British Society of Gerodontology Summer Scientific Meeting

The British Society of Gerodontology (BSG) Summer Scientific Meeting took place in the leafy setting of Sheffield on 10 June 2022. The conference title was Integrated Dental Care for Older People, representing the society's aims - protecting, maintaining and improving the oral health of older people. Jodie Bustin as incoming BSG president hosted and organised the event and will now be working towards the Winter Conference on 1 December in London. All members of the dental team are welcome to join and attend BSG from all dental settings; details are available on .

BSG President 2021 Michael Butler with incoming President Jodie Bustin

The conference began with a thought-provoking talk from Dr Rod Kersh - Consultant Community Physician. It was based around treating older adults with dignity in a community setting rather than in hospital. The 'What matters to you day (WMTYD) 9th June' was discussed and referenced throughout; a TED-style talk on the subject is available and the campaign is based around person-centred care and the 'what matters to you' should be a vital sign. Dr Kersh explained: 'When I say patient, think person'. He has a vast wealth of experience as a consultant geriatrician and runs a blog. He discussed becoming a 'Black belt in medicine' and presented patient cases where they could have been treated in community or hospital. His cases were supported with evidence such as a King's Fund paper 'Making shared decision making a reality' promoting 'Instead of asking what's wrong with you - asking what matters to you?' Vignettes included Doreen, 88, with Alzheimer's and Mick, 81, pulmonary with MND. Finally, Dr Kersh discussed advanced care planning.

The next talk was from Residential Oral Care Sheffield group - Mrs Joanne Charlesworth, Oral Health Promotion Manager. This is a fantastic initiative relating to oral health and comprehensive oral care for care home residents involving both the CDS/GDS. Oral health care training is given every two years to care homes, currently 70 homes in Sheffield. They discussed referrals between the CDS and GDS and that challenges existed such as a high turnover of care staff, and problems with exemptions/medical history/consent forms. Twenty residents were involved in a service evaluation which showed promising results.

Dr Sebastian Francis, consultant in haematology, presented a talk on haematology for the older patient and based his talk around the dental treatment planning advice he commonly gives. He started by explaining that the incidence of myeloid, lymphoid, plasma cell neoplasms increases with age. Cases were presented including a 70-year-old myeloma patient requiring dental treatment and an AML patient who presented with gum hypertrophy. He explained intensive chemo is now given to under-70-year-olds. Also, a case of immune thrombcytopenia purpura was presented with platelets at 22 and a patient with Factor VIII deficiency (haemophilia A). Dr Francis explained that if a patient has not been seen by a dentist, the CCG may not fund a bone marrow transplant. Additional advice on renal function, liver disease and advanced heart failure proved very useful to those practising dentistry for medically compromised patients.

A further talk on endodontic treatment in the older patient gave lots of practical tips for those treating the ageing population. There was discussion on physical frailty, cognitive function and age changes in dentine pulp complex. A confident diagnosis was recommended as the key to treatment planning, and a tooth restorability index was presented including ferrule and strategic value to tooth.

Following a lunch break and sponsor presentations, the next talk was by Sabine Jurge, Consultant in Oral Medicine. Common oral medicine issues for older people were discussed. Dry mouth is reported to affect a third of elderly people. Cases presented included dry mouth, denture stomatitis, black hairy tongue, burning mouth syndrome, oral ulceration and pemphigus. Investigations such as sialometry, ANA/EMA screening, Schirmer's test and further blood investigations were presented: a useful update in managing the older patient with oral discomfort.

A presentation on implant monitoring and maintenance was very useful considering the increasing number of adults having implants placed and maintained into older age. Funding guidance is available from RCS and an update on the fixtures, abutments, screws and prostheses was very informative. Fixed vs removable restorations were discussed and the idea of an 'implant passport'. Advice on implant examination included: visual, probing, prosthesis assessment, radiographic (screws, bone levels, fit). The difference between peri-implant mucositis and peri-implantitis was explained plus biological vs mechanical complications. A case with composite bonded to acrylic for simple repairs of prostheses was presented and advice on planning treatment in an older patient - a 'backing off approach' was presented for managing implants into advanced age.

The complete denture troubleshooting presentation provided an excellent overview for successful complete denture provision. This included: assess freeway space, trimming special trays, use of ZnoEug and Alma Gauge, reg block design, position of lower teeth in relation to ridge, post dam and retromolar pads and upper retention. The final presentation was on the 'Okay to stay' initiative. The Community Matrons within Integrated Community Care Directorate led the implementation of the 'Okay to stay' plan, which aims to support patients with long-term conditions to avoid unnecessary hospital stays, using a simple, accessible patient-centred plan and a coordinated response from community teams. This nicely concluded the conference on an integrated care theme.