What are elderly pts more at risk of?
multiple chronic diseases
polypharmacy
frailty
loss of autonomy
What are some barriers to good oral health?
multi morbidity
cost of dental tx
fear of dental tx
accessibility and availability of dental services - lack of mobility and transport
What does multimorbidity include?
reduced quality of life
reduced cognitive function
reduced manual dexterity
polypharmacy
What oral health conditions are the elderly more at risk of?
denture stomatitis
tooth wear
oral cancer
periodontitis
root caries
xerostomia
What are the common findings in elderly pts?
reduced motor and cognitive function
reliance on high sugar diet with frequent snacking
polypharmacy resulting in dry mouth
high prevalence of chronic diseases and multiple comorbidities
often unable to independently access dental care
What is xerostomia associated with?
multiple meds
chronic health conditions
menopause
radiation
What is denture stomatitis associated with?
poorly fitted denture
lack of dentition
poor plaque control due to reduced function
xerostomia
What is oral cancer associated with?
physiological aging
history of smoking and alcohol misuse
What is root caries associated with?
gingival recession
cariogenic diet
poor OH due to reduced function
dentures
xerostomia
What is periodontitis associated with?
poor OH due to reduced function
comorbidities eg diabetes
multiples meds
impaired wound healing
What is tooth wear associated with?
natural part of aging
pathological is common
What are the wider impacts of poor oral health in elderly?
malnutrition
pneumonia
oral cancer
dignity / socialisation
systemic health
How does poor oral health lead to malnutrition?
makes it difficult to eat and drink
leads to reduced nutritional status and weight loss
How does poor oral health lead to pneumonia?
increases risk of aspiration pneumonia
dental plaque is colonised by pneumonia pathogens
high mortality rates are associated with poor OH (30-70%)
How does poor oral health lead to dignity and socialisation?
inability to smile or talk
can become withdrawn and isolated
bad for mental and physical well being
What various systemic conditions are associated with poor OH?
ineffective endocarditis
rheumatoid arthritis
diabetes
stroke
cardiovascular disease
dementia
cancer
What is the OSCAR approach for tx planning?
O - oral and dental needs eg perio health, restorations
S - systemic factors eg comorbidities , meds
C - capability
A - autonomy
R - reality eg financial issues, life expectancy
Communicate effectively !
What are the barriers to providing good oral health in care homes?
chronic ill health , often advanced dementia
resistance/pt refusal
lack of knowledge and training procedures
lack of time
unclear responsibility to provide oral care
lack of prioritisation of oral care
high turnover of staff
