Ageing and Gerodontology

Question 1

How can you classify ageing of the skin?

Answer 1

intrinsic or extrinsic

Question 2

How is intrinsic ageing histologically visible?

Answer 2

a flattening of the dermal-epidermal interface

Question 3

What processes are reduced in intrinsic skin ageing?

Answer 3

reduced cell turnover and reduced collagen production?

Question 4

What is extrinsic ageing?

Answer 4

any process that prematurely ages the skin

Question 5

What can cause extrinsic ageing?

Answer 5

sun exposure, smoking, repetitive facial expressions, gravity

Question 6

How is extrinsic ageing visible histologically?

Answer 6

presence of inflammatory cells in the dermins and atypical cells in the epidermis

Question 7

What is dermalelastosis?

Answer 7

deposition of abnormal elastic material

Question 8

What causes intrinsic ageing?

Answer 8

genetics

Question 9

When does ageing of skeletal muscle begin?

Answer 9

4th decade

Question 10

How fast is skeletal muscle lost due to age?

Answer 10

1% lean muscle mass lost per year

Question 11

What processes are reduced in skeletal muscle ageing?

Answer 11

production mitochondrial proteins and production of DNA leading to decreased muscle protein turnover

Question 12

Is there any way we can reverse the ageing of skeletal muscle?

Answer 12

by changing our diet and exercise

Question 13

What processes are reduced in salivary gland ageing?

Answer 13

saliva production and saliva excretion

Question 14

Which salivary gland is the least susceptible to ageing?

Answer 14

parotid

Question 15

What structures are reduced in oral mucosa ageing?

Answer 15

collagen and elastin

Question 16

What is age related reduced wound healing related to?

Answer 16

reduced immune response as we age

Question 17

Is gingival recession in older adults definitely caused by ageing?

Answer 17

no, it could be a secondary result of perio disease or toothbrush abrasion

Question 18

What is common in the gingiva of older adults?

Answer 18

flattening of inter-crestal gingiva, gingival fibrosis

Question 19

What are age related changes to enamel?

Answer 19

increased translucency, loss of hydroxyapatite crystals, accumulation of surface staining

Question 20

What are age related changed to dentine?

Answer 20

increased quantity

Question 21

What is primary dentine?

Answer 21

laid before eruption

Question 22

What is secondary dentine?

Answer 22

slower rate of deposition and a different direction of the tubules

Question 23

What is tertiary dentine?

Answer 23

reactive dentine that is laid down in response to irritation or damage in the tooth

Question 24

What are age related changes to the pulp?

Answer 24

reduction in the size of pulp chamber and root canals, decrease in cellular elements, decrease in vascularity and sensitivity

Question 25

What are age related changes to cementum?

Answer 25

increase in amount as cementogenesis continues throughout life

Question 26

Do healthy human teeth become more or less mobile with age?

Answer 26

less

Question 27

What are age related changes to the PDL?

Answer 27

more fibrotic, less elastic, PDL space narrowing

Question 28

How is alveolar bone maintained in the mouth?

Answer 28

in the presence of teeth

Question 29

What is the average life span of osteocytes?

Answer 29

35 years

Question 30

What are the consequences of elderly bones containing increased numbers of dead osteocytes?

Answer 30

mineralisation of lacunae, brittle and sclerotic bone

Question 31

When do females begin bone calcium loss?

Answer 31

40-45

Question 32

When do males begin bone calcium loss?

Answer 32

60

Question 33

What is gerodontology?

Answer 33

the branch of dentistry that deals with ageing and older people

Question 34

Do we use chronological age to determine who is elderly?

Answer 34

no, biological age is more important

Question 35

Why is Gerodontology becoming more relevant?

Answer 35

people are living longer and keeping their teeth longer

Question 36

What changes can you expect in the mouth of an ageing patient?

Answer 36

tooth wear, recession, xerostomia, root caries, increased oral cancer risk

Question 37

Why does oral health and the ageing patient matter?

Answer 37

good oral health can have a positive impact on general well-being and quality of life, unsatisfactory dentition or dentures can lead to social isolation due to wishing to avoid eating with others, if they have reduced chewing efficiency it may lead to malnourishment

Question 38

What are some links between oral health and general health?

Answer 38

oral bacteria have been linked to chest infections, the severity of periodontal inflammation is linked to glycaemic control with diabetes

Question 39

What are some ways retaining the natural teeth can have a benefit on life?

Answer 39

diet, nutrition and quality of life

Question 40

What are some barriers to oral health care in the elderly?

Answer 40

mobility, illness, inconvenience, cost, lack of access to NHS care, fear, anxiety, professional barriers

Question 41

Why can mobility be a barrier to oral health care in the elderly?

Answer 41

can be difficult for them to get to the surgery, patients may find it difficult to get upstairs

Question 42

Why can cost be a barrier to oral health care in the elderly?

Answer 42

there can be lots of costs associated with going to the dentist and many patients will likely be embarrassed by not being able to afford treatment or be scared of the costs

Question 43

Why can fear of the dentist be a barrier to oral health care in the elderly?

Answer 43

fear of the dentist is common among the elderly due to previous personal bad experiences and negative perceptions of dental treatment

Question 44

Why can availability of dental services be a barrier to oral health care in the elderly?

Answer 44

there seems to be difficulty in finding an NHS dentist and can be limited information on dental services in different languages

Question 45

What are root caries?

Answer 45

caries on the root surface after it has been exposed due to recession

Question 46

What are some risk factors for root caries?

Answer 46

high sugar diet, dry mouth, partial dentures

Question 47

How can you prevent root caries?

Answer 47

OHI, diet advice, fluoride

Question 48

Is periodontitis more common in the elderly?

Answer 48

no

Question 49

What are some potential causes of xerostomia?

Answer 49

side effect of medications, radiotherapy to head and neck, diabetes, sjogren's

Question 50

What side effects can occur due to xerostomia?

Answer 50

increased caries risk, perio disease, candida infections, dysphagia, difficulty tolerating dentures

Question 51

How can you manage xerostomia?

Answer 51

regular sips of water, sugar free gum, saliva substitutes

Question 52

What percentage of 75-84 year olds have tooth wear?

Answer 52

95%

Question 53

What may be some presenting complaints associated with toothwear?

Answer 53

sensitivity, sharp teeth, pulpitis, aesthetic concerns

Question 54

Is the treatment plan for toothwear always the same?

Answer 54

no, it depends upon the severity of the toothwear

Question 55

What are the important points for denture hygiene?

Answer 55

remove dentures at night, brush dentures with soap and water, place denture in water overnight, brush teeth if present, remove dentures and clean them during the day if food gets stuck

Question 56

What percentage of stroke survivors require special support?

Answer 56

50%

Question 57

How can a stroke affect how well a denture is tolerated?

Answer 57

reduced muscle control can reduce the retention, trouble inserting and removing dentures