Care of the Older Patient

Question 1

What changes to the dentition can occur as a result of ageing

Answer 1

• Calcification and Mineralisation

- Tooth wear

Question 2

What changes to the mucosa can occur due to ageing

Answer 2

• Loss of vascularity
• Reduction in cell turnover
• Reduction in mucosal thickness

Question 3

What pathological changes can occur as a result of ageing

Answer 3

• Reduction in saliva production
• Alveolar bone resorption
• Loss of muscle tone and strength

Question 4

What can be the impact of chronic dental disease in elderly patients

Answer 4

• Progressive loss of periodontal attachment

- Extensive restoration of teeth

Question 5

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Answer 5

Aspiration pneumonia is a risky ting for older patients and happens a lot as older people in hospitals and care homes tend to have poorer oral and dental hygiene

Question 6

How often is fluoride varnish applied

Answer 6

Every 4 months

Question 7

What conc of fluoride is found in the higher conc toothpastes (duraphat)

Answer 7

2800ppm and 5000ppm

Question 8

What is tooth mousse made of

Answer 8

Amorphous Calcium Phosphate / Casein Phosphopeptide

Question 9

What does Tooth mousse do

Answer 9

Binds to enamel/dentine surface and releases Ca and PO4 when pH falls

Question 10

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Answer 10

Dental treatment is aimed more at QoL factors rather than doing “ideal” dentistry

Question 11

As dental treatment in these older patients is more aimed at QoL what changes might be made from normal treatment

Answer 11

• Repair restorations rather than replacing them

- ART is often used to remove gross caries, then restore with GIC and sealing the cavity is important

Question 12

What are a few questions to keep in mind when treatment planning for these elderly patients

Answer 12

• Is treatment required?
• Do the benefits outweigh the risks
• Can the patient cope with much treatment?