MacEntee MI JADA 2007, Vol 138 Oral Health Model has 4 major themes: comfort, general health, hygiene, diet All affect people ’ s lives both socially and personally.

Geriatric dental care Diagnosis, treatment, prevention of all dental and oral diseases for all older adults Diagnosis, treatment, prevention of all dental and oral diseases for all older adults

What is one of the most significant oral problems found in the elderly? What is one of its most significant contributing risk factors?

Xerostomia Polypharmacy

Why is Oral Health important in the Elderly? Most severe oral health problems are in the oldest and sickest patients Most severe oral health problems are in the oldest and sickest patients Polypharmacy contributes to dry mouth due to decreased salivary flow Polypharmacy contributes to dry mouth due to decreased salivary flow Lowers the oral pH>>> Caries Lowers the oral pH>>> Caries

Institutionalized Elderly At particular risk for poor oral health At particular risk for poor oral health Nursing staff and others rated oral care as important, HOWEVER, other activities were given priority over oral care Nursing staff and others rated oral care as important, HOWEVER, other activities were given priority over oral care Oral care is not considered part of nursing care; omitted from care plans Oral care is not considered part of nursing care; omitted from care plans Frequently unclear as to responsibility Frequently unclear as to responsibility Vargas, Kramarow, Yellowitz, 2001 Wardh et al., 2000

Common Oral Conditions in the Elderly Periodontal disease Periodontal disease (gum disease) (gum disease) Caries Caries (tooth decay) (tooth decay) Xerostomia Xerostomia (dry mouth) (dry mouth)

Summary: Oral health, taste and smell contribute to Oral health, taste and smell contribute to an individual ’ s sense of well-being and quality of life Ritchie CS Clin Ger Med Nov 2002 an individual ’ s sense of well-being and quality of life Ritchie CS Clin Ger Med Nov 2002 Tooth loss, periodontal disease, decreases in saliva production are not normal consequences of aging Tooth loss, periodontal disease, decreases in saliva production are not normal consequences of aging Quality of Life is multifactorial and a personal experience; good oral health enhances QOL Quality of Life is multifactorial and a personal experience; good oral health enhances QOL

Oral Systemic Links are significant Study of older adults, 85+ had PD Study of older adults, 85+ had PD Moderate disease and could be managed by General Dentists with conservative care and good oral hygiene Moderate disease and could be managed by General Dentists with conservative care and good oral hygiene Patients should be routinely assessed for risk of diabetes, HTN, respiratory diseases, osteoporosis. Patients should be routinely assessed for risk of diabetes, HTN, respiratory diseases, osteoporosis. Dentistry and Medicine need to address this together for better care of our patients Dentistry and Medicine need to address this together for better care of our patients

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