Older People Flashcards
what functions can people have oral frailty in
mastication
swallowing
oral motor skill
salivation
what are the consequences of mastication frailty
difficult eating hard or tough foods
inability to chew all types of foods
what are the consequences of swallowing frailty
decreased ability to swallow solid foods and liquids
overall poor swallowing function
what are the consequences of oral motor skill frailty
impaired tongue movement
speech or phonatory disorders
what are the consequences of salivation frailty
hyposalivation
xerostomia
what does quality of life mean for older people
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
what does ART stand for
atraumatic restorative technique
what is ART
spoon excavation to get rid of caries and put glass ionomer over the top
what are the risk factors for ART failure
lower number of tooth brushings/day
absence of prosthesis
posterior location of tooth
higher baseline plaque index
what are the common medical concerns in older people
frailty
polypharmacy
incontinence
falls
bone health
nutrition and weight loss
dementia
parkinsons disease
diabetes
stroke
what are the syndromes that come with frailty
falls
immobility
delirium
incontinence
susceptibility to side effects
what are the causes of falls
intrinsic - postural hypotension
extrinsic - trip hazards
what are the dental implications of falls
dental trauma
sitting patients up slowly after treatment
manual handling
domiciliary visits
what are the dental implications of bad bone health
MRONJ risk
fracture of mandible following fall or extractions
what are the dental implications of older people having a restricted diet due to bad dentures/loss of teeth
delayed healing
NCTSL
haematinics - burning mouth, RAS
higher caries rate
name 4 types of medication which affect the immune system
oral corticosteroids
disease modifying medications
chemotherapy
immunomodulatory treatment for cancer treatment
what are patients more at risk of if they are on medication affecting the immune system
dental infections
prolonged healing if invasive procedures
what is the limit of HbA1C for all dental treatment
<7%
what is the limit of HbA1C for emergency treatment only
9%
what considerations should we take for diabetics when making appointments
in the morning
avoid appointment which coincides with insulin activity peak
what are the risks of diabetes
hyperglycaemia
hypoglycaemia
fatigue
increased risk of infection
poor wound healing
increased risk of periodontal disease
complications related to comorbidities/secondary vascular complications
what is a stroke
sudden interruption of blood supply to brain leading to rapid focal or global neurological disturbance which lasts >24hrs
what are the 4 types of stroke
ischaemic
haemorrhagic
carotid artery dissection
cerebral venous thrombosis
what are the signs and symptoms of stroke
facial weakness
slurred speech
gait disturbance
urinary incontinence
loss of taste
headache
confusion
loss of consciousness
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
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
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
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
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
what is parkinsons
chronic and progressive neurological disorder caused by degeneration of dopaminergic neurons in substantia nigra of basal ganglia
what are the characteristic features of parkinsons
dyskinesia
bradykinesia
akinesia
hypomimia
shuffling gait
resting tremor
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
what are the issues with levadopa which parkinsons patients take
taste issues
red saliva
parafunction
interact with adrenaline
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
what is dementia
acquired progressive loss of cognitive functions, intellectual and social abilities, severe enough to interfere with daily functioning
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
what are the 4 common types of dementia
alzheimers
vascular
lewy-body
fronto-temporal
what are the features of alzheimers
amyloid plaques
neurofibrillary tangles
short term memory loss
what are the features of vascular dementia
series of small strokes
sudden onset memory problems
what are the features of lewy body dementia
changes in behaviour
problems with language
fluctuating cognition
what are the features of fronto-temporal dementia
pick bodies found in cytoplasm
3 variants
seen in younger patients
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
how do you communicate with a dementia patient
engage attention
eliminate distraction
eye contact
hold hand
reassure
call by first name
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
what would mid stage dementia treatment planning look like
maintenance and prevention
access becoming harder
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
what complications of GA increase with age
death
dehydration
insufficient pain treatment
insufficient nutrient intake
thromboembolic events
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
who is eligible for domiciliary visits
patient confined to bed
patient on oxygen therapy
patient in hospital
patient with agoraphobia
end of life care
who can do domiciliary visits
GDP
public dental service
special care dentists
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
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
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
