Module 10 Exam 2 Flashcards
What are primary normal changes with aging
they are physiologic changes
each age level brings changes in what
- body metabolism
- activity of cells
- endocrine balance
- mental processes
are primary physiologic changes unavoidable
yes
during aging there is an overall gradual reduction in functional capacities in _________ with a decrease in cell ______ and numbers of active cell
most organs, metabolism
What are some changes in the musculoskeletal system
- bone volume decreases gradually
- loss of muscle function
- curvature of cervical vertebrae
- joints may stiffen as a result of loss of elasticity
what are some changes we see in the skin
- thin, wrinkled, dry, pigmented spots, loss of tone, atrophy of sweat glands
- reduced tolerance to temperature extremes
what are some changes we see in the cardiovascular system?
- decrease in cardiac output, increase in left ventricle size
- blood vessels less elastic
- antherosclerosis
do changes in cardiovasculature affect function under normal, unstressful situations
no
What are some changes in the respiratory system
- vital capacity diminished
- decreased pulmonary efficiency and gas exchange
- less effective cough reflex, risk for infections
what are some changes in the GI system
- production of HCl decreases
- pertistalsis slowed
- decreased adsorptive functions
what are changes in the central nervous system
- cognitive function slowed
- short-term memory declines
- complex tasks difficult
what are changes in the peripherial nervous system
- decrease in tactile sensitivity
- decreased proprioception
what are changes in the visual senses
- presbyopia
- decrease in visual acuity
- -decreased dilation and constriction of pupils results in difficulty in changed in light
whta are some changes in the hearing senses
- presbycusis
- thicker and dryer cerumen
- -decrease in ability to hear high frequency
- tinnitus
what are changes in the endocrine system
- decrease in thyroid efficency
- decreased basal metabolic rate
- altered thermoregulatory system
what are the changes in the immune system
- body defense systems become less effective
- increase in autoimmune responses (increased risk of perio)
- increased incidence of infections
What is their response to disease in relation to course and severity
disease may occur with greater severity and have a longer course, with slower recovery
what is their response to disease in relation to pain sensitivity
may be lessened
what is their response to disease in relation to temperature response
may be altered so that a patient may be very ill without the expected increase in body temp
what is their response to disease in relation to healing
- decreased healing capacity
- more prone to secondary infection
Due to age-related primary physiological changes older drinkers compared to young drinkers ________
- require less alcohol for effects to occur
- have more severe concequences
What does excessive use of alcohol in an older patient do
- exacerbates medical and emotional problems associated with aging
- predisposes to adverse drug reactions with meds
what is alcohol abuse in seniors associated with
major depressive disorder
What is osteoporosis
bone disease involving loss of mineral content and bone mass
what are the causes of osteoporosis?
endocrine: hormonal disturbances, depletion of estrogen after menopause
calcium deficiency or defective absorbtion of calcium
WHat is the first line of defense against osteoporosis
prevention
What is involved in the prevention of osteoporosis
- adequate calcium intake in adolescence and adulthood
- load bearing exercise
What are risk factors for osteoporosis?
- female:positive fam history
- caucasian or asian
- low calcium and vit D intake
- early menopause or surgical removal of ovaries, eating disorders
- sedentary lifestyle
- alcohol abuse
- high sodium intake
- low BMI
What is the relationship of periodontal disease and osteoporosis
-relationship between reduced bone mineral density of osteoporosis and oral bone loss in skeletal and mandibular bone, oral bone loss pertains to perio bone destruction and residual ridge loss in edentulous person
Osteoporotic bone is less______ and more readily _________
dense, adsorbed
what is the asymptomatic period in osteoporosis
- develops over many years
- long period of bone change with no clinical symptoms
what are the clinical symptoms of osteoporosis
backache, fractures (of spine and long bones), evidence of bone changes in the mandible (ridge resorption)
What does successful treatment and prevention require
simultaneous intake of calcium and vitamin d
what are some medications used in treatment of osteoporosis
- bisphosphonates- inhibit bone resorption
- selective estrogen receptor modulators
- calcitonin
- parathyroid hormone- stimulates bone formation
what kind of activity is used in treatment of osteoporosis
exercise is benefical to bone mass, be careful to not fall
what are some dental hygiene management considerations for osteoporosis patients
-do not rush
-extra time
-bisphosphonates a contraindication for surgery
-
what should we encourage in osteoporosis patients
- smoking cessation
- limit alcohol consumption
- healthy lifestyles
What are the 2 types of alzheimers disease
- early onset- in 30s and 40s
- late onset- people over 65
What is the etiology of alzheimers
unknown,
what is the average duration from the onset of symptoms to death
8 to 10 years
what is the first stage of Alz
no impairment, normal function
what is the second stage of alz
very mild cognitive decline
what is stage 3 of alz
mild cognitive decline
what is stage 4 of alz
moderate cognitive decline
what is stage 5 of alz
moderately severe cognitive decline (moderate or mid stage alz)
what is stage 6 of alz
severe cognitive decline
what is stage 7 of alz
very severe cognitive decline (late stage alzheimer)
Is there treatment available for alz
no, tx is designed for supporting the family and pt
what are the medications used in alz patients with mild to moderate symptoms
cholinesterase inhibitor, which slows the progression of the disease, provides some improvement in behavioral symptoms
what medications are used to address behavioral symptoms in alz
-antidepressants, anti anx, antipsychotics
What are the goals of dental hygiene care in an alz pt
-preserve oral health and function
-provide comfort
prevent disease
what is the care plan in a patient with alz
- directed at stage of disease
- comprehenisive care in anticipation of future decline on Oral health
What are tissue changes in the lips seen?
