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Flashcards in Geriatric Dentistry Deck (43)
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1

 

Geriatric Dentistry

 

Is the delivery of __ ___ to older adults involving the ___, ___ and ___ of problems associated with normal___ and age-related diseases as part of an____ team with other health care professionals

 

Is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal aging and age-related diseases as part of an interdisciplinary team with other health care professionals

2

 

Older Adult Population

One of the fastest growing segments  of the American population 

•Current accepted age to define an older adult is __ years* 

•In 2009, 39.6 million seniors were U.S. residents 

•2030 this aging cohort is expected to reach 72.1 million – an increase of ___% 

•1 in _ Americans will be aged 65+ years in 2050 

 

 

One of the fastest growing segments 

of the American population 

•Current accepted age to define an older 

 

adult is 65 years* 

•In 2009, 39.6 million seniors were U.S. residents 

•2030 this aging cohort is expected to reach 72.1 million – an increase of 82% 

•1 in 5 Americans will be aged 65+ years in 2050 

3

 

Older Adult Population in U.S. 

Close to ___ percent of older Americans do not have dental insurance

 

Older Adult Population in U.S. 

Close to 70 percent of older Americans do not have dental insurance

4

 

Oral and Dental Diseases in Older Adults

___ ___ – (root and/or recurrent) 

___ disease 

___ missing teeth 

___ ___
____ __

 

 

•Dental caries – (root and/or recurrent) 

•Periodontal disease 

•Edentulism/ missing teeth 

•Oral cancer 

•Dry mouth 

5

 

Epidemiology of Xerostomia

 

Approximately __% of adults are ___ - 44 million in the US

>__% of adults ___ from xerostomia

 

Approximately 20% of adults are affected - 44 million in the US >10% of adults suffer from xerostomia

6

 

Dry Mouth / Xerostomia in Older Adults 

Indicators 

•Feeling of ___of oral mucosal surfaces 

•S___mucosa 

•Dry __

•__ ___

 

Causes difficulty in: 

•__

•__

•__

•___ food components 

 

Dry Mouth / Xerostomia in Older Adults 

Indicators 

•Feeling of dryness of oral mucosal surfaces 

•Sensitive mucosa 

•Dry lips 

•Bad breath 

 

Causes difficulty in: 

•Mastication 

•Swallowing 

•Speaking 

•Solubilizing food components 

7

 

Saliva 

•Lubrication & protection 

•Buffering action & clearance 

•Maintenance of tooth integrity 

•Antibacterial activity 

•Taste and digestion 

 

Saliva 

•Lubrication & protection 

•Buffering action & clearance 

•Maintenance of tooth integrity 

•Antibacterial activity 

•Taste and digestion 

8

 

Xerostomia Causes 

•__ __

•Head & Neck ___n therapy 

•___disease or conditions 

•__ __ __

 

Xerostomia Causes 

•Prescription drugs 

•Head & Neck Radiation therapy 

•Systemic disease or conditions 

•Illicit drug use 

9

 

Systemic disease or conditions 

___ changes such as pregnancy or menopause

__ ___

__ __

___d disorders 

__ __

___
___ __

 

 

Systemic disease or conditions 

•Hormonal changes such as pregnancy or menopause 

•Diabetes mellitus 

•Sjögren’s syndrome 

•Thyroid disorders 

•Cystic fibrosis 

•HIV 

•Hepititis C 

 

10

 

Dental Caries in Older Adults 

•Prevalence of ___ caries & ___ caries is ___

 

Caries risk factors 

•Reduced __ __

•Reduced ___ and ___s of oral self-care (mechanical plaque removal) 

•Heavy plaque deposits as result of __ ___

•Presence of __ __ __

•Increased consumption of ___  & simple carbohydrates 

 

Dental Caries in Older Adults 

•Prevalence of root caries & recurrent caries is higher 

•Caries risk factors 

•Reduced salivary flow 

•Reduced frequency & effectiveness of 

 

oral self-care (mechanical plaque removal) 

•Heavy plaque deposits as result of poor cleaning 

•Presence of removable partial dentures 

•Increased consumption of sugars & simple carbohydrates 

11

 

Base treatment plan & management by utilizing ___ __ ___

 

Risk of Caries classified as

Low 

Moderate 

High

 

Base treatment plan & management by utilizing caries risk assessment

 

Risk of Caries classified as

Low 

Moderate 

High

12

 

Colgate PreviDent® 5000

 

__ ___ dispersion than ___e-form Rx dentifrice1

13

 

Sodium Fluoride Mouthrinses 

__ ___s - most widely used for rinses 

 

Clear reduction in___  increments in permanent dentition of children (26% in pooled DMFS prevented fraction)* 

