3. Oral Changes Flashcards
Main feature of aging in cells
- Gradual cell loss
- Reduced mitotic activity
Physiologic systems most affected by aging are those containing post-mitotic cells which are what organs
- Heart
- Brain
- Muscle
- Skeletal system (less so than the other three)
When does the thymus begin to atrophy
Sexual maturity
entire thymus is involuted at what age
40
Lymphoid tissues (other than the thymus) reach max size at
puberty
Function of immune system (increases/decreases) with age
decreases (reduced number of t cells)
People with autoimmune diseases will (improve/decline) with age and why
improve because increase in auto anti-isotypic antibodies are present which fight off autoantibodies
B cell numbers (increases/decreases) with age
either stays same or increases
Primary immune system (increases/decreases) with age
decreases (inital response to antigen)
Secondary immune response (increases/decreases) with age
no change (may explain why few childhood diseases afflict the elderly
Rate of attrition in dentition is dependent on
diet and habits (not age)
Cause of higher incidence in abfraction in elderly is
unknown
Longitudinal cracks in enamel are caused by
thought to be caused by age related change in water content
Reasons why teeth are darker in color for elderly
- Thinning of enamel
- Increased optical density of dentin due to secondary dentin
- Secondary dentin considered reactive and no intrinsic aging
- Shrinkage of pulp
Hydration status of teeth (increases/decreases) with age
decreases
Dentin becomes more (flexible/brittle) with age
brittle
Reason dentin is more brittle with age
may be due to closure of tubules by crystal sedimentation
Sclerosed dentin is (more/less) translucent than normal dentin
more 9contrary to secondary dentin)
Reason for increased translucency of sclerotic dentin is
reduced refractory index difference between peri and intratubular dentin
Translucency of sclerotic dentin begins where
at the apex
Denticles and pulp stones (increases/decreases) in number in elderly
increases
Implications of pulp changes in elderly with performing dentistry
- Pulp is less able to repair after pulp cap
- Harder to find/navigate canals
- Less need for local anesthesia in many cases
Describe the degenerative changes that occur in the periodontium with age
- Less BVs
- Reduced cells
- Coarse and irregular formations of Sharpey’s fibers
- Moderate structural changes in alveolar bone/cementum
T/F Periodontal disease always worsens with age
F- sometimes reverse effect
Describe the reverse effect of periodontal disease seen in some elderly patients
- Minimal loss of marginal soft tissue
- Narrowing of periodontal space
- Firmly attached teeth (almost ankylosed)
- *This is commonly seen in patients with significant attrition**
Sometimes increased cementum deposition
Changes in alveolar bone with age
- Loss of trabeculation
- Cellular atrophy in osteocytes
- Increased bone loss (3% every decade past 40)
- Decreased blood supply (significant inferior alveolar artery arteriosclerosis
When the inferior alveolar artery is blocked due to atherosclerosis the alveolus will be supplied by what vessels
- Perisoteum
- Facial
- Buccal
- Lingual arteries
Changes in oral mucosa with age
- Atrophy of basal rete pegs (smoother surface)
- Submucosal loss of cells and vascular supply
- Thickening of collagen bundles and elastin fibers
- Degeneration of vessel walls (esp in tongue) –> senile amyloidosis
Changes in tongue with age
- Loss of lingual papilla (smoother dorsum) –> smooth dorsum can also be related to nutrient deficiency
- Increased filliform papilla which cluster –> fissured tongue
- Senile amyloidosis
- Increased varicosities
Systems involved in declined sense of taste in elderly
- Saliva **major
- Olfactory – not very significant
- Thermal sensory
- Tactile sensory
- Textural sensory
- Multiple types of taste receptors
- Nutritional (zinc involved with taste acuity)
Prominent reduction in smell is seen in the early stages of what diseases
Alzheimers or Parkinson’s
What tastes don’t decline with age
sweet and sore (old people eat more sweets)
Role of saliva in taste
-Dissolve in order for taste bud perception and breakdown by enzymes
Functions of saliva
- Remineralization
- Anti-microbial
- Lubricaiton
- Digestion (bolus formaiton , breakdown)
- Mucosal repair (epidermal growth facto)
- Buffering capacity
Consequence of salivary hypofunction
- Rampant caries
- Candidiasis
- Mucosal friability (tears more easily without lubrication)
- Dysphagia
- Complaints or oral dryness
- Complaints of altered taste
- Difficulty wearing prosthesis
T/F Xerostomia is a normal part of aging
f
Xerostomia is mostly caused by _ in elderly
meds
Aging changes in salivary system
- Stimulated whole saliva unchaged with aging
- Non-stimulated saliva is reduced
Saliva release from which glands are affect the most to least by aging
minor salivary glands> submandibular> Parotid
Parotid changes with age
- Some degeneration and loss of acinar glandular tissue
- Replacement of lost tissue with fibro-adipose tissue
Submandibular changes with aging
- More degeneration and loss of acinar tissue
- Replacement of lost tissue with fibro-adipose tissue
Minor salivary gland changes with agining
- extensive degeneration and loss of acinar glandular tissue
- Ductal proliferation
Changes in salivary immunoglobulins with age
- Salivary IgA conc. changes with flow rate (no change from aging alone)
- IgG and IgM antibodies decline
Changes in non-immunoglobulin defenses in saliva
None (same lysozyme, lactoferrin, and lacto-peroxidase)
T/F Blocked salivary ducts with plugs of degerative tissue ususally passes
t
T/F No age connection to sialolithiasis
t
Elderly have (higher/lower) biting forces
lower
Changes in muscle contractility in elderlys lead to
- Impairment higher in prostehesis wearers
- Increased time for bolus prepatation
- Increased chocking hazard
increased choking hazard in elderly enhanced by
- Reduced sensory perception
- Reduced proprioception
- Oral dryness
Change in voice with age is the result of
laryngeal stiffening
Speech in elderly also affected by
- Hearing loss
- Teeth loss
- Neuromuscular loss (dysarthria)
- Dysphagia
Alterations in posture that occur with age are
- Drooping lower face
- Hanging lower jaw
- Leads to drooling and spilling food
