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4 - special care > gerodontology > Flashcards

gerodontology Flashcards

1
Q

What can be used for caries management in older people?

A

ART
Atraumatic restorative technique

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2
Q

Name 4 things affected by dry mouth

A

Speech
Nutritional function and intake
Impairs social interaction
Protective features of saliva are lost

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3
Q

Name 6 common medical concerns in older people

A

Any from:
- frailty
- polypharmacy
- incontinence
- falls
- bone health
- nutrition and weight loss
- dementia
- Parkinson’s
- diabetes
- stroke

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4
Q

What is the incidence of falls in older people?

A

1 in 3 >65 year olds fall every year
1 in 2 >80 year olds fall every year

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5
Q

What are the 2 different causes of falls?

A

Intrinsic eg - postural hypotension
Extrinsic eg - trip hazards

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6
Q

Name 4 dental implications of falls?

A

Dental trauma
Sitting patients up slowly after treatment
Manual handling
May need domiciliary visits from fears of falling

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7
Q

What is the incidence of osteoporosis in older people?

A

25% chance at 80 years old

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8
Q

Why is bone more common in older women?

A

Oestrogen withdrawal during menopause impacts bone density

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9
Q

Name 4 medication types that affect the immune system

A

Oral corticosteroids - treats inflammatory conditions
Disease modifying meds for autoimmune conditions eg mycophenolate for SLE
Chemotherapy agents for cancer treatment
Immunomodulatory treatment for cancer eg biologics

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10
Q

What are the different HbA1c levels to carry out tx?

A

If 9% only emergency tx can be carried out
If >12%, no tx can be carried out
Should be <7%

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11
Q

Name 5 risks of uncontrolled diabetes

A

Hyperglycaemia
Hypoglycaemia
Poor wound healing
Increased risk of periodontal disease
Increased risk of infection

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12
Q

What are the signs and symptoms of stroke?

A

Facial weakness
Arm weakness
Slurred speech
Gait disturbance
Urinary incontenance
FAST - face, arms, speech, time

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13
Q

Name 4 dental implications of strokes?

A

Any from:
- access and mobility is difficult
- confusion and memory loss can influence capacity
- dysphagia common
- root caries due to drug induced xerostomia
- denture wearing issues due to loss of muscle control or loss of sensation on one side of the mouth

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14
Q

Name 4 risk factors of stoke?

A

Hypertension
Diabetes
Ischaemic heart disease
Obesity

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15
Q

What dental advice should be given to pts with dysphagia?

A

Brush teeth upright with suction or an aspirating toothbrush
Use low foaming toothpaste
Remove excess water on toothbrush
Rub toothpaste into toothbrush before placing in mouth

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16
Q

What is Parkinson’s disease?

A

A chronic, progressive neurological disorder characterised by the loss of dopamine producing cells in the brain

17
Q

Give 4 non motor Parkinson’s signs and symptoms

A

Any from:
- emotional changes
- dysphagia
- urinary problems
- sleep disturbance
- loss of blink reflex

18
Q

Give 4 motor signs and symptoms of Parkinson’s

A

Dyskinesia - tremor
Bradykinesia - slow movement
Akinesia - stiffening
Resting tremor

19
Q

Name 4 dental implications of Parkinson’s

A

Any from:
- access can be challenging
- xerostomia and root caries
- anxiety increases tremor
- dysphagia
- denture success is related to neuromuscular control
- avoid mouthwash due to aspiration risk
- often rely on others for oral hygiene
- can’t recline more than 45º for airway protection

20
Q

What is dementia?

A

An acquired progressive loss of cognitive functions, intellectual and social abilities characterised by amnesia, inability to concentrate and disorientation

21
Q

What are the different types of dementia?

A

Alzheimer’s
Vascular
Lewy body
Frontotemporal
Other
Mixed

22
Q

Describe Alzheimer’s

A

60% of dementia cases
Involves parts of the brain that control thought, memory and language
Deposits of beta-amyloid protein fragments build up in spaces between nerve cells
Twisted tau protein fibres build up inside cells creating tangles
Associated with Down’s syndrome

23
Q

Describe vascular dementia

A

15% of dementia cases
Disturbances in blood supply to brain cause ischaemic and neuronal death
Risk factors include smoking, diabetes and atrial fibrillation

24
Q

Describe Lewy body dementia

A

10% of cases
Shrinking of frontal and temporal lobes
Symptoms can either be changes in behaviour or problems with language

25
Q

Describe frontotemporal dementia

A

Caused by TDP 43 and tau protein
Can be a behavioural variant, semantic (language and logic) variant or non-fluent variant

26
Q

List 4 ways you can create a dementia friendly environment

A

Reception visible from entrance
Colour and tone of walls distinctive from flooring
Avoid non-essential signs
Any signage at eye level with simple clear text

27
Q

How should you tx plan when a patient has dementia?

A
  1. Comprehensive full routine care with aesthetics and prosthodontics
  2. Prevention
  3. Emergency care only - prevention if possible
  4. No treatment due to cooperation or poor general health

Find key teeth to retain quality of life

28
Q

List 4 dental implications of dementia

A

Prevention
Halitosis
Xerostomia
Root caries

29
Q

What is domiciliary care?

A

A service that reaches out to care for those who cannot reach a service themselves
Includes residential units and nursing homes
Should be offered as a routine option and not last resort

30
Q

Give 5 examples of patients who should be seen via domiciliary visits

A

Pt confined to bed
Pt on oxygen therapy
Pt in hospital
Pt with agoraphobia
End of life care

31
Q

Name 4 items essential for domiciliary visits

A

Any from:
- portable suction
- oral airways and bag-valve mask
- portable oxygen cylinder
- emergency drugs
- mobile phone
- sharp box

32
Q

How can a GDP get an AWI (adults with incapacity)?

A

Further training and complete an assessment and paperwork - Section 47

33
Q

Name 4 common dental issues found in older patients

A

Any from:
- poor denture hygiene
- admitted with poor oral health
- xerostomia
- fungal infections
- viral infections
- ulceration

4 - special care (7 decks)

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