Ageing and Gerodontology Flashcards
How can you classify ageing of the skin?
intrinsic or extrinsic
How is intrinsic ageing histologically visible?
a flattening of the dermal-epidermal interface
What processes are reduced in intrinsic skin ageing?
reduced cell turnover and reduced collagen production?
What is extrinsic ageing?
any process that prematurely ages the skin
What can cause extrinsic ageing?
sun exposure, smoking, repetitive facial expressions, gravity
How is extrinsic ageing visible histologically?
presence of inflammatory cells in the dermins and atypical cells in the epidermis
What is dermalelastosis?
deposition of abnormal elastic material
What causes intrinsic ageing?
genetics
When does ageing of skeletal muscle begin?
4th decade
How fast is skeletal muscle lost due to age?
1% lean muscle mass lost per year
What processes are reduced in skeletal muscle ageing?
production mitochondrial proteins and production of DNA leading to decreased muscle protein turnover
Is there any way we can reverse the ageing of skeletal muscle?
by changing our diet and exercise
What processes are reduced in salivary gland ageing?
saliva production and saliva excretion
Which salivary gland is the least susceptible to ageing?
parotid
What structures are reduced in oral mucosa ageing?
collagen and elastin
What is age related reduced wound healing related to?
reduced immune response as we age
Is gingival recession in older adults definitely caused by ageing?
no, it could be a secondary result of perio disease or toothbrush abrasion
What is common in the gingiva of older adults?
flattening of inter-crestal gingiva, gingival fibrosis
What are age related changes to enamel?
increased translucency, loss of hydroxyapatite crystals, accumulation of surface staining
What are age related changed to dentine?
increased quantity
What is primary dentine?
laid before eruption
What is secondary dentine?
slower rate of deposition and a different direction of the tubules
What is tertiary dentine?
reactive dentine that is laid down in response to irritation or damage in the tooth
What are age related changes to the pulp?
reduction in the size of pulp chamber and root canals, decrease in cellular elements, decrease in vascularity and sensitivity
What are age related changes to cementum?
increase in amount as cementogenesis continues throughout life
Do healthy human teeth become more or less mobile with age?
less
What are age related changes to the PDL?
more fibrotic, less elastic, PDL space narrowing
How is alveolar bone maintained in the mouth?
in the presence of teeth
What is the average life span of osteocytes?
35 years
What are the consequences of elderly bones containing increased numbers of dead osteocytes?
mineralisation of lacunae, brittle and sclerotic bone
When do females begin bone calcium loss?
40-45
When do males begin bone calcium loss?
60
What is gerodontology?
the branch of dentistry that deals with ageing and older people
Do we use chronological age to determine who is elderly?
no, biological age is more important
Why is Gerodontology becoming more relevant?
people are living longer and keeping their teeth longer
What changes can you expect in the mouth of an ageing patient?
tooth wear, recession, xerostomia, root caries, increased oral cancer risk
Why does oral health and the ageing patient matter?
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
What are some links between oral health and general health?
oral bacteria have been linked to chest infections, the severity of periodontal inflammation is linked to glycaemic control with diabetes
What are some ways retaining the natural teeth can have a benefit on life?
diet, nutrition and quality of life
What are some barriers to oral health care in the elderly?
mobility, illness, inconvenience, cost, lack of access to NHS care, fear, anxiety, professional barriers
Why can mobility be a barrier to oral health care in the elderly?
can be difficult for them to get to the surgery, patients may find it difficult to get upstairs
Why can cost be a barrier to oral health care in the elderly?
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
Why can fear of the dentist be a barrier to oral health care in the elderly?
fear of the dentist is common among the elderly due to previous personal bad experiences and negative perceptions of dental treatment
Why can availability of dental services be a barrier to oral health care in the elderly?
there seems to be difficulty in finding an NHS dentist and can be limited information on dental services in different languages
What are root caries?
caries on the root surface after it has been exposed due to recession
What are some risk factors for root caries?
high sugar diet, dry mouth, partial dentures
How can you prevent root caries?
OHI, diet advice, fluoride
Is periodontitis more common in the elderly?
no
What are some potential causes of xerostomia?
side effect of medications, radiotherapy to head and neck, diabetes, sjogren’s
What side effects can occur due to xerostomia?
increased caries risk, perio disease, candida infections, dysphagia, difficulty tolerating dentures
How can you manage xerostomia?
regular sips of water, sugar free gum, saliva substitutes
What percentage of 75-84 year olds have tooth wear?
95%
What may be some presenting complaints associated with toothwear?
sensitivity, sharp teeth, pulpitis, aesthetic concerns
Is the treatment plan for toothwear always the same?
no, it depends upon the severity of the toothwear
What are the important points for denture hygiene?
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
What percentage of stroke survivors require special support?
50%
How can a stroke affect how well a denture is tolerated?
reduced muscle control can reduce the retention, trouble inserting and removing dentures
