Wheelchair Races

Question 1

common oral disorders in the older adult

Answer 1

root caries, tooth loss, xerostomia

Question 2

caries prevalence in the “very old”: __% have coronal decay, maean number of coronal surfaces affected is __. ___% have untreated coronal decay. __% have root caries experience. mean number of root surfaces affected is __. __% have untx root caries

Answer 2

94, 32.1, 22, 54, 3.3, 24

Question 3

lost teeth. 1 in __ adults aged 55 years or older have lost all of their natural teeth with rates of loss doubling between 55-64 and 65-74 and then increasing to more than __ among adults 85 and over

Answer 3

1 in 5 (21%), 40%

Question 4

top 4 causes of tooth loss in old

Answer 4

1. caries, 2. perio, 3. pre-prosthetic, 4. fractures

Question 5

major reason for tooth ext is caries, found in 60% of all cases and __% in the oldest age group

Answer 5

77%

Question 6

xerostomia- there is _ - diminution of parotid fluid output for either the unstimulated or stimulated states

Answer 6

no age-associated

Question 7

parotid fluid rates show constant __ variability but this remains constant across life span. the responsiveness of the parotid gland to physiologic challenge is __ with increased age

Answer 7

normal, unchanged

Question 8

not a flashcard- just a list of the meds that gives you xerostomia

Answer 8

anticonvulsants, antidepressant, antihistamin, anticholinergic, diuretic, hypotensives, muscle relaxants, narcotic, hypnotic, tranquilizers, sympathomimetics

Question 9

4 urinary antispasmodics

Answer 9

hyoscyamine (cystospaz), obybutynin (ditropan), flavoxate (urispas), atropine/hyoscyamine (urised)

Question 10

___ is loss of ability to think and remember of sufficient degree in order to interfere with social functioning and activities of daily living.

Answer 10

dementia

Question 11

to be dx with dementia must have impairment of at least __ brain functions

Answer 11

2

Question 12

according to NIH, swallowing problems occur in about 45% of those diagnosed with

Answer 12

alz and other dementias, this number increases as dementia progresses

Question 13

__ is a progressive neurodegen. disorder that is characterized by relentless decline of cognitive function, judgement, perception, and personality. Ultimately the loss of distinctive and shared qualities that define an individual’s existence

Answer 13

alz

Question 14

in alzheimer’s onset of symptoms until death is __ to __ years, with an average of __ years.

Answer 14

3-20, 8

Question 15

nearly __% of all nursing home patients in us have alz. __% of those afflicted with disease live along. no tx has been proven totally successful in reversing course of the disease

Answer 15

50%, 70%

Question 16

alz: recent __ loss that affects job performance, difficulty performing __ tasks, problems with __, disorientation of __ and __, __ or decreased judgement, problems with __ thinking, misplacing things, changes in mood or behavior, change in personality, loss of initiative

Answer 16

memory, familiar, language, time and place, abstract

Question 17

test for alz

Answer 17

brain biopsy or autopsy

Question 18

2 most common ways for alz pt to die

Answer 18

1. bronchopneumonia or aspiration pneumonia (40%) AND 2. ischemic heart disease (23%); cancer was only 3%

Question 19

clinical issues when dealing with demented patients are cooperation, medications that alter oral environment, providing __ __, __ habits, post-operative care, and __ __

Answer 19

informed consent, dietary habits, home care

Question 20

stages of alz disease. stage 1

Answer 20

disoriented in time (still able to perform self care, adapt to new removeable prosthetic, can introduce family to friend in oral health care)

Question 21

stages of alz disease. stage 2

Answer 21

disoriented in time and place (engage family or friend in oral health care, power driven toothbrush of high value, use antimicrobial agents, removal posterior teeth with questionable prognosis)

Question 22

stages of alz disease. stage 3

Answer 22

disoriented in time, place, and person (removable symptomatic teeth, med induced xero prevalent, discontinue removable prosthetic use)

Question 23

after the age of __ patients teeth tend to become __, ___, and more ___, with the exception of __ sites which become __

Answer 23

35, darker, redder, saturated, yellow

Question 24

old teeth have decreased __ and increased __

Answer 24

value, crhoma

Question 25

when you get old there is graduate reduction in the amount of __ __ exposure and gradual increase in __ __ exposure

Answer 25

maxillary incisor, mandibular tooth

Question 26

1 cause of disability in US

Answer 26

stroke

Question 27

90% of strokes in old people are __, 10% are __

Answer 27

ischemic, hemorrhagic

Question 28

controllable risk factors for stroke (sorry this is lazy of me)

Answer 28

high BP, aFib, high cholesterol, diabetes, atherosclerosis, circulation problems, tobacco use and smoking, alcohol use, physical inactivity, obesity

Question 29

uncontrollable risk factors for stroke

Answer 29

age, gender, race, family history, previous stroke/ TIA

Question 30

common meds prescribed for stroke patients with implications for dentistry: 1. urinary antispasmodics cause ___. 2. antidepressants cause __ and __ __. 3. antiHTN cause ___ and _ __. 4. anticoagulants cause __ __. 5. broad spectrum antibiotics cause __ __

Answer 30

1. urinary antispasmodics cause xero
2. antidepressants cause xero and increased appetite
3. antiHTN cause xero and orthostatic hypotension
4. anticoagulants cause abnormal hemostasis
5. broad spectrum antibiotics cause oral candida

Question 31

pts with stroke, dementia, pd, all, ms, or mg are at risk for

Answer 31

neurogenic dysphagia (stroke 45-75%, dementia 45%)

Question 32

dysphagia affects about 50% of stroke its initially and improves within __ to __ days. __-__% are still dysphagia at 6 months

Answer 32

7-14 days, 11-13%

Question 33

what is eval in oral mucosa sensory eval?

Answer 33

buccal, labial, lingual mucosas

Question 34

posterior occlusal relationship: “freedom in ___”, a wide __ is mandatory. horizontal overjet __mm throughout. minimal __ overlap. non-anatomic/flat plan tooth form, consider __ occlusion

Answer 34

centric, centric, 1.5mm, vertical, lingualized

Question 35

oral and dental complications with stroke

1. absent or attenuated __ __, 2. __
2. __ and __ biting
3. compromised __
4. reduced _ retention

Answer 35

gag reflex
dysphagia
cheek and tongue
self-care
denture

Question 36

__ is a chronic neurodegenerative movement disorder affecting voluntary and emotional movements and most commonly seen int he elderly, but is also found int he young and inexorably progresses leading to significant disability

Answer 36

PARKINSONS

Question 37

leading cause of death in parkinson pts

Answer 37

pneumonia (50-64%), due to increasingly very high prevalence of dysphagia

Question 38

common co-morbidities with parkinson’s disease are (4)

Answer 38

caries, perio, diabetes, and chronic liver disease

Question 39

there is an assoc. between hospitalization for pneumonia and untreated __ __

Answer 39

dental caries

Question 40

in parkinsons pt, high prevalence of difficulty swallowing, perio and dental caries may lead to a greater risk of _ _

Answer 40

aspiration pneumonia (so maintain good OHI and use SDF!!!!!)

Question 41

PD patients with bad tremors could benefit from a __ _ denture

Answer 41

implant supported