consequences of tooth loss and challenges managing older patients

Question 1

How can you make the dental experience for an elderly patient easier?

Answer 1

Seating- upright or slowly alter position
Noise- low n slow
Confusion- reduce speed, less instruction, check med history
Appt timing- meds, capability, convenience

Question 2

How might you help an elderly patient to adapt to change?

Answer 2

Small changes to existing dentures- reline or adapt
Copy dentures w alterations
New dentures w similar aspects to old

Question 3

What does loss of teeth in the maxilla lead to?

Answer 3

More loss of thinner buccal cortical plate w gradual reduction in width and length of residual ridge

Question 4

What does loss of teeth anteriorly in the mandible lead to?

Answer 4

Slightly thinner buccal plate so residual ridge moves slightly lingually

Question 5

What does loss of teeth in the premolar region of the mandible lead to?

Answer 5

Equal thickness of buccal and lingual plates so residual ridge maintains position

Question 6

What does loss of teeth in the molar region of the mandible lead to?

Answer 6

Buccal plate is reinforced by external oblique ridge, resorption of thinner lingual plate occurs
~ residual ridge moves slightly buccally

Question 7

What happens if there is too little resorption?

Answer 7

Bulky alveolar ridges
Little space for dentures
Would lead to frequent denture fracture or excessive face height

Question 8

What would happen if you increase the size of the denture?

Answer 8

Compromises appearance and function

Not enough free way space

Question 9

What happens if there is irregular resorption?

Answer 9

Sharp bone
Traumatised soft tissues
~ ulcers and discomfort
Might need surgical reduction of ‘knife-edge’ ridge

Question 10

What happens if there is excessive resorption?

Answer 10

Normal relationship of posterior teeth may change
~ posterior crossbite
Edge-to-edge incisor relationship or prominent mandible may occur
Atrophy of alveolus
~ superficial mental foramen
Mylohyoid ridge on lingual aspect of mandible becomes sharp

Question 11

What happens if there is normal resorption?

Answer 11

Few months- dentures start to feel loose due to resorption

Need reclining or replacing

Question 12

What clinical techniques are helpful?

Answer 12

Check record
Windowed trays
Neutral zone impression technique
Retained roots
Polycarbonate
Soft liners

Question 13

What oral surgery techniques may be required for difficult prosthetics cases?

Answer 13

Implants
Sulcus deepening
Ridge augmentation