MacEntee MI JADA 2007, Vol 138

Oral Health Model has 4 major themes: Oral Health Model has 4 major themes: comfort, general health, hygiene, dietcomfort, general health, hygiene, diet

All affect people All affect people’’s lives both socially and personally.s lives both socially and personally.

Geriatric dental careGeriatric dental care

• Diagnosis, Diagnosis, treatment , treatment , prevention of all prevention of all dental and oral dental and oral diseases for all diseases for all older adultsolder adults

What is one of the most What is one of the most significant oral problems significant oral problems

found in the elderly?found in the elderly?

What is one of its most What is one of its most significant contributing risk significant contributing risk

factors?factors?

Xerostomia

Polypharmacy

Why is Oral Health Why is Oral Health important in the Elderly?important in the Elderly?

• Most severe oral health problems are Most severe oral health problems are in the oldest and sickest patientsin the oldest and sickest patients

• Polypharmacy contributes to dry Polypharmacy contributes to dry mouth due to decreased salivary flowmouth due to decreased salivary flow

• Lowers the oral pH>>> CariesLowers the oral pH>>> Caries

Institutionalized ElderlyInstitutionalized Elderly• At particular risk for poor oral healthAt particular risk for poor oral health• Nursing staff and others rated oral care as Nursing staff and others rated oral care as

important, HOWEVER, important, HOWEVER, other activitiesother activities were given were given priority over oral carepriority over oral care

• Oral care is not considered part of nursing care; Oral care is not considered part of nursing care; omitted from care plansomitted from care plans

• Frequently unclear as to responsibilityFrequently unclear as to responsibilityVargas, Kramarow, Yellowitz, 2001 Wardh et al., 2000

Common Oral Conditions Common Oral Conditions in the Elderlyin the Elderly

• Periodontal diseasePeriodontal disease

(gum disease)(gum disease)

• CariesCaries

(tooth decay)(tooth decay)

• XerostomiaXerostomia

(dry mouth) (dry mouth)

Summary:Summary:

• Oral health, taste and smell contribute toOral health, taste and smell contribute to an individualan individual’’s sense of well-being and s sense of well-being and

quality of life quality of life Ritchie CS Clin GerRitchie CS Clin Ger Med Nov 2002Med Nov 2002

• Tooth loss, periodontal disease, decreases Tooth loss, periodontal disease, decreases in saliva production are not normal in saliva production are not normal consequences of agingconsequences of aging

• Quality of Life is multifactorial and a Quality of Life is multifactorial and a personal experience; good oral health personal experience; good oral health enhances QOLenhances QOL

Oral Systemic Links are Oral Systemic Links are significantsignificant

• Study of older adults, 85+ had PDStudy of older adults, 85+ had PD• Moderate disease and could be managed Moderate disease and could be managed

by General Dentists with conservative by General Dentists with conservative care and good oral hygienecare and good oral hygiene

• Patients should be routinely assessed for Patients should be routinely assessed for risk of diabetes, HTN, respiratory risk of diabetes, HTN, respiratory diseases, osteoporosis.diseases, osteoporosis.

• Dentistry and Medicine need to address Dentistry and Medicine need to address this together for better care of our this together for better care of our patientspatients

Thank you for your Thank you for your attention!attention!