What are 9 'barriers' for the elderly pt? from (little)
reduced visual acuity
reduced hearing
vestibular dysfunction
dementia
musculoskeletal
foot disorders
postural hypertension
use of medications
What are 5 barriers to treatment for the elderly pt in the outline?
attitude/perceptions
denture related issues
caries
OHI
xerostomia
the anatomic or physiologic age of a person as determined by changes in organismic structure and function; takes into account features such as posture, skin texture, strength, speed, and sensory acuity
biologic age
the actual measure of time elapsed since a person's birth
chronologic age
What type of aging depends on the individual? And what type is due to the passage of time?
biologic
primary
the type of aging described as minimal physiologic decline from aging alone; associated with healthier lifestyle - excersising habits, cognition
successful aging
type of aging that refers to more common mode of aging and is associated with decline in organ and sensory function
usual aging
Primary normal changes associated with aging
physiologic aging
What are 10 areas that can be affected in physical age related changes?
musculoskeletal system
skin
cardiovascular system
respiratory system
GI system
vision
hearing
Endocrine system
Immune system
Hepatic functions
What are 2 cognitive areas that are affected in age related changes?
CNS
peripheral nervous system
Age changes in bone mass, muscle function, and stiffened joints affect what?
musculoskeletal system
Age changes causing thinnes, wrinkles and loss of tone affect what?
skin
Age changes causing slow resting heart rate, increased size of left ventricle, heart valve thickening, atherosclerosis, and endocarditis affect what?
cardiovascular system
Age changes causeing decreased pulmonary efficiency, higher infection risk due to less effective cough reflex, and respiratory problems occuring under stress affect what?
respiratory system
Age changes causing decreased hydrochloric acid and other secretions, peristalis slowing, and a decreased rate of absorption affect what?
GI system
Age changes that cause slower cognitive function, complex tasks more difficult, decline in short term memory with long term memory still intact affect what?
Central nervous system
Age changes that decrease tactile senses and decrease depth perception affect what?
peripheral nervous system
Age changes such as presbyopia (far sighted) visual aciuty decrease, decreased peripheral vision, decreased function of pupil dilation, cataracts, diabetes, glaucoma, can affect what?
vision
age changes such as presbycusis (lessening of hearing), wax, high frequency tones hard to hear, and tinnitus can affect what?
hearing
age changes such as deccreased thyroid function and thermoregulatory system altered affect what?
endocrine system
what declines with age and varies from person to person as we age?
immune system
liver weight declines due to blood flow lowering the number of hepatocytes, reduces ability to process certain meds, and must adjust drugs and monitor blood levels, in what age related change?
hepatic functions
Attrition is affected as we age, what are 5 factors of this?
diet
occupational factors
bruxism
chipping, brittle teeth
leads to loss of vertical dimensions of occlusion
Denture-related __________ is the most common lesion in the mouth of aging patients
candidiasis
What are 2 things in denture related candidiasis that allow the fungus to grow?
improperly fitting dentures
lack of salivary support
What are 3 things related to the bone of oral findings in aging periodontium?
osteoperosis
depressed vascularity
reduction in metabolism
What is 1 thing related to the cementum of oral findings in aging periodontium?
increased thickness
What are 3 things related to the gingiva of oral findings in aging periodontium?
changes result of infection
anatomic factors - recession
blood vessel density
true or false. salivary function doesn't usually change in healthy older adults. It usually just affects older adults with chronic illness because of all their medication
both are true
true or false. In elderly patients their sense of taste and smell diminishes
true
What are three conditions of the tongue that can occur as a result of aging?
atrophic glossitis (burning tongue)
dulled taste sensations
sublingual varicosities
What is angular chelitis?
a condition affecting the lips in aging patients
inflammation of the lips
what percent of all medications are taken by the elderly?
30%
What are 4 things that affect pt compliance in taking medication?
cost
lack of education
unacceptable adverse effects such as dry mouth or cognitive effects
complex medical regiments, and not feeling like they need them
Process of care is based on what?
individual patient needs
What is the most common barrier to patient care in elderly patients?
lack of perceived need
true or false. Flouride intake of a pregnant women will benefit the mother and child
true
flouride given to mothers in their _____ and ________ trimesters resulted in ______% of offspring being caries free for up to 10 years
2nd
3rd
97
true or false. Systemic prenatal fluoride was also proven to decrease premature delivery and increase birth weight
true
Maternal periodontitis can have what affect on the fetus?
hinder development
low birth weight
premature
Pts with what 4 viruses/infectious diseases are at high risk for caries and can cause their children to be at high risk for caries?
HIV
herpes
hep B
varicella
The risk of teratogenicity is in the first _______ weeks of pregnancy
14
Mothers taking respiratory depressants can cause what in the fetus?
fetal hypoxia
Mothers taking tetracycline during pregnancy can cause what 4 things in the fetus?
staining at 4th month of gestation
toxic action on ear (deaf)
8th cranial nerve damage
bone growth inhibition
When is HIV therapy best used at?
after the 14th week
Taking alcohol during pregnancy may cause what?
Fetal Alcohol syndrome
low birth weight
using concaine while pregnant may cause what in baby?
seizures
true or false. taking x-rays on a pregnant patient is controversial and should be avoided in the first trimester. don't take x-rays on pregnant pt unless you absolutely have to
true
With a lead apron on the pregnant pt how many FMX series would we have to take to damage the baby?
1000
the risk of fetal defet from radiographic exam is what?
9 in one billion
What is the most common oral complication in pregnancy that is caused because of poor oral hygiene, or caused by changes in hormones that may alter tissue reaction?
pregnancy gingivitis
What can pregnancy gingivitis lead into?
pregnancy tumors or pyogenic granuloma
an overgrowth of tissue; a benign inflammatory lesion that usually occurs in the labial aspects of interdental area
pyogenic granuloma
What are 3 symptoms of gingival enlargements in the pregnant pt such as pyogenic granuloma?
bleeds easily, even on brushing
most often is painless
usually goes away with cleaning and after pregnancy
What can be caused by morning sickness with vomiting; mostly seen on palatal surfaces of teeth, it is demineralization and acid erosion?
enamel erosion
If pregnancy does not increase the amount of caries, then what 2 things do?
diet during pregnancy - eating more sweets and more often
neglect of oral care - more lax due to nausea, and brushing may cause gagging
during what trimester do we just assess and instruct and do a baseline prophy?
first trimester
what trimester is the best for general dental treatement?
2nd
What are 2 common things to look for when reveiwing the HHx of pregnant patients?
gestational diabetes and hypertension
What is a common positioning adjustment you may have to make with pregnant patients?