 

 Advantages 

___ and ___ of ___

 

Sodium Fluoride Mouthrinses 

Na formulations - most widely used for rinses 

 

Clear reduction in caries increments in permanent dentition of children (26% in pooled DMFS prevented fraction)* 

 

 Advantages 

– effectiveness 

– simplicity of use 

14

 

Colgate® PreviDent® Varnish

 

Active Ingredients 

5% __ ___22,600 ppm F-) 

 

Indication 

____: post ___/ __ ___, post ___ surgery, ___exposure 

15

 

Protective Factors Saliva Plays an important role in protection 

___ s the salivary pH 

Provides___s & facilitates delivery of ___

 

Xerostomia places patient at a higher risk for __ __ loss

 

Protective Factors Saliva Plays an important role in protection 

Buffers the salivary pH 

Provides minerals & facilitates delivery of fluoride 

 

Xerostomia places patient at a higher risk for hard tissue loss

16

 

Commonly a combination of factors: 

___ ___
____

__ ___
improper__ ___habits

 

Commonly a combination of factors: 

acidic diet bruxism 

gastric acids improper oral hygiene habits

17

 

Attrition – wear produced by ___ __ __ __ ___

 

Attrition – wear produced by direct tooth-tooth contact

18

 

Erosion + Attrition 27 

Cupping is caused by ___ not ____

Erosion will ___e attrition

 

Erosion + Attrition 27 

Cupping is caused by erosion not attrition Erosion will accelerate attrition

19

 

Abrasion – ___l wear produced by an ___ ___

 

Abrasion – mechanical wear produced by an external source

20

 

Erosion + Abrasion 29 

 

__ __ + __ 

 

Erosion + Abrasion 29 Acidic diet and poor OH

21

 

Diagnosis

In-depth assessment of __ __ and medical/dental ___y 

__ ___

 

Diagnosis

In-depth assessment of risk factors and medical/dental history photographs: Ren 2010 

Clinical evaluation

22

Erosion may lead to 

 

May lead to Dentin Hypersensitivity

23

 

Mechanism of Hypersensitivity

Stimulus: t__ ___ __ ___

___ Dentin; open tubles

Change in __ of dentin __ __

Generation of __ in i___ ___

AP pass to ___ to cause pain

Mechanism of Hypersensitivity

Stimulus: thermal, mechanical, evaporative, chemical

Exposed Dentin; open tubles

Change in rate of dentin fluid flow

Generation of AP in intradental nerves

AP pass to brain to cause pain

24

 

Dentin Hypersensitivity Affects Patients‘ Quality of Life

 

Normal, everyday activities can become troublesome 

• Ingesting___ food, drinks or sweets 

• Scraping of a ___ utensil 

• ___ in air 

• Routine __ __e practices 

Panagakos et al. Am J Dent. 2009

Dentin Hypersensitivity Affects Patients‘ Quality of Life

 

Normal, everyday activities can become troublesome 

• Ingesting cold food, drinks or sweets 

• Scraping of a metal utensil 

• Breathing in air 

• Routine oral hygiene practices 

Panagakos et al. Am J Dent. 2009

25

 

 

Deposits Covering Dentin Tubules 

–Smear Layer; ___ and ___ ebris 

–___

 

 

Deposits Covering Dentin Tubules 

–Smear Layer; organic & inorganic debris 

–Calculus 

26

 

Dentin Hypersensitivity - Treatment Options

 

___ the __ __

___ the ___s:  Depolarizing the nerves with ___ ___

Dentin Hypersensitivity - Treatment Options

 

Occluding the dentin tubules

Desensitizing the nerves: Depolarizing the nerves with Potassium salts

27

 

Treatment options: Nerve Depolarization

 

5% __ ___e (2% potassium ion) 

Compatible with __

•___ and ___ sodium fluoride concentrations 

Measurable sensitivity reduction 

•minimum of ___o weeks 

•___ daily use 

Significant level of pain relief after ~___ weeks 

 

5% Potassium Nitrate (2% potassium ion) 

Compatible with fluoride 

•OTC & Rx sodium fluoride concentrations 

Measurable sensitivity reduction 

•minimum of two weeks 

•twice daily use 

Significant level of pain relief after ~4-8 weeks 

28

 

Occlusion of Tubules

 

8% ___/___ is effective at occluding dentin tubules

 

8% Arginine/CaCO3 is effective at occluding dentin tubules

29

 

Colgate offer ___ tubule occluding therapies

___ and __ __

 

Colgate offers two tubule occluding therapies In-office At home

30

 

Periodontitis affects almost ___% of US Adults

 

Periodontitis affects almost 50% of US Adults