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DG2013 - Day 8 Special Care Dentistry > SCD - Gerodontology > Flashcards

SCD - Gerodontology Flashcards

1
Q

What is the difference between chronological and biological age?

A

Chronological = count of number of years, months and days since birth

Biological = the age they appear

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2
Q

What happens to our cells as we age?

A

Aging affects the cells ability to multiply and divide and they start to accumulate lipids

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3
Q

What happens to our tissues as we age?

A

Tissues lose mass or their elasticity and begin to accumulate fatty substance

Lose ability to supply nutrients and remove waste products

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4
Q

What happens to our organs as we age?

A

Organs lose their reserve capacity and therefore struggle when under more demand from illnesses, medication and physical activity

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5
Q

What is Osteoporosis?

Who is most affected by this and why?

How is it managed and what is the risk of this?

A

Loss of bone mass which causes bones to become weak

Females as it is inversely linked to Oestrogen levels

Managed by oral bisphosphonates - risk of BRONJ lower than with IV

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6
Q

What is Osteoarthritis?

What are the symptoms?

How is it managed?

A

OA affects weight-baring joints resulting in degeneration of the articular cartilage and subchondral bone

Symptoms = pain and stiffness in joints

Managed = NSAIDs and physiotherapy - severe cases may need joint replacement

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7
Q

List 3 reasons why the skin wrinkles and sags as we age:

A
  1. Thinning of outer layer - Epidermis
  2. Reduction in pigmentation cells - Melanocytes
  3. Reduction in subcutaneous fat
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8
Q

List 3 age-related skin illnesses:

A
  1. Fissuring = painful irritation around skin folds
  2. Changes in sensation - tingling, numb
  3. Malignancy
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9
Q

What 3 hormones decrease with age and what do they do?

A
  1. Aldosterone which helps control BP
  2. Cortisol = stress hormone
  3. Sex hormones - testosterone and oestrogen
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10
Q

What is Arteriosclerosis?

A

An increase in BP associated with a decrease in aortal pressure

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11
Q

What is postural hypotension?

A

Low BP when standing or sitting

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12
Q

What is temporal arteritis?

A

When the arterial walls become thickened

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13
Q

What can Vitamin C deficiency lead to?

What is senile purpura?

A

Scurvy

A large irregular bruise usually on the forearms, hands and face

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14
Q

What is Megaloblastic anaemia?

A

Abnormal red blood cells usually related to vitamin B12 and folic acid deficiency

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15
Q

How are the lungs affected by age?
(give 2 features)

A
  1. Lung capacity falls with age
  2. Bronchi have reduced ability to clear mucus - increased risk of lower lung infections
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16
Q

What is pneumonia?

A

An infection of the air sacks of the lungs

17
Q

What happens to the kidney and bladder as we age?

A

Kidney function impaired as reduction in nephrons

Bladder muscles become weaker with age

Urethra blockages common

18
Q

List 3 significant physiological changes in elderly patients:

A
  1. Decrease in hydrochloric acid in the stomach
  2. Reduction in cardiac output
  3. Reduction in hepatic and renal blood flow
19
Q

What drugs do elderly patients have increased sensitivity to?

How are adverse drug reactions affected as we age?

A

Benzodiazepines

Adverse drug reactions increase 10 fold in the elderly

20
Q

How is the dose of LA affected in elderly patients?

A

Elderly patients have a reduction in hepatic clearance so reduction in dose is required

21
Q

How are the following affected in elderly patients:

  1. Fluoride
  2. Dentine and Pulp chamber
  3. Cementum
A
  1. Fluoride = concentration in enamel increase with age but teeth become brittle and darker with stains
  2. Dentine in pulp chamber continues to be laid down - often a narrowing of the pulp
  3. Cementum continues to grow throughout lifetime
22
Q

What causes dentinal sclerosis in elderly patients?

A

Peritubular dentine formation

23
Q

As we age, the epithelial cells in our oral mucosa become flatter and thinner - what does this make the mouth more susceptible to?

A

Risk factors of oral cancer i.e. smoking and alcohol

24
Q

What 5 drug categories are associated with Xerostomia?

A
  1. Tricyclic antidepressants
  2. Antihistamines
  3. Antihypertensives
  4. Cytotoxics
  5. Anti Parkinson’s drugs
25
Q

Give 4 reasons why elderly patients are at risk of root caries:

A
  1. Presence of dentures
  2. Reduced dexterity
  3. Poor nutrition
  4. Inadequate OH
26
Q

What is the difference between active and inactive root caries?

A

Active = soft and leathery

Inactive = hard and shiny

27
Q

List 4 ways to manage root caries in elderly patients:

A
  1. Fluoride application
  2. Chlorhexidine mouthwash
  3. Diet advice
  4. GI for restorations
28
Q

What is the strongest predictor of periodontal disease progression?

A

P. gingivalis

29
Q

List 2 calcium channel blockers which can cause gingival overgrowth:

A

Nifedipine and amlodipine

30
Q

What is the most common type of tooth wear in the elderly population?

A

Physiological

31
Q

Describe the clinical presentations of:

  1. Attrition
  2. Abrasion
  3. Erosion
A
  1. Attrition = loss of tooth structure leading to a flattened occlusal/incisal surface
  2. Abrasion = notches in the cervical areas or cupping in the occlusal/incisal surfaces
  3. Erosion = on palatal/labial surfaces - shiny glass appearance with existing restorations unaffected
32
Q

Alongside bleaching, what can whitening trays be used for?

A

Fluoride application

33
Q

Give an example of a oral mucosal lesion which has an increased prevalence with age:

A

Oral Lichen Planus

34
Q

List 4 common mucosal findings on elderly patients:

A
  1. Fissure tongue and atrophy of tongue
  2. Denture stomatitis
  3. Angular cheilitis
  4. Traumatic ulcers
35
Q

List 3 types of orofacial pain common in elderly patients:

A
  1. Burning mouth syndrome
  2. Trigeminal neuralgia - carbamazepine to treat
  3. Giant cell arteries - systemic steroids
36
Q

What is Domiciliary care?

What Acts enforced this?

A

Service which allows people to remain in their home

Disability Discrimination Act, 2005 and
Disability Equality Duty, 2006

37
Q

What does the acronym ‘CAMPING’ represent for domiciliary care?

A

C = Communication
A = Assertiveness and anticipation
M = Manual handling and map reading
P = Planning and time management
I = Improvisation
N = Networking and liaison
G = Gerodontology

38
Q

What is ‘mix and match’ care?

A

When care is split between domiciliary and surgery based visits

39
Q

What is Palliative Care?

What is the goal for dental palliative care?

A

To ultimately relive pain and make patients comfortable to give the best quality of life

To help relieve oral side effects of a serious disease that allow patients to eat drink and speak as comfortably as possible

DG2013 - Day 8 Special Care Dentistry (6 decks)

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