A- Ageing Flashcards

Question

( 1) What is the life course and how does this relate to ageing?

Answer 1

Ageing is a process that continues from birth to death, although the transitions between different phases are not pre-determined A life course approach includes both consideration of people’s social surroundings, and stories of people’s lives over time

Answer 2

Age strata – people who share similar social rights and duties by virtue of age Age cohort – people born at a particular time who have experiences in common

Answer 3

Social contexts of dental treatment: Prevalence of caries Lack of equipment and pain relief Multiple teeth removed under anaesthetic leading to lifelong fear

Answer 4

- Legal rule changes - Ongoing research - Social campaigning - Changes to beliefs > changes to social rules/norms (Shaped by social, cultural and material changes)

Answer 5

Theories as a way of explaining particular phenomena How ageing is viewed and experienced

Answer 6

1. Disengagement theory 2. Structured dependency theory 3. Cultural gerontology 4. Critical gerontology

Answer 7

Functionalist theory: focuses on how elements of society work together - Growing old is an inevitable mutual withdrawal or disengagement resulting in decreased interaction between an ageing person and others in the social system he belongs to... - Irreversible process

Answer 8

Individuals are not free to act in any way they see fit. - focuses on ways in which social institutions shape people’s lives. Dependency structured by retirement, poverty, institutionalisation in residential and nursing homes and the restriction of domestic and community roles.

Answer 9

Limitations to domiciliary care, lack of knowledge and training, poor monitoring of care Lack of equipment in care homes, limited time and reimbursement for leaving private practice

Answer 10

Focus on role of culture (varied and complex systems of meaning that constitute everyday life). Multiple cultures of ageing, with different representations of old age: 1) The third age 2) The challenge of individualisation 3) The fourth age

Answer 11

Life after responsibilities of paid employment and child rearing Social and cultural phenomenon- Social: Rests upon social practices (key structure of retirement) Cultural: Given symbolic meaning Varied experiences of ageing process, older people as active citizens and consumers?

Answer 12

Social identity less of a ‘given’ and more of a ‘task’ to be achieved – the individual is charged with ‘the responsibility for performing that task and for the consequences (also the side-effects) of their performance'

Answer 13

Social imaginary – ‘a set of unstated but powerful assumptions concerning the dependencies and indignities of ‘real’ old age’ Meanings attributed to ageing bodies: > Fourth age can appear to be ‘nothing but the body’ > Beauty work and distancing processes to avoid appearing ‘old’

Answer 14

Critiquing and changing society Three main areas - Structural pressures and constraints - Meaning - Empowerment Ageing as socially constructed! Ageing negotiated by the individual, but considering the role of economic and political systems in shaping power arrangements and inequalities.

Answer 15

Biographically informed approach to thinking about older age. - Interview transcripts

Answer 16

- Increase in numbers of older people - People are living longer - Medical intervention & treatment - Better social conditions - Improvements in public health - Women living longer than men - Baby boomers of 1940’s & 1960’s

Answer 17

Large proportion edentulous | Plastic tooth generation

Answer 18

Retained much/most of their natural dentition Requires maintenance to avoid tooth loss Heavy metal generation

Answer 19

Good oral health Cosmetic dentistry - White tooth generation

Answer 20

- Genetic & environmental factors -Life-style -Effect of illness & disability -Effects of medication -Personality: Rigid/pessimistic or flexible/optimistic -Psychiatric history -Level of independence: Mobility Activities of daily living - washing, dressing, bathing, personal hygiene

Answer 21

``` Medical problems Drug interactions Ability to understand and tolerate treatment Financial Access Low expectations Acceptance of loss of function and pain ```

Answer 22

This guideline covers oral health, including dental health and daily mouth care, for adults in care homes. The aim is to maintain and improve their oral health and ensure timely access to dental treatment.

Answer 23

Improve eating Improve speech Improve facial appearance Decrease pain All help to reduce social isolation. Poor masticatory function may mean a poor/ restricted diet.

Answer 24

Tooth loss and replacement Tooth wear Collapsing/failing/terminal dentition Dry mouth due to medication Compromised self-care due to disability

Answer 25

No previous denture wearing experience Less able to learn skills High expectations

Answer 26

