Common oral health conditions in older adults Flashcards
T/F: after the age of approximately 35 years, patients’ teeth tended to become somewhat darker, somewhat redder, and more saturated, with the exception of the cervical sites, which apparently become yellow
true
T/F: older patients have increased value and decreased chroma
false, decreased value and increased chroma
T/F: mean amount of tooth exposed in MAXILLARY central incisor decreases with age
true
T/F: mean amount of tooth exposed in MANDIBULAR central incisors decreases with age
false, increases
what is the #1 cause of disability in the US?
stroke
T/F: initial attacks of strokes are higher in women until about 30 years old and then becomes more frequent in men
true
90% of strokes in older adults are what type?
ischemic stroke
remaining 10% of strokes in older adults are what type?
hemorrhagic stroke
ischemic stroke
blockage of blood vessels leading to lack of blood flow to affected area
hemorrhagic stroke
rupture of blood vessels leading to leakage of blood
controllable risk factors for stroke
- high BP
- atrial fibrillation
- high cholesterol
- diabetes
- atherosclerosis
- circulation problems
- tobacco use and smoking
- alcohol use
- physical inactivity
- obesity
uncontrollable risk factors for stroke
- age
- gender
- race
- family hx
- previous stroke or TIA
implication for dentistry in stoke patients prescribed urinary antispasmotics
xerostomia
implications for dentistry in stoke patients prescribed antidepressants
- xerostomia
2. increased appetite
implications for dentistry in stoke patients prescribed antihypertensives
- xerostomia
2. orthostatic hypertension
implication for dentistry in stoke patients prescribed anticoagulants
abnormal hemostasis
implication for dentistry in stoke patients prescribed broad spectrum abx
oral candidiasis
who is at risk for neurogenic dyspagia
stroke patients (45-75%) > dementia patients (45%)
dysphagia affects about what percent of stroke patients initially but improves within 7-14 days?
50%
conditions associated with strokes that compromise the rendering of dental care
- transferring into and out of dental chair
- providing informed consent
- visualizing instructions
- food selections
- depression
treatment consideration for stroke patient with paralysis
special transfer training or assisted devices
treatment consideration for stroke patient with loss of cognitive or communication skills
obtain informed consent from guardian
treatment implications for stroke patient with visual field deficit
proper positioning when speaking to patient
treatment implications for stroke patient whose food selections are highly cariogenic
recurrent and root caries
treatment implications for stroke patient who has depression
- xerostomia
2. difficulty making decisions
oral motor sensory evaluation
- gag reflex
- facial symmetry
- lip posture
- tongue range of movement
- mandibular range of movement
posterior occlusal relationship
- “freedom in centric” so mandatory wide centric
- horizontal overjet 1.5 mm throughout
- minimal vertical overlap
- non-anatomic/flat plane tooth form
- consider lingualized occlusion
absent or attenuated gag reflex is due to what?
loss of sensory input in pharynx
treatment consideration for stroke patient with absent or attenuated gag reflex
- sit patient up-right
- throat pack
- avoid low viscosity impression materials
treatment consideration for stroke patient with dysphagia
- sit patient up-right
2. high speed evacuation
cheek and tongue biting in stroke patients are due to what?
paresthesia of buccal and labial tissues
treatment consideration for stroke patients who experience cheek and tongue biting
increase horizontal overlap
treatment consideration for stroke patients who are experiencing reduced denture retention due to loss of sensory input
initially prescribe denture adhesive, later reline or remake existing denture
Parkinson’s disease
chronic neurodegenerative MOVEMENT disorder affecting voluntary and emotional movements and most commonly seen in t he elderly, but is also found in the young and inexorably progresses leading to significant disability
what is the leading cause of death in Parkinson’s patients?
pneumonia (aspiration or broncho-)
what percent of Parkinson’s patients have died due to pneumonia?
50-64%
what are the most common comorbid physical diseases in Parkinson’s patients?
dental caries > periodontitis > pulmonary diseases > diabetes mellitus > chronic liver disease
T/F: the high prevalence of impaired swallowing, perio disease and dental caries may lead to a greater risk of aspiration pneumonia
true
T/F: Maintenance of good OH and control of oral biofilm formation in the elderly reduce the number of potential respiratory pathogens in the oral secretions, which in turn reduces the risk of pneumonia
true
T/F: SDF is often use to treat severe root caries in the nursing home population
false, SDF in elderly population should only be used as a temporary measure to control small areas of caries until they can be restored at a later time
T/F: edentulous patients with Parkinson’s disease may benefit from implant-retained dentures if they have a lot of oral-facial involvement including tremors
true
