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Systemic Disease in Dentistry > Elderly Patients > Flashcards

Elderly Patients Flashcards

1
Q

Describe the changing demographic with regards to the ageing population

A
  • Population is ageing worldwide
  • Fertility rates declining
  • Dramatically increased life expectancy
  • Global life expectancy will reach 76 by 2045
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2
Q

Name 5 reasons for increasing life expectancy

A
  1. Increasing prosperity
  2. Education
  3. Public hygeine
  4. Improved housing
  5. Advances in healthcare
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3
Q

What are 2 major implications of an ageing population?

A
  1. Funding of healthcare as less economically active people per OAP
  2. Pensions and increasing retirement age
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4
Q

What are 2 major issues of arthritis?

A
  1. Restricted movement

2. Manual dexterity

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5
Q

What is a common medication from a person suffering from arthritis?

A

Pain relief

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6
Q

Describe OHI for a person suffering from arthritis

A
  • Frequency of brushing
  • Technique
  • Modifications to toothbrushes
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7
Q

Describe the management of patients with head and neck cancer

A
  • Patients should be rendered dentally fit prior to radiotherapy treatment
  • Reduce saliva flow post treatment can increase likelihood of caries
  • Meticulous oral hygeine required including saliva substitutes
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8
Q

Name 4 possible causes of xerostomia in elderly adults

A
  1. Radiation therapy
  2. Diabetes
  3. Alzheimers
  4. Medications
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9
Q

Describe the best ways to treat a patient suffering from COPD

A

Upright position while avoiding rubber dams

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10
Q

Name 3 common medications a patient suffering from COPD may be taking

A
  1. Bronchodilators
  2. Corticosteroids
  3. Oxygen
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11
Q

What is the main hazard during treatment for a patient with diabetes?

A

Hypoglycaemia

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12
Q

Name 2 common medications a diabetic patient may be on

A
  1. Insulin

2. Metformin

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13
Q

Describe the considerations for a dentist when treating a diabetic patient

A
  • Ensure patient has eaten and taken medication
  • Prescribed medications can impact glycaemic control
  • Poor wound healing
  • Increased periodontal disease
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14
Q

What are 5 common medications for someone with cardiovascular disease?

A
  1. ACE inhibitors
  2. ARBs
  3. Beta blockers
  4. Diuretics
  5. GTN
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15
Q

What is the most common anticoagulant?

A

Warfarin

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16
Q

Name 4 reasons anticoagulants may be prescribed

A
  1. Prevent blood clotting
  2. Heart disease
  3. Pulmonary embolism
  4. Artificial heart valves
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17
Q

What is the most commonly used anti platelet?

A

Aspirin

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18
Q

Name 3 reasons anti platelet medications may occur

A
  1. Prophylactically to prevent cardiovascular disease
  2. Prophylactically to prevent stroke
  3. Atrial fibrillation
19
Q

What is a common mental health condition in elderly patients?

A

Cognitive decline and dementia

20
Q

What is the major concern of patients suffering from cognitive decline / dementia?

A

Issues around consent as patients find it difficult to remember and understand treatment concepts

21
Q

What is osteoporosis?

A

A health condition which weakens bone making them fragile and more likely to break, developing over several years and often only diagnosed when bones fracture

22
Q

How is the diagnosis of osteoporosis carried out?

A

Bone density scan (DEXA scan)

23
Q

What is the most common medication associated with osteoporosis?

A

Bisphosphonates

24
Q

What are the implications of patients on bisphosphonates in dentistry?

A

During invasive dental procedures patients are susceptible to ONJ as bone will not heal

25
Q

What is the common medication for Parkinson’s Disease?

A

Levodopa

26
Q

Describe the trends of oral health in older adults

A
  • Increased tooth retention
  • Reduced rates of edentulousness
  • Changing attitudes
  • Partially dentate elderly more common
27
Q

What are more common oral diseases in elderly patients?

A

Chronic dental diseases e.g caries, periodontal disease, toothwear

28
Q

Describe 4 challenges of an elderly patient’s oral environment

A
  1. Fermentable carbohydrates fuel cariogenic bacteria
  2. Root surfaces prone to decay
  3. Tooth brushing compromised by reduced manual dexterity
  4. RPDs can complicate cleaning
29
Q

How does periodontal disease usually present in old age?

A

Gingival recession

30
Q

Describe root caries

A
  • Disease almost unique to older patients associated with gingival recession
  • Reduced mechanical cleaning and presence of RPDs
  • Xerostomia may contribute to problem
31
Q

Name 4 methods of combatting root caries in the elderly

A
  1. High fluoride toothpaste
  2. TeePee brushes (easier to use than floss)
  3. MI paste
  4. Tooth Mousse
32
Q

Describe caries-infected dentine for removal

A
  • Outermost, necrotic zone with mineral component extensively destroyed
  • High bacterial load
  • Dentinal tubular structure destroyed
33
Q

Describe caries-affected dentine which should be maintained

A
  • Inner layer
  • Lower bacterial content, less collagen damage and less mineral dissolution
  • Dentinal tubular structure gradually returns
34
Q

What is the usual aim of treatment when managing existing restorations?

A

Repair the restoration rather than replace unless defect is very large

35
Q

What does ART stand for?

A

Atraumatic Restorative Technique

36
Q

What is ART?

A

Using hand instruments to remove caries

37
Q

What is the benefit of ART?

A

Minimum invasive caries removal

38
Q

Describe how teeth are restored following ART?

A

Adhesive material, most commonly GIC

39
Q

Describe GIC as a restorative material

A
  • Adhesive and chemically cured
  • Aesthetic
  • Relatively moisture tolerant
40
Q

When may ART be of particular use regarding elderly patients?

A

Patients in care homes who receive dental treatment outside of the clinical setting

41
Q

Describe the biological cost of RPDs

A
  • Accumulate plaque
  • Increase caries and periodontal disease incidence
  • Increase likelihood of further tooth loss
42
Q

What is functionally orientated treatment?

A

Based on the Shortened Dental Arch concept where not all natural teeth need to be replaced, only 10 occluding pairs

43
Q

What are 3 benefits of functionally orientated treatment?

A
  1. Low maintenance
  2. Well accepted
  3. Cost effective
44
Q

Name 4 alternatives to RPDs when restoring teeth to a SDA

A
  1. Conventional fixed prosthodontics
  2. Resin bonded bridgework
  3. Implants
  4. Fibre reinforced composite

Systemic Disease in Dentistry (22 decks)

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