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3 Special Care Dentistry > Older Person Symposium > Flashcards

Older Person Symposium Flashcards

1
Q

What are the challenges of treating the older population?

A

Increasing number of people with long term conditions
Increasing age with concurrent increase in co-morbidities
Polypharmacy
Dementia
Impaired ability to cooperate

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2
Q

What are the effects of Lichen Planus?

A

Discomfort in eating
Difficulty in performing OH
Risk of malignancy
Systemic disease and polypharmacy may contraindicate therapies

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3
Q

What is aspiration pneumonia?

A

Food, liquid or teeth are breathed into the airway or lungs, causing pneumonia
Most common cause of death in patients with dysphagia associated with neurological impairment

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4
Q

Describe tx planning in the early stages of dementia?

A

Planning for future
Identify and attempt to retain key teeth
Focus on high quality restorations
Are complex restorative tx able to be cared for in the long term?
Establish a preventative regime

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5
Q

Give examples of key teeth?

A

Occluding pairs of teeth
Anterior teeth

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6
Q

Describe tx planning during the mid-stage of dementia?

A

Maintenance and prevention
Consider medical status and its implications on care
Access becomes more challenging

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7
Q

What is ART?

A

Atraumatic Restorative Technique

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8
Q

Describe tx planning during late stage dementia?

A

Focus on comfort
Moist, clean and healthy mouth free of pain and infection
Non-invasive
Emergency management - limited options

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9
Q

What do we need to control, to control oral biofilm based disease?

A

OH and removal of biofilm
Sugar
Level and quality of care
Teeth
Fluoride
Operation intervention when required

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10
Q

What are techniques for communicating with older people?

A

Approach from the front
Break it down into steps - short words, simple sentences
Non-verbal - smile, gentle touch
Get the environment right - quiet
Distraction

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11
Q

What is dementia?

A

An acquired progressive loss of cognitive function, intellectual and social abilities
May see amnesia, inability to concentrate, disorientation and intellectual impairment

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12
Q

What does dementia affect?

A

Memory
Thinking
Orientation
Judgement
Learning capacity

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13
Q

What are the different types of dementia?

A

Alzheimer’s
Vascular dementia
Dementia with Lewy Bodies
Frontotemporal

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14
Q

Give examples of rarer forms of dementia?

A

Parkinson’s disease
Multiple sclerosis

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15
Q

What are the risk factors of dementia?

A

Age
Gender - woman more likely
Genetic background
Medical history
Lifestyle

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16
Q

What are the early stage symptoms of dementia?

A

Loss of STM
Confusion
Poor judgement
Anxiety
Communication problems

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17
Q

What are the middle stage symptoms of dementia?

A

More support required
Aggression and anger
Increasingly forgetful
May behave inappropriately
May experience hallucinations

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18
Q

What are the late stage symptoms of dementia?

A

Inability to recognise familiar objects, surroundings and people
Increasing physical frailty
Difficulty eating and swallowing
Incontinence
Gradual loss of speech

19
Q

What is the treatment for dementia?

A

No pharmacological, surgical or behavioural care
Counselling can delay residential care by up to a year
Aspirin and reducing cardiac risks
NSAIDs may slow progression

20
Q

What can make a healthcare environment dementia friendly?

A

Reception desk visible from the entrance
Avoid non-essential signs
Signage should be eye level with simple, clear use of text and colour
Good levels of natural light to minimise artificial light

21
Q

What conditions do we need to manage in older patients?

A

Dry mouth
Ulceration
Infection and pain

22
Q

What is a haemangioma?

A

Malformation of blood vessels creating a pool of blood under the mucosa

23
Q

What is a fibroepithelial polyp?

A

Caused by trauma
Tissue doesn’t heal properly so more tissue is produced in response

24
Q

What is black hairy tongue?

A

Variation of normal anatomy
Overgrowth of normal surface of tongue

25
Q

What is geographical tongue?

A

Affects 10% of population
Variation of normal anatomy
Areas of atrophy in tongue look like a map and can change size, shape and position

26
Q

What is atrophic glossitis?

A

Smooth tongue most commonly caused by low haematinics

27
Q

What is frictional keratosis?

A

White patch caused by trauma - similar to guitar playing causing callouses

28
Q

What is speckled leukoplakia?

A

White patch with underlying candidosis
More common in smokers, especially pipe smokers
Potential to turn malignant so must monitor

29
Q

What is sublingual keratosis?

A

Homogenous white patch on ventral surface of tongue
High risk

30
Q

What is traumatic keratosis?

A

Ill fitting dentures cause white patch with tram line running through it

31
Q

What is denture-induced hyperplasia and how is it managed?

A

Excess of mucosa due to rubbing of denture - more common in lower
Managed by surgery or dramatic trimming of denture

32
Q

What is denture stomatitis?

A

Candida infection causing erythema of fitting surface
From poor oral and denture hygiene

33
Q

What is angular cheilitis?

A

Bacterial/fungal infection of corners of mouth found in denture wearers
Reduced OVD can cause creasing of skin

34
Q

What are the main causes of xerostomia?

A

Polypharmacy
Radiotherapy of head and neck
Sjogren’s

35
Q

How is xerostomia managed?

A

Change medication
Salivary replacement - saliva orthana
Salivary stimulants - sugar free chewing gum

36
Q

Which drugs cause Lichen Planus and Lichenoid Tissue Reactions?

A

NSAIDs
B-Blockers
Diuretics
Oral hypoglycaemics
Statins
Antimalarials
Sulphonamides

37
Q

Give examples of uses of bisphosphonates?

A

Osteoporosis
Paget’s disease
Multiple myeloma
Breast/prostate cancer

38
Q

What are the risk factors for MRONJ?

A

Age
Concurrent use of corticosteroids
Malignancy
Systemic conditions affecting bone turnover
Chemotherapy, radiotherapy
Previous diagnosis of MRONJ
Periodontal disease
Poor oral hygiene
Alcohol or tobacco use

39
Q

What is the Herpes Zoster Virus?

A

Causes shingles
Can affect any branch of the trigeminal nerve

40
Q

What is post herpetic neuralgia?

A

Patient had previous episode of shingles
Constant burning sensation in dermatomal distribution
Resolves within 2 months in 50%

41
Q

What is the treatment for post herpetic neuralgia?

A

Antidepressants
Gabapentin
Carbamaezpine

42
Q

What is trigeminal neuralgia?

A

10/10 electric shock pain
Affects V2 and V3 branches
Patients have risk of suicide

43
Q

How is trigeminal neuralgia managed?

A

Carbamazepine
Gabapentin
Oxycarbazepine

44
Q

What are common causes of burning mouth syndrome?

A

No identified cause in 50% of patients
ACE inhibitors
Dry mouth
Candidosis
Haematinic deficiencies
Diabetes

3 Special Care Dentistry (7 decks)

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