Oral Medicine Problems in Elderly Flashcards
1
Q
What is the percentage of elderly with chronic disease?
A
- 75% have chronic disease
- Atypical presentation
- Polypharmacy
- Abnormal reactivity to drugs
- Compliance is poor
2
Q
What are the oral conditions affecting the elderly?
A
- Lichen planus
- Mucous membrane pemphigoid
- Herpes Zoster
- Carcinoma
- Potentially malignant lesions
- Sore tongue
- Candidosis
3
Q
What is a haemangioma?
A
- Benign vascular tumour derived from blood vessel cell types
- If you traumatise this can bleed profusely (be careful of blood thinners)
- Most common on inside of lip or side of tongue
- Cryotherapy used to treat in oral surgery hospital setting due to risk of bleeding
4
Q
What is a fibroepithelial Polyp?
A
- Not sinister as the mucosa covering the bump looks like the skin as rest of mouth
- Caused by trauma like sharp tooth etc and it doesn’t heal properly
- Lump on inside of mouth
- When they get large best to get it removed
5
Q
What is black hairy tongue?
A
- Staining on tongue
- Common with smokers, elderly, people who use pipe
- Overgrowth of normal surface of tongue
- May have smell attached with it
- Not sinister but unpleasant for patient
- Hard to get rid of but clean with tongue scraper or toothbrush
6
Q
What is geographic tongue?
A
- Erythema migrains aka
- 10% population
- Red areas of atrophy of tongue surrounded by white margins
- Spicy citrus foods can irritate it for some people]
- Areas can change shape and size over time
- Normal and not to worry
7
Q
What is Atrophic Glossitis?
A
- Smooth tongue
- Low iron or folate or B12 can cause this
- If iron and vit B12 drops further it can begin to ulcer which is very uncomfortable
- If discover this then ask GP to do haematics and bloods
8
Q
What is Frictional Keratosis?
A
- White patch caused by trauma
- Essentially calluses on soft tissue
- Sharp tooth or sharp filling for example
- If you can’t find obvious cause then review as this can turn malignant
- If can find obvious cause then sort it out
9
Q
What is Speckled Leukoplakia?
A
- AKA hyperplastic candidiasis
- Speckled appearance of white over the red mucosa
- Can be unilateral or bilateral
- Common in smokers
- Premalignant and needs to be monitored every 6months
- May need antifungals so swab this and biopsy may be required
10
Q
What is Sublingual Keratosis?
A
- Under the tongue is a homogenous thick white patch
- If site is ventral or crossing the mid line then it is considered high risk site
- Concerned and refer to oral medicine for inspection
11
Q
What is Traumatic Keratosis?
A
- Very common
- Dentures in mouth for long time and are ill fitting
- AKA frictional keratosis
- White patch along line of denture fitting surface
12
Q
What is denture-related hyperplasia?
A
- Excess mucosa due to rubbing of ill fitting denture
- Very common
- More common in lower
- Looks like a flap of skin
- Remove the denture and surgically remove the excess skin
- If don’t want surgical resolve then trim the denture as much as poss in
- Mucosa is same colour as other mucosa therefore not dangerous
13
Q
What is denture induced stomatitis?
A
- Poor denture hygiene and leaving denture in 247
- Redness and inflammation of mucosa under the fitting surface of denture
- Painless and patients not massively bothered
- Encourage to take out as much as poss and give chlorohexidine rinse and really good clean before putting back in
- Don’t sleep with denture in at night and let your mouth breath
14
Q
What is angular cheilitis?
A
- Inflammatory condition causing swollen red patches at corners of mouth
- Bacterial or fungal infection
- Useful to swab area to see which bacteria is causing it
- Usually ass with old dentures
-Useful to ask GP for bloods to check for deficiency as usually deficiency makes it worse - Find cause of problem before prescribing antibiotics
15
Q
What is Xerostomia?
A
- Dry mouth (salivary glands don’t make enough saliva to keep mouth wet)
- Common causes are Polypharmacy, chemotherapy, aging, high salt intake, dehydration
- Drug induced dry mouth give fissures on tongue, sjogrens
- Use mirror stick test, put mirror on tongue or mucosa and if it sticks then dry mouth
- Bacteria builds up as saliva not removing it and can enter blood stream which