``` Reduced face height Pulp death Sensitivity Aesthetics Sharpness to tongue Brittle Difficult extractions ```

Answer 27

``` Difficulty in wearing dentures Root caries Difficulty with mastication Difficulty with speech Soreness & ulcers Lack of appetite ```

Answer 28

``` Multiple abscesses Bleeding gums Mobility Pain Halitosis Aesthetics ```

Answer 29

Salaried service working jointly with GDPs in city to increase numbers of people in care homes able to access oral care

Answer 30

- Knowing who actually needs tx - Don't usually come to dentist bc of pathology - Physically proving the tx (transport) - The dental surgery environment may be difficult for the older patient to manage - Older patients have reduced ability to adapt to change

Answer 31

``` Denture stomatitis Oral cancer Denture granuloma Lichen planus Oral infections ```

Answer 32

- Domiciliary care? - Ambulance/meditaxi to bring in - Capability travelling alone? - Neighbours/ family?

Answer 33

Easy for the patient but more difficult for the clinician. Chaperone necessary Take all equipment necessary including light and take all clinical waste away.

Answer 34

``` Access Toilets Lighting Busy environment TIME ```

Answer 35

``` Confusion Lack of compliance Intolerant of long procedures Bright light Too noisy Postural problems ```

Answer 36

Seating – keep upright, or slowly alter position Noise – low tones, reduce noise and speed Confusion – reduce speed, less instruction- - check medical history (GP or family) Timing of appointment – medication, capability,convenience

Answer 37

1) Make small changes to existing dentures reline adapt existing denture 2) Copy existing dentures, having made alterations 3) Make new dentures that are similar to some aspects of previous dentures

Answer 38

Age | Consequences of tooth loss

Answer 39

- impression taking, - jaw registration, - retention and stability of the denture - ability to wear the denture

Answer 40

Following tooth loss, alveolar bone resorbs, rapidly at first but decreases with time After loss of the teeth the remaining alveolar bone forms the alveolar ridge - gives support to a denture - part of the denture-bearing area.

Answer 41

Approximately 4 times as much resorption of mandible as maxilla More in mandible!!!

Answer 42

Around an individual tooth, resorption is greater where the cortical plate is thinner.... i.e.: Maxilla: LOSS buccally most; MOVES LINGUALLY Mandible: (in at front, out at back) - Anterior: LOST buccally... MOVES LINGUALLY - Posterior: Buccal plate is reinforced by external oblique ridge; there is resorp of thinner lingual plate-->> movement of residual ridge => BUCCALLY!!

Answer 43

Too little resorption Irregular resorption Excessive resorption Normal resorption

Answer 44

Too little resorption will lead to bulky alveolar ridges with little space in which to place dentures - adequate interalveolar space. - frequent denture fracture - excessive face height - Denture too big... - Compromised function to speak, eat (Size of denture is usually increased to give strength...)

Answer 45

Bone may be sharp and the soft tissues may get traumatised under the denture leading to ulcers and discomfort. Surgical reduction of the ‘knife-edge’ ridge may be needed.

Answer 46

normal relationship of the posterior teeth may be changed? With the increase in width of the mandible posteriorly, a ‘posterior crossbite’ is produced. Anteriorly, where buccal resorption of the maxilla predominates, an edge-to-edge incisor relationship or prominent mandible may occur.

Answer 47

atrophy of the alveolus causes the mental foramen to become superficial (nerve?) the mylohyoid ridge on the lingual aspect of the mandible becomes sharp and prominent. Both may cause pain during denture wear.

Answer 48

A few months after extraction resorption has taken place. The dentures start to feel loose- the dentures need relining or replacing to improve the retention.

Answer 49

``` Check record Windowed trays Neutral Zone Impression Technique Retained roots Polycarbonate Soft Liners ```

Answer 50

For anterior flabby ridges An overall impression is taken in a ‘windowed’ tray constructed on a primary impression. With the impression in the mouth the ‘window’ is filled with a fluid impression material (silicone, plaster etc.).

Answer 51

To reduce likelihood of midline fracture

Answer 52

More comfortable base over irregular ridges Processed onto denture in laboratory. Lasts 6/12 – 3 years.

Answer 53

Implants Sulcus deepening Ridge augmentation