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Geriatrics > 3. Oral Changes > Flashcards

3. Oral Changes Flashcards

1
Q

Main feature of aging in cells

A
  • Gradual cell loss

- Reduced mitotic activity

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2
Q

Physiologic systems most affected by aging are those containing post-mitotic cells which are what organs

A
  • Heart
  • Brain
  • Muscle
  • Skeletal system (less so than the other three)
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3
Q

When does the thymus begin to atrophy

A

Sexual maturity

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4
Q

entire thymus is involuted at what age

A

40

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5
Q

Lymphoid tissues (other than the thymus) reach max size at

A

puberty

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6
Q

Function of immune system (increases/decreases) with age

A

decreases (reduced number of t cells)

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7
Q

People with autoimmune diseases will (improve/decline) with age and why

A

improve because increase in auto anti-isotypic antibodies are present which fight off autoantibodies

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8
Q

B cell numbers (increases/decreases) with age

A

either stays same or increases

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9
Q

Primary immune system (increases/decreases) with age

A

decreases (inital response to antigen)

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10
Q

Secondary immune response (increases/decreases) with age

A

no change (may explain why few childhood diseases afflict the elderly

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11
Q

Rate of attrition in dentition is dependent on

A

diet and habits (not age)

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12
Q

Cause of higher incidence in abfraction in elderly is

A

unknown

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13
Q

Longitudinal cracks in enamel are caused by

A

thought to be caused by age related change in water content

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14
Q

Reasons why teeth are darker in color for elderly

A
  • Thinning of enamel
  • Increased optical density of dentin due to secondary dentin
  • Secondary dentin considered reactive and no intrinsic aging
  • Shrinkage of pulp
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15
Q

Hydration status of teeth (increases/decreases) with age

A

decreases

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16
Q

Dentin becomes more (flexible/brittle) with age

A

brittle

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17
Q

Reason dentin is more brittle with age

A

may be due to closure of tubules by crystal sedimentation

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18
Q

Sclerosed dentin is (more/less) translucent than normal dentin

A

more 9contrary to secondary dentin)

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19
Q

Reason for increased translucency of sclerotic dentin is

A

reduced refractory index difference between peri and intratubular dentin

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20
Q

Translucency of sclerotic dentin begins where

A

at the apex

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21
Q

Denticles and pulp stones (increases/decreases) in number in elderly

A

increases

22
Q

Implications of pulp changes in elderly with performing dentistry

A
  • Pulp is less able to repair after pulp cap
  • Harder to find/navigate canals
  • Less need for local anesthesia in many cases
23
Q

Describe the degenerative changes that occur in the periodontium with age

A
  • Less BVs
  • Reduced cells
  • Coarse and irregular formations of Sharpey’s fibers
  • Moderate structural changes in alveolar bone/cementum
24
Q

T/F Periodontal disease always worsens with age

A

F- sometimes reverse effect

25
Q

Describe the reverse effect of periodontal disease seen in some elderly patients

A
  • Minimal loss of marginal soft tissue
  • Narrowing of periodontal space
  • Firmly attached teeth (almost ankylosed)
  • *This is commonly seen in patients with significant attrition**

Sometimes increased cementum deposition

26
Q

Changes in alveolar bone with age

A
  • Loss of trabeculation
  • Cellular atrophy in osteocytes
  • Increased bone loss (3% every decade past 40)
  • Decreased blood supply (significant inferior alveolar artery arteriosclerosis
27
Q

When the inferior alveolar artery is blocked due to atherosclerosis the alveolus will be supplied by what vessels

A
  • Perisoteum
  • Facial
  • Buccal
  • Lingual arteries
28
Q

Changes in oral mucosa with age

A
  • Atrophy of basal rete pegs (smoother surface)
  • Submucosal loss of cells and vascular supply
  • Thickening of collagen bundles and elastin fibers
  • Degeneration of vessel walls (esp in tongue) –> senile amyloidosis
29
Q

Changes in tongue with age

A
  • Loss of lingual papilla (smoother dorsum) –> smooth dorsum can also be related to nutrient deficiency
  • Increased filliform papilla which cluster –> fissured tongue
  • Senile amyloidosis
  • Increased varicosities
30
Q

Systems involved in declined sense of taste in elderly

A
  • Saliva **major
  • Olfactory – not very significant
  • Thermal sensory
  • Tactile sensory
  • Textural sensory
  • Multiple types of taste receptors
  • Nutritional (zinc involved with taste acuity)
31
Q

Prominent reduction in smell is seen in the early stages of what diseases

A

Alzheimers or Parkinson’s

32
Q

What tastes don’t decline with age

A

sweet and sore (old people eat more sweets)

33
Q

Role of saliva in taste

A

-Dissolve in order for taste bud perception and breakdown by enzymes

34
Q

Functions of saliva

A
  • Remineralization
  • Anti-microbial
  • Lubricaiton
  • Digestion (bolus formaiton , breakdown)
  • Mucosal repair (epidermal growth facto)
  • Buffering capacity
35
Q

Consequence of salivary hypofunction

A
  • Rampant caries
  • Candidiasis
  • Mucosal friability (tears more easily without lubrication)
  • Dysphagia
  • Complaints or oral dryness
  • Complaints of altered taste
  • Difficulty wearing prosthesis
36
Q

T/F Xerostomia is a normal part of aging

A

f

37
Q

Xerostomia is mostly caused by _ in elderly

A

meds

38
Q

Aging changes in salivary system

A
  • Stimulated whole saliva unchaged with aging

- Non-stimulated saliva is reduced

39
Q

Saliva release from which glands are affect the most to least by aging

A

minor salivary glands> submandibular> Parotid

40
Q

Parotid changes with age

A
  • Some degeneration and loss of acinar glandular tissue

- Replacement of lost tissue with fibro-adipose tissue

41
Q

Submandibular changes with aging

A
  • More degeneration and loss of acinar tissue

- Replacement of lost tissue with fibro-adipose tissue

42
Q

Minor salivary gland changes with agining

A
  • extensive degeneration and loss of acinar glandular tissue
  • Ductal proliferation
43
Q

Changes in salivary immunoglobulins with age

A
  • Salivary IgA conc. changes with flow rate (no change from aging alone)
  • IgG and IgM antibodies decline
44
Q

Changes in non-immunoglobulin defenses in saliva

A

None (same lysozyme, lactoferrin, and lacto-peroxidase)

45
Q

T/F Blocked salivary ducts with plugs of degerative tissue ususally passes

A

t

46
Q

T/F No age connection to sialolithiasis

A

t

47
Q

Elderly have (higher/lower) biting forces

A

lower

48
Q

Changes in muscle contractility in elderlys lead to

A
  • Impairment higher in prostehesis wearers
  • Increased time for bolus prepatation
  • Increased chocking hazard
49
Q

increased choking hazard in elderly enhanced by

A
  • Reduced sensory perception
  • Reduced proprioception
  • Oral dryness
50
Q

Change in voice with age is the result of

A

laryngeal stiffening

51
Q

Speech in elderly also affected by

A
  • Hearing loss
  • Teeth loss
  • Neuromuscular loss (dysarthria)
  • Dysphagia
52
Q

Alterations in posture that occur with age are

A
  • Drooping lower face
  • Hanging lower jaw
  • Leads to drooling and spilling food

Geriatrics (11 decks)

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