SCD 3 Flashcards
what is the general implication of dementia
progressive deterioration of cognitive function
(memory, language, orientation etc)
what are the 4 different types of dementia
alzheimers
vascular
dementia with lewy bodies
fronto temporal
alzheimers dementia
most common
severe size reduction of hippocampus
results in communication difficulties , moodswings, confusion , loss of confidence, memory loss
vascular dementia
reduction in blood flow to brain which damages and eventually kills brain cells
can be a result of a stroke or multiple TIAs
sees anxiety, memory problems, delusions, visospatial difficulties
dementia with lewy bodies
has similarities to parkinsons
cognitive ability fluctuates, STML, hallucinations, speech and swallowing problems, sleep disorders
frontotemporal dementia
jim
younger onset
personality changes, possible aggresion , difficulty with language
STML not always present
early symptoms of dementia
STML
confusion , poor judgement, not wanting to make decisions
communication issues
anxiety
middle stage symptoms of dementia
increasingly forgetful , may not recognise loved ones
distress, anger and frustration
risk of wandering , leaving oven on etc
reminders needed to eat / wash / dress
how is dementia diagnosed
cognitive testing
mini mental state examination is the most common - easy to do and samples a range of cognitive function
however does not test frontal lobe very well and is not sensitive to mild impairment - no time limit between question and recall
chronological vs biological old age
chronological = actual age e.g 78
biological = lifestyle age - are they independent , good mobility and have good cognitive function
what is frailty
a state of increased vulnerability to stressors due to age related declines in physiological reserves across neuromuscular, metabolic and immune systems
what have studies shown increases oral health related quality of life
increased number of teeth
having anterior teeth
increased pairs of occluding teeth
what is candidosis/ candidiasis
accumulation of candida albicans fungus in mouth also known as oral thrush
appears as white patches that may bleed upon removal
predisposing factors for candidiasis
antibiotic use, smoking, xerostomia, iron deficiency , cushings, diabetes
what is miconazole gel and what pts shouldnt be given it
an antifungal that can be used to treat candidiasis
can be put on fitting surface of dentures if denture stomatitis present
contraindicated for warfarinised patients (increased anticoagulating effects) or patients taking statins (increased risk of myopathy)
haemangioma
collection/ malformation of bvs creating a pool of blood under mucosa
if traumatised it will bleed
most common oral sites = edges of tongue and inside lip
require hospital removal
fibroepithelial polyp
nothing sinister
skin tags whose mucosa looks the same as the mucosa in the rest of the mouth
root cause = trauma with inproper healing
sides of cheeks = most common site
black hairy tongue
seen in elderly smokers
due to overgrowth of tongue surface which easily picks up staining
difficult to get rid of
(nothing sinister, but may smell)
Geographic tongue
erythema migrans
aread of atrophy (reddish) surrounded by white slightly raised margins
spicy and citrus foods can cause sensitivity
atrophic glossitis
really smooth tongue
most common cause = haematinic deficiency , request bloods from GP
can lead to ulceration
frictional keratosis
white patch from trauma thats undergone keratinisation
always review for healing
closely monitor if no trauma/ denture cause found
sublingual keratosis
leukoplakia in sublingual region
refer to OM could be malignant
denture induced hyperplasia
growth of excess mucosa due to denture rubbing
denture induced stomatitis
erythema of hard palate due to candida infection
often painless
remind pt to remove and clean denture at night
angular chellitis
mixed bacterial/ fungal infection at commisures of mouth
difficult to heal
often due to poor hygiene dentures providing a reservoir for bacteria and fungi
try and deal with problem e.g increasing a reduced OVD before prescribing any meds
what two drug tablets may cause burns if pt pouches them
iron and aspirin tablets
lichenoid reaction
direct reaction to certain drugs and materials
e.g NSAIDS, diuretics, amalgam
action of bisphosphonates and what patients might be taking them
bisphosphonates inhibit osteoclast formation and bone turnover
patients with osteoporosis and bone malignancies may take these
MRONJ
exposed bone, for more than 8 weeks, in patients with a history of anti resorptive or anti angiogenic drugs and no history of radiotherapy
risk factors for MRONJ
previous MRONJ
on bisphosphonates for more than 5 years
on bisphosphonates in combination with systemic glucosteroids
taking angiogenic and/or anti-resorptive drugs for cancer management
