challange of service provision for older people

Question 1

differnt ages and diff teeth

Answer 1

1) Very old
- large proportion edentulous
- plastic tooth generation
2) Entering old age
- retained most of their natural dentition
- requires maintenance to avoid tooth loss
- heavy metal generation
3) Future older people
- middle age and younger
- good oral health
- cosmetic dentistry
- white tooth generation

Question 2

influences on aging

Answer 2

1) Genetic/environmental factors
2) lifestyle
3) effect of illness and disability
4) effects of medication
- inc alcohol
5) personality
- rigid/pessimistic vs
- flexible/optimistic
6) Psychiatric history
7) level of independence
- mobility
- activities of daily living (washing, bathing, dressing)

Question 3

oral/dental status of old people

Answer 3

1) Increasing numbers are dentate
2) more concerned with retaining teeth
3) dentate more likely to attend regularly
4) Greater expectations from dental services
5) Greater awareness of oral and dental health
6) more frail/functionally dependant who are dentate

Question 4

oral heath care older people 2020 vison

Answer 4

Looks at dental service provision for older people needed by 2020

• should be free assessments for everyone over 60
• special care dentistry should be a new speciality
• should be clinical pathway particularly for the elderly

Question 5

NICE guidance

Answer 5

• guidline covers oral health, including dental health and daily mouth care for adults in care homes
• aim is to maintain and improve oral health and ensure timely access to dental treatment

Question 6

common oral health problems

Answer 6

1) tooth loss and replacement
2) tooth wear
3) dry mouth due to medication
4) compromised self care due to disability
5) collapsing/failing/terminal dentition

Question 7

tooth wear

Answer 7

• reduced face height
• pulp death
• sensitivity
• aesthetics
• sharpness to tongue
• brittle
• difficult to extract
• often difficult to root treat

Question 8

dry mouth

Answer 8

• may be due to age or medication
• difficulty in wearing dentures
• root caries
• difficulty with speech
• difficulty with mastication
• soreness and ulcers
• lack of appetite

Question 9

periodontal diease symptoms

Answer 9

• multiple abscesses
• bleeding gums
• mobility
• pain
• halitosis

Question 10

shortened dental arch concept

Answer 10

Anterior teeth and premolars can compensate for function of the molars for a number of years

Question 11

treatment planning

Answer 11

• Problem oriented approach to immediate treatment needs
• Multidisciplinary approach inc hygienists and specialise nurses
• Maintenance of quality standards
• Repair not replace
• Informed consent (look at capacity of patient)
• Evaluation of provisional treatment plan
• Maintenance of oral hygiene
• Simple patient specific treatments

Question 12

patient management

Answer 12

• Well trained and capable support staff
• Contact with outside agencies eg carers/GP’s
• Organisation of transport
• Moving and handling
• collaborate with Senior Colleagues

Question 13

treatment for this group

Answer 13

Simple
- carried out at home with portable equipment
Complex
- at the surgery

Question 14

prevention for this group

Answer 14

• Continuing Care and regular visits/recalls.
• Familiarity with the patient and carers.
• Communication
• Developing a working relationship with the carers.
• Involvement of the whole dental team.
• Training Care Staff in Oral Health Promotion.