Oral health of older people Flashcards
What is healthy ageing?
The process of developing and maintaining the functional ability that enables well-being in older age
Aging can be associated with physiological changes that can impact on nutritional status. What can this be caused by?
- sensory impairments (decreased sense of taste or smell)
- reduced appetite
- dental problems
- impaired gastric acid secretion
- limited mobility and ability to care for oneself
What psychosocial and environmental changes can aging also be associated with?
Isolation, loneliness, depression and inadequate finances, which can have significant impacts
on diet.
What are the underlying principles of long-term care for the older population?
THINK PEARS
* * Affordable and accessible
* Enhance dignity, and enables
self-expression
* Person-centred
* Regulated
* Building workforce capacity and supporting of carers
What are the most common OH diseases?
Dental caries
Periodontitis
Tooth loss
Oral cancer
Candidiasis
Dry mouth
What OH issues are prevalent in long term care?
Increased caries prevalence & gum disease
Edentulous= decreased functional dentition
Difficulty in access to dental care
Why is oral health important in the older population?
- Being free of pain and discomfort
- Ability to function: chewing, eating will have an impact on nutrition
- Ability to smile and socialise will have an impact on self-esteem and mental health
- Increased risk to infections: dental abscess, candidiasis, pneumonia
- Frailty, disability and dementia: increases risk of poor general and oral health and access to care
What measure is used to record the consequences of untreated dental caries?
PUFA
P (visible pulpal involvement)
U (ulceration caused by dislocated tooth or fragments)
F (fistula)
A (abscess)
What issues & considerations should you have when dealing with patients with dementia?
Issues with cooperation & communication
Carer may not have time, confidence or training
Considerations
-clear short instructions
-smiling & using appropriate touch & reassuring gestures
-distraction/encouraging techniques
-time of day best for oral care
How is hospitalisation associated with oral health?
Deterioration in oral health
* Increase in hospital acquired infections
* Poor nutritional intake
* Longer hospital stays
* Increased care costs
What are Pechansky and Thomas’ five dimensions of access (1981)? (The 5As)
What is the guidance for the aging population and the dental public health response?
- NICE guidelines 2016- OH for adults in care homes
- PHE 2018- commissioning better OH for vulnerable older people
3- CQR- oral health care in care homes
What are the recommendations & rationales (NICE 2017) regarding oral health in care homes?
- OH assessed on admission
- between dental services and GMP, occupational therapist, Speech and language therapist
-existing disease identified
-tailored care started immediately - Mouth care needs RECORDED in their personal care plan.
- ensure action is taken to meet the person’s needs
-mouth care needs are regularly reviewed.
-referral to local NHS dental services- collaborate with local dental services - Supported to MAINTAIN their oral health
- collaborate with nurses, HCAs ect - Healthy snack policies
- Consulting w relatives
-they have opportunities to
observe, advise and support. - Staff training
7.Collaborative practice
What OH interventions can be implicated to improve OH of residents in care homes?
- Use of dentifrices containing 2,800 or 5,000 ppm F to prevent or arrest caries in dentate
vulnerable older people - Good evidence for the effectiveness of quarterly application of fluoride varnish.
- Oral hygiene regime to improve oral health and possibly reduce the risk of aspiration pneumonia
- Training of car home staff on oral health
- Protocols of oral care and an oral health champion
- Dietary changes to promote health eating
- Outreach into care homes
Considering the NICE guidance of 2017, what should be ensured the staff who provide daily personal care to residents can provide?
- Understand the importance of residents’ oral health and the potential effect on their general health,
wellbeing and dignity. - Understand the potential impact of untreated dental pain or mouth infection on the behaviour, and
general health and wellbeing of people who cannot articulate their pain or distress or ask for help. - Know how and when to reassess residents’ oral health
- Know how to deliver daily mouth care
- Know how and when to report any oral health concerns for residents, and how to respond to a
resident’s changing needs and circumstances. - Understand the importance of denture marking and how to arrange this for residents, with their
permission.
