Summary Creating of protocol for the education for oral health and improving oral hygiene among institutionalized elderly is of great significance in prevention of the consequences that can provide numerous oral diseases among the elderly. Activation of as much as possible range of professionals in the field of dentistry in creation of this protocol and the fundamentals for the education of dental staff, and other professionals who care for health also has great significance. In this way with minimal financial loss will be reached maximum benefit-improved quality of life for institutionalized elderly. Taking into consideration the previously mentioned facts about of oral health, the presence of numerous dental problems and increased health needs and poor health among institutionalized elderly the aim of this paper was made- to make a draft protocol for education of the staff responsable for care of the institutionalized elderly aged over 65 years. In this paper are presented fundamentals of a proposed protocol for improving of oral health and hygiene among institutionalized elderly. Presented are all disadvantages in of oral health care for the elderly, are given directions and goals in order for improving of oral health and hygiene among the elderly, guidelines and targets for prevention programs to educate the professionals who care for them.

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SUMMARYIntroduction. Poor oral health among elderly is most common dental problem nowadays, especially among the institutionalized persons.Aim. To detect DMFT index among the institutionalized elderly.Material and Method. Oral examination was made to make adequate evaluation. A total number of 70 subjects were evaluated. DMFT index has been detected only with dental mirror and probe, without using additional instruments and methods.Results. Average value of DMFT index in our survey was 24.84 ± 4.56 (with Confidence interval from 23.77 to 25.89). M-component was dominant − 21.56 ± 7.79 (with Confidence interval from 15.74 to 23.38). D-component indicated by carious teeth and persistent roots had value 2.60 ± 3.54 (with Confidence interval from 1.77 to 3.42). Mean value of teeth with definitive fillings (F-component of DMFT index) was 0.34 ± 1.42 (with Confidence interval from 0.33 to 1.01).Conclusion. DMFT index among the institutionalized elderly had one of the biggest values in the literature. M-component was dominant and indicator of the absence of many teeth. Therefore it is of great importance to prepare adequate protocol for oral health care among the institutionalized elderly.

Background: Evaluation of the position of foramen mentale has great significance and it is very important aids in endodontic, oral-surgical, periodontal interventions, as well as diagnostic procedures. Thus, in view of this, the present study was conducted among the population in North Macedonia, to determine the most common location of the mental foramen and to estimate difference in position of foramen mentale in correlation with the second lower premolar teeth. The mental foramen is an opening located on the external surface of the mandible in the region of the mandibular premolars. Radiographically the foramen mentale can be as an oval or round radiolucent zone in the inferior part of corpus mandible on lateral sides, on the left and right side. Panoramic radiographs are the most commonly used extra-oral radiographic aids in dentistry since they provide a rapid and wide picture of mandible and the maxilla in the same time. This technique allows the adequate localization of foramen mentale. The main aim of study is to evaluate the position of the mental foramen and its relationship with mandibular premolars among the population in Republic of North Macedonia Material and method: A total number of 250 panoramic radiographs were evaluated for the positioning of the mental foramen. When assessing the position of the mental foramen, its position is determined in relation with the mandibular premolars and the mandibular median line. All radiographic images in which can not be localized and confirmed the presence of the mental aperture was also excluded from the examination. The examination was performed on a negatoscope if it is classical panoramic x-ray or adequate software used for digital panoramic x-rays. If necessary, magnification was used for magnification of the images. The relationship of foramen mentale with the lower premolars was given according to the following classification: (1) if the position of foramen mentale is distally from the line that passes between the second premolar and the first molar in the lower jaw-first class; (2) if the position of foramen mentale is between the vertical central axis of the second premolar and the passing line between the second premolar and the first molar in the lower jaw- second class; (3) if the position of the foramen mentale is between the vertical axis of the second premolar and the line passing between the first and second premolars in the lower jaw- third class; (4) if the position of foramen mentale is between the line that passes between the first and second premolars in the lower jaw and the vertical central axis of the first premolar-fourth class and if the position of foramen mentale is mesially from the vertical center axis of the first premolar- fifth class. Results: On the basis of the data from our research, it is noted that in near 60%, foramen mentale is positioned between the roots of the first and second lower premolars. The most common position for foramen mentale is the third class (which means that foramen mentale is between the vertical axis of the second premolar and the line passing between the first and second premolars in the lower jaw). Conclusion: In conclusion, the present results showed variations in position of foramen mentale. So it must be noted that local differences in foramen mentale position may occur in a population. This variability should alert the oral surgeons while performing oral surgical and periodontal interventions. If the studies related to variations in the position of foramen mentale are carried out in larger numbers, this data will be reliable for dental medicine clinicians, and with this type of information the possibility of complications will be minimized.

Тhe mandible is a paired bone that develops within the mandibular arch, embedding teeth and forming anarticulation of the jaw with the cranium. Morphological changes are brought about by aging. The gonial angle, orthe angle of mandible, is formed by the line tangent to thelower border of the mandible and the line tangent to the distal border of the ascending ramus and condyle ie the lower jaw angle is formed by the ramus line (RL) and the mandibular line (ML), where RL is the tangent to the posterior border of the mandible and ML is the lower border of the mandible through the gnathion (gn) Withage the masticatory muscles change in function and structure with decreased contractile activity and lower muscle density. The gonial angle can be used as a tool inforensic odontology, but has received less attention. The aim of this study was to evaluate the angle of mandible comparing mandibular bones and OPGs. The study further intends to evaluate the variation in age using the gonialangle as a parameter. A total of 50 mandibles and 50 OPGs were included in the study. The study materials were obtained from theDepartment of Anatomy and the Department of Radiology of Simple methodology was employed for obtaining data. The gonial angle in mandibular bones was measured as the angle formed by the base of the mandible and the posterior border of the ramus by the scale of protractor, which isplaced over the angle of mandible in such a way that the base of the protractor coincides with the base of the mandible. The angle was recorded in degrees.The gonial angle in OPG was measured by a line drawn tangential to the lower border of the mandible and the linedrawn tangential to the posterior border of the ramus and the condyle. The intersection of these two lines formed the gonial angle which was measured using a protractor in the same way. The angle was recorded in degrees.All the readings were recorded and the mean value was calculated.The present study shows various values of gonial angle inOPG and mandibular bones. No significant difference was observed between these two. On comparison of gonial angle the mandibular bone showed slightly greater value than OPG The mean value of the gonial angles were found to beslightly more in mandibular bones and were lesser in OPG.There seems to be differencein the gonial angle with different age groups but not significant. Both mandibular bones and OPGs showed almost similar readings. Thusgonial angle serves as an adjuvant and additional forensic parameter which guides for age group assessment, subjectto odontological status.