Older People Flashcards
1
Q
What are the potential reasons for loss of teeth?
A
- exfoliation
- NCTSL
- endodontic infection
- dental caries
- periodontal disease
- head and neck cancer
- trauma
- congenitally missing
2
Q
What are the risk factors for loss of teeth?
A
- salivary flow
- impairment/disability
- access
- oral hygiene
- sugar
- socioeconomic status
- genetic
- nutritional deficiencies
- smoking/tobacco use
- alcohol
- HPV
- medical status
- lifestyle
- environmental
- socio-cultural
2
Q
What are the risk factors for loss of teeth?
A
- salivary flow
- impairment/disability
- access
- oral hygiene
- sugar
- socioeconomic status
- genetic
- nutritional deficiencies
- smoking/tobacco use
- alcohol
- HPV
- medical status
- lifestyle
- environmental
- socio-cultural
3
Q
What are the potential factors that increase the caries risk in the older population?
A
- frailty
- mental confusion
- housebound/institutionalised
4
Q
What are the challenges to dental care related to the ageing population?
A
- population at increased risk of oral disease
- polypharmacy
- impaired ability to cooperate
- access (moving and handling - wheelchair, hoist, etc.)
- medical conditions complicating/contraindicating dental treatments
5
Q
Why is oral hygiene challenging in the elderly population?
A
- patients likely to be care dependent
- third party care
- poor manual dexterity possible
- may have reduced visual activity
6
Q
What type of caries are often seen in the older population?
A
- root caries
- circumferential around the cervical margins
- crown fracture leaving carious retained roots
- high risk sites include RPD clasp locations
7
Q
What disease processes are seen in the older population?
A
- caries
- periodontal disease
- oral mucosal disease
8
Q
What types of oral mucosal disease may be seen in the elderly population?
A
- denture induced stomatitis
- opportunistic
- ulceration
- angular chelitis
- lichenoid tissue reactions
9
Q
How does lichen planus present in the elderly?
A
- autoimmune condition causing discomfort in the mouth
- difficulty eating
- difficulty performing oral hygiene
- management
- medications
- toothpaste without SLS
- treatment be contraindicated by existing medications
- risk of malignant change
10
Q
What are the additional challenges presented by head and neck cancer in older people?
A
- delayed diagnosis (more advanced disease)
- unable to communicate symptoms
- lack of attention paid
- misdiagnosis
- access challenging
- high risk of recurrence after previous head and neck cancer
- radiation induced xerostomia
- reduced mouth opening
- oral hygiene challenging
11
Q
What is aspiration phneumonia and what is its relevance to the elderly population?
A
- plaque, bacteria, calculus, mucus crusting can be aspirated into the lungs
- bacterial reservoirs
- most commonly staphylococcus aureus
- can be fatal
- most common cause of death for patients with dysphagia associated with neurological impairment
- dried secretions
- NG tube or PEG fed
- mouth secretions
- carers think brushing is not required as not eating through mouth
- preventable with good oral hygiene
11
Q
What is aspiration phneumonia and what is its relevance to the elderly population?
A
- plaque, bacteria, calculus, mucus crusting can be aspirated into the lungs
- bacterial reservoirs
- most commonly staphylococcus aureus
- can be fatal
- most common cause of death for patients with dysphagia associated with neurological impairment
- dried secretions
- NG tube or PEG fed
- mouth secretions
- carers think brushing is not required as not eating through mouth
- preventable with good oral hygiene
12
Q
What does quality of life mean for older people?
A
- having good social relationships
- maintaining social activities and retaining a role in society
- having a positive psychological outlook
- having good health and mobility
- to enjoy life and retain independence and control over life
13
Q
What is the importance of teeth for older people?
A
- positively influenced by natural teeth
- easier to eat and maintain good nutrition levels
- preservation of teeth contributes to positive body image and self worth
- more comfortable socialising
14
Q
What does early stage dementia treatment planning involve?
A
- oral assessment
- multi-disciplinary care
- planning for future
- dementia will progress
- assessment
- identify and attempt to retain key teeth
- focus on high quality restorations
- complex restorative treatments can be difficult to care for
- establish a preventative regime
- high fluoride toothpaste
- regular cleaning
15
Q
How can provision for loss or breakage of dentures for dementia patients be made?
A
- consider replica dentures
- take impressions/scans
- make new dentures if lost or broken
- removes challenge of having to take impression from older person
16
Q
What teeth are considered key teeth?
A
- occluding pairs of teeth
- essential for mastication
- number of teeth
- SDA
- anterior teeth
- aesthetics
- confidence
17
Q
What are the considerations for a full clearance in an elderly patient?
