Common oral health conditions in older adults

Question 1

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

Answer 1

true

Question 2

T/F: older patients have increased value and decreased chroma

Answer 2

false, decreased value and increased chroma

Question 3

T/F: mean amount of tooth exposed in MAXILLARY central incisor decreases with age

Answer 3

true

Question 4

T/F: mean amount of tooth exposed in MANDIBULAR central incisors decreases with age

Answer 4

false, increases

Question 5

what is the #1 cause of disability in the US?

Answer 5

stroke

Question 6

T/F: initial attacks of strokes are higher in women until about 30 years old and then becomes more frequent in men

Answer 6

true

Question 7

90% of strokes in older adults are what type?

Answer 7

ischemic stroke

Question 8

remaining 10% of strokes in older adults are what type?

Answer 8

hemorrhagic stroke

Question 9

ischemic stroke

Answer 9

blockage of blood vessels leading to lack of blood flow to affected area

Question 10

hemorrhagic stroke

Answer 10

rupture of blood vessels leading to leakage of blood

Question 11

controllable risk factors for stroke

Answer 11

1. high BP
2. atrial fibrillation
3. high cholesterol
4. diabetes
5. atherosclerosis
6. circulation problems
7. tobacco use and smoking
8. alcohol use
9. physical inactivity
10. obesity

Question 12

uncontrollable risk factors for stroke

Answer 12

1. age
2. gender
3. race
4. family hx
5. previous stroke or TIA

Question 13

implication for dentistry in stoke patients prescribed urinary antispasmotics

Answer 13

xerostomia

Question 14

implications for dentistry in stoke patients prescribed antidepressants

Answer 14

1. xerostomia

2. increased appetite

Question 15

implications for dentistry in stoke patients prescribed antihypertensives

Answer 15

1. xerostomia

2. orthostatic hypertension

Question 16

implication for dentistry in stoke patients prescribed anticoagulants

Answer 16

abnormal hemostasis

Question 17

implication for dentistry in stoke patients prescribed broad spectrum abx

Answer 17

oral candidiasis

Question 18

who is at risk for neurogenic dyspagia

Answer 18

stroke patients (45-75%) > dementia patients (45%)

Question 19

dysphagia affects about what percent of stroke patients initially but improves within 7-14 days?

Answer 19

50%

Question 20

conditions associated with strokes that compromise the rendering of dental care

Answer 20

1. transferring into and out of dental chair
2. providing informed consent
3. visualizing instructions
4. food selections
5. depression

Question 21

treatment consideration for stroke patient with paralysis

Answer 21

special transfer training or assisted devices

Question 22

treatment consideration for stroke patient with loss of cognitive or communication skills

Answer 22

obtain informed consent from guardian

Question 23

treatment implications for stroke patient with visual field deficit

Answer 23

proper positioning when speaking to patient

Question 24

treatment implications for stroke patient whose food selections are highly cariogenic

Answer 24

recurrent and root caries

Question 25

treatment implications for stroke patient who has depression

Answer 25

1. xerostomia

2. difficulty making decisions

Question 26

oral motor sensory evaluation

Answer 26

1. gag reflex
2. facial symmetry
3. lip posture
4. tongue range of movement
5. mandibular range of movement

Question 27

posterior occlusal relationship

Answer 27

1. “freedom in centric” so mandatory wide centric
2. horizontal overjet 1.5 mm throughout
3. minimal vertical overlap
4. non-anatomic/flat plane tooth form
5. consider lingualized occlusion

Question 28

absent or attenuated gag reflex is due to what?

Answer 28

loss of sensory input in pharynx

Question 29

treatment consideration for stroke patient with absent or attenuated gag reflex

Answer 29

1. sit patient up-right
2. throat pack
3. avoid low viscosity impression materials

Question 30

treatment consideration for stroke patient with dysphagia

Answer 30

1. sit patient up-right

2. high speed evacuation

Question 31

cheek and tongue biting in stroke patients are due to what?

Answer 31

paresthesia of buccal and labial tissues

Question 32

treatment consideration for stroke patients who experience cheek and tongue biting

Answer 32

increase horizontal overlap

Question 33

treatment consideration for stroke patients who are experiencing reduced denture retention due to loss of sensory input

Answer 33

initially prescribe denture adhesive, later reline or remake existing denture

Question 34

Parkinson’s disease

Answer 34

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

Question 35

what is the leading cause of death in Parkinson’s patients?

Answer 35

pneumonia (aspiration or broncho-)

Question 36

what percent of Parkinson’s patients have died due to pneumonia?

Answer 36

50-64%

Question 37

what are the most common comorbid physical diseases in Parkinson’s patients?

Answer 37

dental caries > periodontitis > pulmonary diseases > diabetes mellitus > chronic liver disease

Question 38

T/F: the high prevalence of impaired swallowing, perio disease and dental caries may lead to a greater risk of aspiration pneumonia

Answer 38

true

Question 39

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

Answer 39

true

Question 40

T/F: SDF is often use to treat severe root caries in the nursing home population

Answer 40

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

Question 41

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

Answer 41

true