Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly

Oral Health

Periodontal inflammation begins with the action of periodontopathogenic bacteria on the gingival sulcus, clinically developing from a simple reversible gingivitis to alveolar bone destruction, with consequent tooth mobility and loss or extraction.(3)

 

Impact of oral health on mastication and nutrition

Poor oral health status is one of the leading causes of malnutrition due to its effect on mastication and swallowing.(4)

Malnutrition risk is influenced by multiple factors besides dental status (5), including

  • general state of health

  • degree of dependence

  • socioeconomic status

  • diet

Deficient mastication is related to (6)

  • tooth loss

  • lack of saliva

  • decreased mastication force

  • malocclusion problems

                                               

Relationship between oral health and systemic disease

Local periodontal infection may be an independent risk factor for certain diseases, including

  • diabetes (7)

  • cardiovascular disease (8)

  • dementia (9)

  • pulmonary infections

  • some types of cancer

  • kidney disease

  • erectile dysfunction

The most widely proposed mechanisms are. (10)

  • inflammatory mechanisms

    • inflammation derived from the host immune response against periodontal pathogens originates molecules that gain access to the circulatory system, producing systemic inflammation with vascular and other repercussions

  • bacterial mechanisms

    • bacteria or bacterial products directly invade the tissues of the organism

  • vascular mechanisms

    • activated by the presence in the systemic circulation of periodontal pathogens, causing platelet aggregation and atheroma/small thrombus formation

 

 

Dental caries

Incidence (11) :

  • affects approximately 20% of the elderly

Facilitated by :

  • age-related salivary changes

  • a poor diet

  • exposure of the root surface by gingival recession

  • greater likelihood of drug treatment with xerostomia (dry mouth) as a side effect

Management :

  • remove the least possible amount of decayed tooth

  • focus on remineralizing the affected tooth with fluoride

 

Periodontal disease

Chronic infectious disease that affects tooth support tissues, including gingiva and alveolar bone

  • low

Facilitated by :

  • accumulation of bacterial plaque with consequent gingivitis and mild or moderate alveolar bone loss (12)

.

Edentulism

Incidence :

  • Variations in the degree of edentulism among countries (13) are attributable to

    • differences in the utilization of dental services

    • provision of public financial support

    • implementation of oral health policies

Facilitated by :

  • mastication and nutritional problems

Management :

The care, hygiene, and routine dental control of prostheses (14)

  • aimed at avoidance of stomatitis and traumatic ulcer

    • exacerbated by poor nutrition and unhealthy lifestyles

      • poor oral hygiene

      • excessive alcohol consumption

      • tobacco use.

 

Dry mouth in the elderly

Incidence :

  • high (15)

Facilitated by :

  • polymedication (especially with antihypertensives, antidepressants, and antipsychotics) (16)

  • poor general health

  • female sex

  • older age (17)

Management :

  • treatment success rates are low (18)

  • products specifically indicated for dry mouth, such as artificial saliva (19)

    • saliva-stimulating drugs (pilocarpine)

    • rectification of the underlying cause of xerostomia (drugs, diabetes, etc)

  • avoidance of (19)

    • dry hot environments

    • dry foods

    • drugs

    • alcohol

    • smoking

  • regular moistening of the mouth with (20)

    • small sips of water

    • lip balm

    • olive oil

 

Oral cancer

It includes lip, oral cavity, and pharyngeal cancer

Incidence (21):

  • eighth most common cancer worldwide

  • variations among countries are attributable to

    • differences in risk profiles

    • availability of and accessibility to health services

Facilitated by :

  • gender

  • higher in men than in women.

  • age

  • over 65-year-olds

Management :

  • surgery

  • radiotherapy

  • chemotherapy

This Read More page is an extension of

Oral Health

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