exam 4- lecture 2 (the older adult patient) Flashcards
what is the etiology of Alzheimer’s?
unknown.. thought to include genetics, environment, nutrition, free radicals and infections agents..
average duration is 8-10 years from onset of symptoms to death
this is dryness of the mouth found in elderly patients with pathologic states, drug induced, radiation therapy, healthy elderly have normal salivary flow..medication is the most common influence
xerostomia
what is the relationship with root caries on aging?
with roots exposed by perio infection, increase in caries of the cementum may occur.. rampant caries are due to dry mouth or masticatory abilites
what are the two types of Alzheimer’s?
early onset: rare, reported in individuals in their 30’s and 40’s
late onset: most common in people over 65
the anatomic or physiologic age of a person as determined by changes in organismic structure and function; takes into account features such as posture, skin, texture, strength, speed and sensory acuity
biological age
what are the causes of osteoporosis?
depletion of estrogen after menopause or calcium deficiency
severe mental deterioration involving impairment of mental ability; organic loss of intellectual function
dementia
low bone mass resulting from an excess of bone resorption over bone formation, with resultant bone fragility and increased risk of fracture
osteoporosis
what is the most common caries in the elderly?
root caries
what happens with lip changes in the elderly?
dehydration and loss of elasticity within tissue..
angular chelitis- fissuring at angles of the mouth, candidiasis and vitamin b defec.
this is bone disease involving loss of mineral content and bone moss that is common in patients older than 60
osteoporosis
difficulty swallowing
dysphagia
what are the risk factors for osteoporosis and periodontal disease?
smoking, nutrition deficiencies, alcohol use, hormonal status, female gender, Caucasian or Asian ethnicity, sedentary lifestyle
what is attrition and how is it affected with aging?
signs of wear.. from long term effects of diet, occupational factors of bruxism, teeth may chip or become more brittle
this is prevalent in the elderly but not a consequence with age
xerostomia
the actual measure of time elapsed since a person birth
chronological age
what type of oral mucosa changes occur in the elderly?
atrophic changes- smooth shiny appearance due to thinning epithelium
hyperkeratosis- white patchy areas from sharp edges of broken teeth, dentures, or from tobacco use
capillary fragility- facial bruising, and petechial of the mucosa are common
what is the relationship of dental pulp with aging?
this is questionable.. occurs as a reaction to caries, restorations, bruxism and other assults.. pulp chambers and root canals narrow, increase deposit of secondary dentin.. progressive deposit of pulp stones or denticles
discrimination toward/against the older adult population
ageism
ringing, buzzing, tinkling, or hissing sounds in the ear
tinnitus
what are some oral changes that occur in the elderly?
lip changes., oral mucosa, tongue changes, xerostomia and oral candidiasis
what are some effects of the peripheral nervous system in the elderly?
decrease in tactile sensitivity and decrease in proprioception (sense of ones position in space and has risk for falls)
what can increase the risk of oral candidiasis?
medical conditions such as diabetes and HIV increase risk.. xerosotmia increase incidence
what are some guidelines for caregivers of patients with Alzheimer’s?
keep same daily routine..
use clocks, calendars and newspapers to maintain pt. orientation
watch pts. medical and oral health.. encourage reg. visits
positive reinforcement and communication
what is candidiasis associated with?
the use of antibiotics, head and neck radiation therapy, chemotherapy, steroids and other immunosuppressive drugs
an immunological disorder characterized by insufficient production of lacrimal gland to produce tears and the salivary glands to produce saliva that results in abnormally dry eyes or mouth
sjogrens syndrome
what is the relationship of osteoporosis to periodontal disease?
relationships exist between the reduced bone mineral density of osteoporosis and oral bone loss in skeletal and mandibular bone..
both have mutual risk factors
osteoporotic bone is less dense and more readily absorbed.. periodontal pathogenic microorganisms provide toxic products for increased periodontal breakdown
osteoporosis can be considered a risk factor for periodontal bone loss
a form of irreversible dementia.. usually occurring in older adulthood, characterized by gradual deterioration of memory, disorientation and other features of dementia
Alzheimer’s disease
the age of a person as determined by his or her feelings, attitudes, and life perspective
physiological age
what are some tongue changes that occur within the elderly?
atrophic glossits- burning tongue (shiny, smooth, bald- anemia related)
taste sensation-taste buds do not decrease but taste change due to meds
sublingual varicosities- deep red, or bluish nodular dilated vessels(occur frequently but no direct relation to systemic disease)
what happens to the color of teeth with aging?
color changes from tobacco or foods such as coffee and tea.. dark intrinsic stains from dental restorations
what are the stages of Alzheimer’s disease?
stage 1- normal function
stage 2- very mild
stage 3- mild
stage 4- moderate
stage 5- moderately severe
stage 6- severe
stage 7- very severe
what is the most common infection of the oral mucosal tissues?
oral candidiasis
what does tooth loss increase with?
increases with age, BUT NOT because of age
what happens to teeth with aging?
color, attrition, abrasion, root caries and dental pulp
what are the treatments of osteoporosis?
Biphosphonates- inhibit bone resorption
selective estrogen receptor modulators (SERMS)
calcitonin
parathyroid hormone (PTH)- stimulates bone formation
how is abrasion associated with aging on the teeth?
extended use of hard tooth brush, and abrasive dentifrices are used in horizontal motion
