exam 4- lecture 2 (the older adult patient)

Question 1

what is the etiology of Alzheimer’s?

Answer 1

unknown.. thought to include genetics, environment, nutrition, free radicals and infections agents..

average duration is 8-10 years from onset of symptoms to death

Question 2

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

Answer 2

xerostomia

Question 3

what is the relationship with root caries on aging?

Answer 3

with roots exposed by perio infection, increase in caries of the cementum may occur.. rampant caries are due to dry mouth or masticatory abilites

Question 4

what are the two types of Alzheimer’s?

Answer 4

early onset: rare, reported in individuals in their 30’s and 40’s

late onset: most common in people over 65

Question 5

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

Answer 5

biological age

Question 6

what are the causes of osteoporosis?

Answer 6

depletion of estrogen after menopause or calcium deficiency

Question 7

severe mental deterioration involving impairment of mental ability; organic loss of intellectual function

Answer 7

dementia

Question 8

low bone mass resulting from an excess of bone resorption over bone formation, with resultant bone fragility and increased risk of fracture

Answer 8

osteoporosis

Question 9

what is the most common caries in the elderly?

Answer 9

root caries

Question 10

what happens with lip changes in the elderly?

Answer 10

dehydration and loss of elasticity within tissue..

angular chelitis- fissuring at angles of the mouth, candidiasis and vitamin b defec.

Question 11

this is bone disease involving loss of mineral content and bone moss that is common in patients older than 60

Answer 11

osteoporosis

Question 12

difficulty swallowing

Answer 12

dysphagia

Question 13

what are the risk factors for osteoporosis and periodontal disease?

Answer 13

smoking, nutrition deficiencies, alcohol use, hormonal status, female gender, Caucasian or Asian ethnicity, sedentary lifestyle

Question 14

what is attrition and how is it affected with aging?

Answer 14

signs of wear.. from long term effects of diet, occupational factors of bruxism, teeth may chip or become more brittle

Question 15

this is prevalent in the elderly but not a consequence with age

Answer 15

xerostomia

Question 16

the actual measure of time elapsed since a person birth

Answer 16

chronological age

Question 17

what type of oral mucosa changes occur in the elderly?

Answer 17

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

Question 18

what is the relationship of dental pulp with aging?

Answer 18

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

Question 19

discrimination toward/against the older adult population

Answer 19

ageism

Question 20

ringing, buzzing, tinkling, or hissing sounds in the ear

Answer 20

tinnitus

Question 21

what are some oral changes that occur in the elderly?

Answer 21

lip changes., oral mucosa, tongue changes, xerostomia and oral candidiasis

Question 22

what are some effects of the peripheral nervous system in the elderly?

Answer 22

decrease in tactile sensitivity and decrease in proprioception (sense of ones position in space and has risk for falls)

Question 23

what can increase the risk of oral candidiasis?

Answer 23

medical conditions such as diabetes and HIV increase risk.. xerosotmia increase incidence

Question 24

what are some guidelines for caregivers of patients with Alzheimer’s?

Answer 24

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

Question 25

what is candidiasis associated with?

Answer 25

the use of antibiotics, head and neck radiation therapy, chemotherapy, steroids and other immunosuppressive drugs

Question 26

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

Answer 26

sjogrens syndrome

Question 27

what is the relationship of osteoporosis to periodontal disease?

Answer 27

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

Question 28

a form of irreversible dementia.. usually occurring in older adulthood, characterized by gradual deterioration of memory, disorientation and other features of dementia

Answer 28

Alzheimer’s disease

Question 29

the age of a person as determined by his or her feelings, attitudes, and life perspective

Answer 29

physiological age

Question 30

what are some tongue changes that occur within the elderly?

Answer 30

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)

Question 31

what happens to the color of teeth with aging?

Answer 31

color changes from tobacco or foods such as coffee and tea.. dark intrinsic stains from dental restorations

Question 32

what are the stages of Alzheimer’s disease?

Answer 32

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

Question 33

what is the most common infection of the oral mucosal tissues?

Answer 33

oral candidiasis

Question 34

what does tooth loss increase with?

Answer 34

increases with age, BUT NOT because of age

Question 35

what happens to teeth with aging?

Answer 35

color, attrition, abrasion, root caries and dental pulp

Question 36

what are the treatments of osteoporosis?

Answer 36

Biphosphonates- inhibit bone resorption

selective estrogen receptor modulators (SERMS)

calcitonin

parathyroid hormone (PTH)- stimulates bone formation

Question 37

how is abrasion associated with aging on the teeth?

Answer 37

extended use of hard tooth brush, and abrasive dentifrices are used in horizontal motion