9 - Gerodontology Flashcards
What factors impact oral frailty?
- mastication (difficulty eating hard foods or complete inability to chew)
- swallowing (decreased ability to swallow food or liquids)
- motor skill (impaired tongue movement, speech or phonatory disorders)
- salivation (hypo salivation or xerostomia)
What do family deem important in end of life care?
- cleanliness
- free of pain
- family present
- dignity maintained
How does frailty impact oral health?
- communication, halitosis, comfort
- immune status, OHRQoL and pain/infection
- nutrition
What is an alternative to conventional restoration in older people?
ART
What are common oral problems in the older population?
- oral candidiasis
- xerostomia
What are the dental implications of falls?
- dental trauma
- sit patients up slowly after treatment (postural hypotension)
- manual handling
- domiciliary visits
- MRONJ
What are the dental implications of poor nutrition?
- delayed healing
- NCTSL
- haematinics (burning mouth syndrome, RAS)
- higher caries rate
What are the dental implications of poor diabetic control?
- hyper/hypoglycaemia
- fatigue or reduced tolerance of long treatment
- infection risk
- poor wound healing
- periodontal disease
How do you manage dysphagia?
- altered consistency of food
- non oral feeding NG or PEG
- tuck chin to chest when swallowing
- rehab
What dental advice can you give someone with dysphagia?
- brush teeth with suction/self aspirating toothbrush
- low foaming toothpaste
- no excess water on toothbrush
- rub toothpaste in mouth prior to brushing
What changes can be made to make an environment dementia friendly?
- good acoustics to aid communication
- walls, doors and floor different colours
- clear signage
- well lit
What communication tools should you use to communicate with someone with dementia?
- engage and eliminate distraction
- eye contact
- physical contact to maintain attention
- verbal cues and short sentences
- reassure and use humour
- use first name
What are key teeth for OHRQoL?
- occluding pairs
- increased number of teeth
- anterior teeth
What are the dental implications of dementia?
- progressive neglect or inability to undertake OH
- inability to accept treatment
- xerostomia
- halitosis
- caries and periodontal disease progression
What patients require domiciliary visits?
- bed bound
- oxygen therapy
- hospitalised
- agoraphobic
- end of life care
Who provides dental domiciliary visits?
- GDP
- PDS
- SCD
What is the lone working policy?
Always have a chaperone (can be dental nurse)
What are you required to take with you on domiciliary visits?
- ID
- portable suction
- emergency bag including drugs
- dental equipment
- sharps box
- PPE
What treatment is appropriate for domiciliary visits?
- replacing dentures
- assessment of ST disease
- simple extractions
- ART
- supragingival PMPR
- prevention
What is recommended for palliative oral care?
- moisten mouth every 30 mins (ice, water spray, lubricant)
- remove risk of pain or infection where possible
- general OHI
What is is palliative care?
Active total care of patients who are not responsive to curative treatment, including control of pain, other symptoms and of social and spiritual problems
