Treating the geriatric dental patient

Dental providers must be prepared to treat this population, requiring a thorough knowledge of geriatric issues, which are not just physical but social and psychological as well. Quality of life can be significantly affected by poor oral health.

Many seniors are affected by one or more chronic diseases/conditions, which have various oral manifestations; and if the disease itself does not produce an oral manifestation, oftentimes the medication used to treat the disease will. Most dental providers are aware that one of the most common chronic diseases of the elderly, diabetes, results in increased periodontal disease and delayed wound healing. Some may not be aware that enlarged salivary glands/xerostomia and oral candidiasis can also be oral manifestations. Xerostomia and candidiasis, however, are oral manifestations of immune system disorders as well as alcoholism, both experienced by many seniors, necessitating an even more extensive medical history taking and consultation process for these patients.

Dental providers must also stay abreast of the many medications prescribed for senior adults treated in their practices, as they typically take several medications to control chronic conditions. The most common oral side effect of medications is xerostomia, which can lead to increased dental caries and periodontal issues. The role of the hygienist in assisting the patient with plaque control is of utmost importance and can be quite challenging as many seniors experience decreased mobility and hand-eye coordination. They will need assistance in choosing products for maintaining optimum oral health, requiring different oral hygiene instruction than discussed with younger, more dexterous patients. An interproximal brush may be much more useful than dental floss, or a power toothbrush more effective than manual. Products for alleviating xerostomia may need to be prescribed such as xylitol or pilocarpine, and fluoride varnish may need to be applied to exposed root surfaces.

Oral cancer screenings are important for all patients, but even more so for the geriatric patient. Examination of the tissues underneath dental prostheses is critical for oral cancer prevention/detection. A thorough knowledge of pathologies affecting denture wearers is important for dental providers as they formulate a differential diagnosis from the identification of an oral lesion. Denture-induced fibrous hyperplasia, inflammatory papillary hyperplasia,

As America experiences this dramatic increase in the older adult population, it would behoove the dental community to learn as much as possible about this complex population. The oral-systemic link has been well documented and will be even more important as we deliver comprehensive oral care to a large population of senior adults in the 21st century.

Original Source: Surgical