geriatricdentistry-2nbhfgvyhgf11201192628.pptx

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1. Geriatric Dentistry

2. Introduction
The Geriatric Patient
The Age-related Changes
Geriatric as Dental Speciality
Objectives of Geriatric Dentistry
Required Competencies
The Role of Dental Care Providers
Domiciliary or Home Care
Consideration and Management of Elderly Patients Contents 2

3. Introduction Geriatric dentistry is the delivery of oral care to older patients Many of whom require diagnosis, management, prevention and treatment of dental problems associated with age-related diseases. 3

4. According to Ettinger and Beck ( 1984 ) : The population of people aged 60 and over is growing faster than any other younger age group. Geriatric population / classification Classified population into three functional categories to reflect their ability to seek dental services : 4

5. Frail Can access without help. May present some No longer access without help of others. They require a greater understanding of medicine and pharmacology. unable to move and fully dependent on continuous assistance. Functionally independent Functionally dependent Ettinger-Beck classification 5

6. Age-related changes Depression, anxiety, schizophrenia or dementia Psychological Hypertension, DM, heart diseases, or cancer Chronic diseases Decrease in efficiency Organs / Systems Thinner and wrinkled skin Diminution of senses Physiological Bones tend to become less dense, Arthritis . Bones / Joints 6

7. Orofacial age-related changes Alveolar bone : Resorption due teeth loss or extraction. May appears in shape of a “Knife edge ” due to resorption. 7

8. Partial or complete disc displacement. Disc degeneration TMJ: 8

9. Salivary flow ↓ /dryness of mouth. An Iraqi study, consisted of 83 patients found that Hyposalivation was the main oral symptom with rate 72% . Xerostomia Salivary glands: 9

10. Oral mucosa: Loss of sensitivity . (In the same last study) 48% of the total elderly people have oral mucosal lesions (O.M.Ls). Cancer Denture Stomatitis 10

11. Tooth’s structure changes The Enamel : Attrition / dental erosion. Discolouration Permeability ↓ The Dentine: continues to be produced (secondary dentine) Permeability ↓ . 11

12. The Pulp: Decreased sensitivity to stimuli, and reduced blood supply. 12

13. 13 The Cementum: Hypercementosis Cementicles

14. What makes the geriatric dentistry important is those age-related problems and medications can make oral health diseases and conditions much more serious and complicated to treat. Geriatric Dentistry as Specialty 14

15. Brazil was the first country in the world to recognise and establish the specialty of Geriatric Dentistry in 2001. It also has been recognised by the D ental Board of Australia as “Special needs dentistry”. 15

16. Objectives of Geriatric Dentistry Recognize & relieve oral health issues Restoration & preservation of function Maintain ideal health & function of masticatory system 17

17. 18 Biology, physiology, psychology & sociology of aging Pharmacology drug interactions • General medicine / systemic diseases Ability to communicate. Management and treatment planning. Empathy , understanding , caring, respect & flexibility in treatment planning Knowledge Skills Attitude Geriatric Dentist / Required Competencies

18. The role of Dental Care Providers: ✓ Responsibility . ✓ Using Proper chairs with arms for support. ✓ Providing adequate lighting . ✓ Portable dental equipment. ✓ Wheelchair accessible clinic. 19

19. Domiciliary or home care The provision of dental care in an environment where a person is resident. Access issues, lighting, lack of time, provision of equipment, & Poor quality of service, are barriers. Prosthetic procedures & check-up ( most common treatment types ). 20

20. Treatment Considerations and Management of Elderly Patients O S C A R approach to treatment planning for older adults , which stands for. O Oral factors Systemic factors Capability Autonomy Reality S C A R 21

21. Polypharmacy Management in Older Patients: Common oral conditions that dentists should be aware of when treating older adults who are taking numerous medications, such as:  Xerostomia (dry mouth). Root caries. Candidiasis infection . Periodontal disease 22

22. CARE OF SOFT TISSUES: - Relief of compression of soft tissue and massage the tissues under denture Ask patients to check for any inflamed or irritated areas. DENTURE CARE: Importance of cleaning dentures are 1) Stain, plaque, etc are removed 2) Breeding ground for microorganisms. 3) Esthetics 4) Offensive mouth odor 23

23. Geriatric patients reinforcement is important, this can be done by: Home care Tooth brush instructions Flossing Well balanced diet One of the problems facing dentist is communication specially with geriatric patients, to avoid that : Look at patient when talking. Talk slowly and carefully . Body language is important . Use a sense of humor . 24