the individual oral care plans, which are constituted within 6 weeks after an individual enters a nursing home. The basic elements of an oral care plan are not dependent on the type of patient: plaque should be daily removed adequately and fluoride applied. Additional measures have to be taken on individual indication. There is a need for more effective self-care products which could be products with SnF2 or with increased levels of fluoride (5000ppm) or products that combine fluoride and chlorhexidine effectively. In the dental office, dentists should be on the alert about even small changes in the oral health conditions and should consider future risks of elderly people in designing treatment plans. IATROGENIC DAMAGE DURING TOOTH PREPARATION AND ITS PREVENTION Lussi Adrian Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland Intensive preventive efforts have resulted in a remarkable reduction of dental caries. Shorter recall intervals favour early detection of incipient dental decay. Furthermore, it has been shown that smaller restorations have a longer lifespan. Finishing of occlusal cavity margins does not carry a risk of damaging adjacent teeth. However, removal of the proximal enamel fin with rotary instruments is virtually impossible without damaging the surface of the adjacent tooth. This holds true for Class II preparations and all other forms of approximal reduction. Pediatric dentists are often the first dentists to prepare teeth and therefore knowledge about possibilities to protect damage is very important. This lecture will concentrate on two preparation
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techniques to avoid damage during preparation. These techniques are the Prepcontrol system and Sonicsys. THE RESPONSIBILITY OF THE DENTISTS IN THE PREVENTION OF SECONDARY DISEASES Márton Ildikó University of Debrecen, Debrecen, Hungary Recent advances of dental and medical sciences support the impact of oral inflammatory lesions on certain systemic diseases, such as atherosclerosis and cardiovascular diseases, adverse pregnancy outcome and lung diseases. Properly executed epidemiologic studies identified an increased risk. Local and systemic spread of oral pathogens, local production of microbial and host-derived soluble mediator compounds, that may initiate or amplify inflammation, and the presence of common extrinsic and intrinsic pathways may impair both local and general health. Well planned dental and medical research efforts, including the contribution of gynecologists, pediatricians, cardiologists, pulmonologists, and orthopedic surgeons, may reveal the details of these emerging associations with a significant impact on public health and national economics. The lecture will summarize the increased and accumulated knowledge about the possible relationship between the chronic persistent oral inflammatory lesions and the secondary diseases. XEROSTOMIA AS A RISK FACTOR IN THE MIRROR OF THE ORAL HEALTH STATUS Márton Krisztina, Madléna Melinda, Nagy Gábor Semmelweis University, Department of Prosthodontics, Budapest, Hungary Xerostomia (dry mouth) is caused by systemic conditions and/or diseases, and generally accompanied by salivary hypofunction. Objective of this study was to assess the prevalence of oral dryness and the related extraoral sicca symptoms in the population at large in Hungary, and to evaluate the association of those symptoms to the unstimulated whole saliva flow rate (UWS). A further aim was to find correlation between the level of UWS and the oral health status of the questioned persons. 600 patients (selected according to the current regional age distribution scheme of the Hungarian Statistical Office) have been involved into the investigation. The first stage consisted of a questionnaire designed to determine the subjective presence or absence of oral dryness and the related sicca symptoms, then an assessment of UWS and the complete oral health status (including dental, periodontal and mucosal status)