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BDS3 BAMS Special Care Dentistry > Oral Medicine in Elderly > Flashcards

Oral Medicine in Elderly Flashcards

1
Q

What are the predominantly oral conditions in the elderly

A 
lichen planes 
mucous membrane pemphigoid
herpes zoster
post herpetic neuralgia 
carcinoma
potentially malignant lesions
sore tongue
candidosis
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2
Q

What are the predominantly cardiovascular conditions in the elderly

A

hypertension and ischemic heart disease
cardiac heart failure
temporal arteritis

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3
Q

What are the predominantly respiratory conditions in the elderly

A

chronic bronchitis and emphysema

pneumonia

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4
Q

What are the musculoskeletal conditions in the elderly

A

osteoarthritis
osteoporosis
paget’s disease

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5
Q

What are the hematological conditions in the elderly

A

anaemia
chronic leukaemia
multiple myeloma

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6
Q

What are the genito-urinary conditions in the elderly

A

urinary retention
urinary incontinence
prostatic hypertrophy and cancer
renal failure

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7
Q

What are the neurological conditions in the elderly

A 
poor vision
multi-infarct dementia
parkinsons disease
storkes
ataxia 
trigeminal neuralgia 
alzheimers disease
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8
Q

What are the psychological conditions in the elderly

A 
insomnia 
dependence on hypnotics
loneliness
depression
paranoia
acute confusional states
atypical facial pain
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9
Q

What are other conditions seen in the elderly

A

nutritional deficiency
accidents
malignancies

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10
Q

What is a hemangioma

A

collection of BV

looks like a red bump

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11
Q

What is a fibroepithelial polyp

A

there is a bit of trauma and instead of healing properly there is a build up of tissue

can be sessile or on a stalk

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12
Q

What is black hairy tongue

A

overgrowth of the surface of the tongue

commoner in those who smoked

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13
Q

What is geographic tongue

A

looks like a map

10% find it sensitive

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14
Q

What is atrophic glossitis

A

smooth and shiny tongue
uncomfortable
commonest cause if low iron or B12

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15
Q

What are denture related problems

A

traumatic keratosis

frictional keratosis

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16
Q

What is traumatic keratosis

A

trauma lines that run through white patch

need to take away the pressure

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17
Q

What is frictional keratosis

A

trauma

keratinization around it to protect it

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18
Q

What is speckled leukplakia

A

rare type of leukaplakia
can be unilateral or bilateral
more common in pipe smokers

premalignant lesion so must be followed up
linked to candidiasis

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19
Q

What is sublingual keratosis

A

seen under tongue

20
Q

What is denture induced hyperplasia

A

results in flaps of tissue to protect itself

may see ulcers

21
Q

What’s denture stomatitis

A

often people don’t know they have it because its painless

there is an area of erythema that corresponds to the denture fitting surface is the candida hyphe burrow onto the surface of the mucosa and into the plastic of the denture

22
Q

What is angular cheilitis

A

often a staph element to it
check dentures to ensure no issue
take bloods for iron levels
for some elderly face sags and can get moisture into the skin folds creating irritation

23
Q

What is xerostomia often due to in the elderly

A

polypharmacy most common

radiotherapy

24
Q

What is a good test of xerostomia

A

use front of mouth mirror
does it stick to tongue?
if sticks then saliva quality is bad

25
Q

What is management of xerostomia

A

change medication
salivary replacement
salivary stimulants

26
Q

What are possible salivary replacements

A

saliva orthana
glandosane
biotene oral balance
bioXtra

27
Q

What are possible salivary stimulants

A

chewing gum

glycerine and lemon

28
Q

What drugs can cause topical drug reactions

A

aspirin and iron can cause burns

29
Q

What drugs can cause lichen planus / lichenoid reactions

A 
NSAIDs 
Beta blockers
diuretics 
oral hypoglycaemics
statins
antimalarials
sulphonamides
30
Q

What do bisphosphonates do

A

incorporated into skeleton
inhibit bone turnover
no repair of microdamage
anti-angiogenic

31
Q

What are the non malignant use of bisphosphonates

A 
osteoporosis
paget's disease
osteogenesis imperfecta
fibrous dysplasia
primary hyperparathyroidism
osteopenia
32
Q

What are the malignant uses of bisphosphonates

A 
multiple myeloma
breast cancer
prostate cancer
bony metastatic lesions
hypercalcemia of malignancy
33
Q

What are risk factors for MRONJ

A 
extremes of age
concurrent use of corticosteroids
systemic conditions affecting bone turnover
malignancy
coagulopathies, chemotherapy
radiotherapy 
duration of therapy
previous diagnosis of MRONJ
potency of drug
invasive dental procedures
denture trauma
poor oral hygiene 
periodontal disease 
alcohol or tobacco use
thin mucosa coverage
34
Q

How do we treat patients at risk fo MRONJ

A

advise patient of risk
informed consent
emphasize rarity of conditions
don’t discourage from meds

35
Q

What are patient advice for those at risk fo MRONJ

A

regular dental checks
maintain good OH
limit alcohol and stop smoking
report any symptoms

36
Q

What is post herpetic neuralgia

A

previous episode of shingles
constant burning sensation in dermatomal distribution
resolves within 2 months
may persist for 2 years or longer
suicide risk
incidence possibly reduced by antiviral therapyy and steroids

37
Q

What is tx for post herpetic neuralgia

A 
antidepressants
gabapentin
carbamazepine
topical capsaicin
TENS
38
Q

What is medical management of trigeminal neuralgia

A 
carbamazepine
oxcarbazepine
gabapentin
pregabalin
lamotrigine
sodium valproate 
phenytoin
39
Q

What can surgical management for trigeminal neuralgia split into

A

peripheral procedures

ganglion procedures

40
Q

What are the peripheral procedures for trigeminal neuralgia

A

cryotherapy
injection of alcohol or glycerol
neurectomy
avulsion of nerve

41
Q

What are the ganglion procedures for trigeminal neuralgia

A 
balloon compression
radio frequency thermocoagulation
alcohol or glycerol injection
microvascular decompression
gamma knife radiosrgery
42
Q

What other conditions should you consider for trigeminal neuralgia esp if in younger people

A

MS

space occupying lesion

43
Q

What is burning mouth syndrome

A

more common in females

very often underlying degree of depression and anxiety

44
Q

What are causes of burning mouth syndrome

A 
most common is no cause
psychogenic
drugs
(ACE or protease inhibitors)
dry mouth
candidosis
hematinic deficiencies 
diabetes
parafunctional acitivty
denture factors
hypothyroidism
allergy
45
Q

What are the issues with burning mouth syndrome

A

may lead to malnutrition
slow rehabilitation
slow recovery
reduce QoL

BDS3 BAMS Special Care Dentistry (14 decks)

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