-dry, purse-string opening results from dehydration and loss of elasticity in the tissues
what is angular cheilitis
- caused by candidiasis and vitamin B deficiency
- skin fold fissuring at angles of mouth
what changes can we see in the oral mucosa
- atrophic- tissue thinner, less vascular
- hyperkeratosis- white patchy areas from irritation of broken teeth ect
- capillary fragility- facial bruises and petichiae
What is atrophic glossitis in changes of the tongue?
- burning tongue
- smooth, shiny, bald, atrophied papillae
- related to anemia from a deficiency in iron
what are the changes in taste sensations of the elderly
-renewal of tastebuds is slower
-perception for salt declines
-perception of sweet and sour doesnt decline
-
what is the appearance and significance of sublingual varicosities?
- deep red, bluish, nodular
- do not have a direct relation to systemic conditions
What is xerostomia in the elderly
- can be present but not a consequence of age
- medication caused
- autoimmune and radiation therapy caused
what is the most common infection of the oral mucosal tissues
oral candidiasis
what are the two forms of oral candidiasis
angular chelitis, denture stomatitis
What is candidiasis assoicated with
- use of antibioitcs
- head and neck radiation therapy
- chemo
- steriods, immunosupressive drugs
patients with xerostomia have an increased incidence of what
candidiasis
what is the color of elderly peoples teeth
- darkening or yellowing from changes in dentin
- long use of tobacco or tea
- intrinsic stains from restorations
what happens to the dental pulp when someone is older
-pulpal changes develop as a reaction to wear, caries, resoration, bruxism
what changes of the pulp may be observed
- narrowing of pulp chambers and canals
- deposition of calcified masses
- number of blood vessels decline
what is the prevalence of root cares in older adults
-more than any other age group, risk factors not age is reponsible
what are risk factors for root caries
- exposed root surfaces
- biofilm retention due to inadequate OH
- xerostomia and meds
- high carb diet
what is the effect of fluoride on root caries
fewer leisons in those who have lived a long time in a fluoridated communithy
What are changes in the bone of the periodontium
-osteoporosis
depressed vascularity, reduced healing of bone
what are changes in the cementum of the periodontium
increased thickness has been demonstrated
what are changes in the gingiva of the periodontium
gingival changes traced to effects of infection or anatomic factors
what are risk factors for changes of tissues of the periodontium
-same as young adults but may be modified by medications and chronic diseases
What do periodontal tissues reflect
the health and disease of the patient over the years
we need to review each medication of the patients to determine
- potential side effects
- possible drug interactions
- certain medications may require bathroom break
what requires antibiotic premedication
- prosthetic heart valve
- uncontrolled diabetes, those with increased susceptibility to infection
why is the intra/extra exam so important for the elderly
because oral cancer occurs with increasing frequency with advancing years
what are factors contributing to accumulation of biofilm
- gingival recession with wide embrasures
- exposed cementum with areas of abrasion or caries
- decreased saliva production reduces cleansing and lubricating effects
what conditions can contribute to the lack of biofilm removal
arthritis, parkinsons
what symptoms are related to vitamin B deficiencies
-angular chelitis, burning tongue, atrophic glossitis,
what factors contribute to dietary and nutritional deficiencies
limited budget, not eating regular meals, lack of intrest in shopping, taste lowered, cant chew, difficulty swallowing, alcoholism
what 3 vitamins so the elderly have an increased need for
vit D, calcium, folate
