[Surgical dentistry and geriatrics in Senegal]

Geriatric medicine is developing more and more as a specialism. Odontology is not behindhand. That is why, even in an African setting, when life expectancy is still not as high as in the West, we are finding ourselves treating older and older patients.

During the course of the academic year 1989-1990, we treated 40 patients of both sexes, of different ethnic and social backgrounds aged from 55-89 years. Besides age, the patients had all undergone endo-buccal surgery, with the exception of parodontology surgery. According to sex: The forty patients comprised 27 men and 13 women. These figures are interesting and we will return to them during the discussion. According to age: The ages of our patients ranged from 55-89 years, with an average of 72. The distribution of age brackets shows a strong percentage (52.5%) of patients between 55 and 64 years of age. According to oral stage: In general, our patients neglect oral hygiene: 67.5% presented at least tartaric gingivitis. This negligence was evident in more men than women. According to general state: More than half the sample had at least one general pathological disorder. They ranged from cardio-vascular ailments, to differing digestive disorders, to neurological and endocrinal pathologics.

The data was collected using the following 3 methods which slowly built up: questionnaire clinical examination the operation

The dividing-up of the different operations: we realised a total of 71 operations, this being an average 1.77 per patient. Distribution of pathological ailments according to type and nature: About 55% of our patients had a general pathology. Cardio-vascular ailments took first place with a frequency of 52.16%, followed by digestive problems with 26.08% neurological syndromes with 13.04% and ailments with endocrinal origins with a rate of 8.69%. Incidents during operation: incidents linked to the anaesthetic, incidents linked to the operation itself, post-operative incidents, healing.

Age: The most representative age-band was between 55 and 64 years (with a six ration of 1:5). Multiple extractions: Apart from a defective oral state, these extractions are always motivated by the need for prosthesis. All the patients were missing at least one tooth, confirming the thesis of Dubois, according to which "the repercussion of oral ageing appears in all its simplicity in either partial or total toothlessness".

Elderly Senegalese patients present serious oral problems since extraction comprises the main part of surgical odontological operations. A better way of dealing with these subjects, weakened by old age and general pathology, is desirable.