A
- natural teeth have a significant impact on quality of life
- chewing and eating
- nutrition
- independence/pride and achievement
- social aspects of life
18
Q
What does mid-stage dementia treatment planning involve?
A
- aims to have clean and healthy teeth
- maintenance and prevention essential
- limited ability to provide care and intervention
- reduced cooperation
- medical status
- polypharmacy
- access challenging
- attending appointments
- costs associated
19
Q
What is atraumatic restorative technique?
A
- removal of soft infected carious tissue leaving a layer of stained affected dentine over the pulp, sealed and restored with glass ionomer
- maintains tooth and keeps cleanable
- seals off bacteria
- can be performed with limited cooperation
- spoon excavator and glass ionomer
20
Q
What are the risk factors for restoration failure after atraumatic restorative technique
A
- low number of tooth brushings per day
- absence of prosthesis (increased force applied to teeth)
- posterior teeth
- higher baseline plaque index
21
Q
What does late stage dementia treatment planning involve?
A
- focus placed on comfort
- moist, clean and health mouth
- pain free
- free from infection
- non-invasive
- access is difficult
- emergency management
- limited options
22
Q
How can oral bio-film based diseases be controlled?
A
- control of
- oral hygiene and removal of biofilm
- sugar
- level and quality of care
- teeth
- fluoride
- operative intervention
23
Q
How can communication be altered to suit a patient with dementia?
A
- approaching from the front
- break down tasks into steps
- short words
- simple sentences
- non-verbal
- smile
- gentle touch
- right environment
- quiet
- avoid sensory overload
- techniques
- distraction
- bridging (brief answer then new topic if potential to upset)
- hand over hand (hold hand to guide person)
- chaining (start task and they finish or vice versa)
24
Q
What is Caring for Smiles?
A
- national programme to promote good oral health for residents in care homes
- trains carers
- values dependent people and those involved in their care
- adults moving into care homes have their mouth assessed on admission
- mouth care needs recorded in personal care plan
- supported to clean teeth twice daily or daily denture care
25
Q
What type of tasks do elderly people potentially struggle with?
A
- mobility
- dexterity
- communication
26
Q
What is dementia?
A
- acquired progressive loss of cognitive functions, intellectual and social abilities severe enough to interfere with daily function
- chronic or progressive nature
- deterioration in cognitive function
- beyond that expected of normal ageing
27
Q
What does dementia affect?
A
- memory
- particularly day to day
- difficulty recalling recent events
- thinking
- process of thoughts altered
- orientation
- visuospatial skils (distance, 3D vision)
- losing track of day or date
- confused about location
- comprehension
- calculation
- learning capacity
- inhibited
- language
- difficulty following conversation
- difficulty finding correct word
- judgement
- organisation
- concentrating, planning and organising challenging
- difficulties making decisions and problem solving
- challenging to carry out sequences of tasks
28
Q
What is dementia characterised by?
A
- amnesia
- inability to concentrate
- disorientation in time, place or person
- intellectual impairment
29
Q
What accompanies the impairment of cognitive function in dementia?
A
- deterioration in:
- emotional control
- social behaviour
- motivation
30
Q
What is Alzheimer’s?
A
- most common form of dementia (60%)
- reduction in size of cortex
- severe in hippocampus
- plaques deposited in spaces between nerve cells
- deposit of protein fragment (beta-amyloid)
- tangles are twisted fibres of tau protein build up inside cells
- distinctive features
- short term memory loss
- aphasia
- communication difficulties
- muddled over everyday activities
- mood swings
- withdrawal
- loss of confidence
31
Q
What factors are associated with the development of Alzheimer’s?
A
- age
- gender
- more female than male
- head injury
- lifestyle
- increased risk
- smoking
- hypertension
- low folate
- high blood cholesterol - decreased risk
- physical, mental and social acitivities
- increased risk
- genetic
- abnormalities on chromosomes 1, 14 or 21
32
Q
What is vascular dementia?
A
- dementia caused by reduced blood flow to the brain
- damages and eventually kills the brain
- can develop as a result of
- small vessel disease
- narrowing and blockage of deep small vessels - single large stroke
- many mini-strokes
- underlying health conditions
- high blood pressure
- diabetes
- smoking
- overweight
- small vessel disease
- distinctive features
- memory problem of sudden onset
- visuospatial difficulties
- anxiety
- delusions
- seizures
33
Q
What is dementia with lewy bodies?
A
- deposits of an abnormal protein called levy bodies inside brain cells
- same deposits as Parkinson’s disease
- areas responsible for memory and muscle movements
- distinctive features
- short term memory less
- cognitive ability fluctuates
- visuospatial difficulties
- attentional difficulties
- overlapping motor disorders (speech and swallowing)
- sleep disorders
- delusions
