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Special Care Dentistry BDS4 > Older People > Flashcards

Older People Flashcards

1
Q

what functions can people have oral frailty in

A

mastication
swallowing
oral motor skill
salivation

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2
Q

what are the consequences of mastication frailty

A

difficult eating hard or tough foods
inability to chew all types of foods

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3
Q

what are the consequences of swallowing frailty

A

decreased ability to swallow solid foods and liquids
overall poor swallowing function

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4
Q

what are the consequences of oral motor skill frailty

A

impaired tongue movement
speech or phonatory disorders

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5
Q

what are the consequences of salivation frailty

A

hyposalivation
xerostomia

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6
Q

what does quality of life mean for older people

A

having good social relationships
maintaining social activities and retaining a role in society
having positive psychological outlook
having good health and mobility
enjoy life and retain ones independence and control

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7
Q

what does ART stand for

A

atraumatic restorative technique

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8
Q

what is ART

A

spoon excavation to get rid of caries and put glass ionomer over the top

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9
Q

what are the risk factors for ART failure

A

lower number of tooth brushings/day
absence of prosthesis
posterior location of tooth
higher baseline plaque index

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10
Q

what are the common medical concerns in older people

A

frailty
polypharmacy
incontinence
falls
bone health
nutrition and weight loss
dementia
parkinsons disease
diabetes
stroke

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11
Q

what are the syndromes that come with frailty

A

falls
immobility
delirium
incontinence
susceptibility to side effects

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12
Q

what are the causes of falls

A

intrinsic - postural hypotension
extrinsic - trip hazards

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13
Q

what are the dental implications of falls

A

dental trauma
sitting patients up slowly after treatment
manual handling
domiciliary visits

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14
Q

what are the dental implications of bad bone health

A

MRONJ risk
fracture of mandible following fall or extractions

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15
Q

what are the dental implications of older people having a restricted diet due to bad dentures/loss of teeth

A

delayed healing
NCTSL
haematinics - burning mouth, RAS
higher caries rate

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16
Q

name 4 types of medication which affect the immune system

A

oral corticosteroids
disease modifying medications
chemotherapy
immunomodulatory treatment for cancer treatment

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17
Q

what are patients more at risk of if they are on medication affecting the immune system

A

dental infections
prolonged healing if invasive procedures

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18
Q

what is the limit of HbA1C for all dental treatment

A

<7%

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19
Q

what is the limit of HbA1C for emergency treatment only

A

9%

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20
Q

what considerations should we take for diabetics when making appointments

A

in the morning
avoid appointment which coincides with insulin activity peak

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21
Q

what are the risks of diabetes

A

hyperglycaemia
hypoglycaemia
fatigue
increased risk of infection
poor wound healing
increased risk of periodontal disease
complications related to comorbidities/secondary vascular complications

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22
Q

what is a stroke

A

sudden interruption of blood supply to brain leading to rapid focal or global neurological disturbance which lasts >24hrs

23
Q

what are the 4 types of stroke

A

ischaemic
haemorrhagic
carotid artery dissection
cerebral venous thrombosis

24
Q

what are the signs and symptoms of stroke

A

facial weakness
slurred speech
gait disturbance
urinary incontinence
loss of taste
headache
confusion
loss of consciousness

25
what are the risk factors for having a stroke
carotid artery diseases congestive heart failure age genetics sickle cell disease smoking, alcohol, physical inactivity, poor diet
26
what are the dental effects of stroke
access mobility and communication issues depression leading to self neglect OH deteriorates on affected side impaired manual dexterity dysphagia denture wearing issues due to loss of muscle control root caries due to drug induced xerostomia
27
what are the treatment recommendations for someone who has had a stroke
treat upright short mid-morning appointments extra care care with anticoagulants and adrenaline with LA avoid BDZ due to respiratory depression
28
what must we consider when treatment planning for stroke patients
high risk root caries ART when difficult to cooperate SDA adhesive bridges to replace single units antiplatelets for extractions consider copy denture over new denture
29
what is the dental advice for the people who have dysphagia
brush teeth upright with suction or aspirating toothbrush low foaming toothpaste remove excess water on toothbrush rub toothpaste into toothbrush before placing in mouth
30
what is parkinsons
chronic and progressive neurological disorder caused by degeneration of dopaminergic neurons in substantia nigra of basal ganglia
31
what are the characteristic features of parkinsons
dyskinesia bradykinesia akinesia hypomimia shuffling gait resting tremor
32
what are the dental implications of parkinsons
access is challenging xerostomia, root caries, denture issues, poor OH, periodontal disease anxiety increases tremor movement, drooling dysphagia problems with drooling denture struggles due to rigid facial muscles
33
what are the issues with levadopa which parkinsons patients take
taste issues red saliva parafunction interact with adrenaline
34
what are the treatment recommendations for parkinsons patients
extra weight of electric toothbrush can help reduce tremor avoid mouthwash as aspiration risk give time for communication mouth props and head support dont recline more than 45 degrees use airway protection
35
what is dementia
acquired progressive loss of cognitive functions, intellectual and social abilities, severe enough to interfere with daily functioning
36
what are the characteristic features of dementia
amnesia inability to concentrate disorientation in time, place, person intellectual impairment deterioration in emotional control social behaviour and motivation
37
what are the 4 common types of dementia
alzheimers vascular lewy-body fronto-temporal
38
what are the features of alzheimers
amyloid plaques neurofibrillary tangles short term memory loss
39
what are the features of vascular dementia
series of small strokes sudden onset memory problems
40
what are the features of lewy body dementia
changes in behaviour problems with language fluctuating cognition
41
what are the features of fronto-temporal dementia
pick bodies found in cytoplasm 3 variants seen in younger patients
42
what would a dementia friendly dental practice look like
reception desk visible from entrance avoid non-essential signs signs at eye level good natural light
43
how do you communicate with a dementia patient
engage attention eliminate distraction eye contact hold hand reassure call by first name
44
what would early stage dementia treatment planning be like
planning for future identify and attempt to retain key teeth focus on high quality restorations establish preventative regime
45
what would mid stage dementia treatment planning look like
maintenance and prevention access becoming harder
46
what would late stage dementia treatment planning look like
focus on comfort aim for moist, clean and healthy mouth which is free of pain non-invasive
47
what complications of GA increase with age
death dehydration insufficient pain treatment insufficient nutrient intake thromboembolic events
48
what are the dental implications of dementia
involve carers prevention dentures broken or lost xerostomia/hyposalivation dysphagia halitosis periodontal disease loss of taste = high sugar diet
49
who is eligible for domiciliary visits
patient confined to bed patient on oxygen therapy patient in hospital patient with agoraphobia end of life care
50
who can do domiciliary visits
GDP public dental service special care dentists
51
what are the scottish palliative care guidelines
routine oral assessments to ensure comfort and minimise pain advice on oral hygiene and denture care moisten mouth every 30mins
52
what can the dental team do for patients in the hospital
assess patients provide treatment where necessary advise on mouth care advise on most effective products provide education act as resource for hospital staff
53
what are the common dental issues which elderly patients suffer from
poor denture hygiene admitted with poor oral health xerostomia fungal and viral infections ulceration oral cancer mucositis

Special Care Dentistry BDS4 (5 decks)

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