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M. Petrina Sweeney

ORAL HEALTH OF OLDER PEOPLE. Friday 23 rd September. M. Petrina Sweeney. WHAT IS ORAL HEALTH?.

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M. Petrina Sweeney

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  1. ORAL HEALTH OF OLDER PEOPLE Friday 23rd September M. Petrina Sweeney

  2. WHAT IS ORAL HEALTH? “It is a standard of health of the oral and related tissues which enables an individual to eat, speak and socialise without active disease, discomfort and embarrassment and which contributes to general well being” Oral Health Strategy Group, UK Department of Health 1994

  3. ORAL HEALTH AND QUALITY OF LIFE AMONG THE ELDERLY Communication Facial appearance Drinking Eating

  4. THE ORAL MICROFLORA • 108 microorganisms per millilitre of saliva • 350 cultivable bacterial species

  5. MAINTENANCE OF ORAL HYGIENE IS ESSENTIAL FOR MAINTAINING ORAL HEALTH AND QUALITY OF LIFE

  6. ORAL ASSESSMENT • Oral problems common in care home • patients • A thorough oral assessment is the • vital first step in planning effective • care • Encourage patients to report any oral • discomfort • Use of assessment tools

  7. MAINTENANCE OF ORAL HYGIENE • Should not be difficult or time • consuming • Encourage patients to be independent • if possible • Regular assessment • Frequency of care • Multidisciplinary approach

  8. ACTUAL AND PROJECTED % OF EDENTATE ADULTS IN SCOTLAND BY AGE GROUP (1978-2028) An Analysis of the Dental Workforce in Scotland – A Strategic Review 2010 : Scottish Government

  9. DENTAL CARIES IN THE ELDERLY “…the incidence of caries in a population aged 65 and older is greater than in a population of 14-year olds living in a non-fluoridated area.” Ettinger RL Dental Clinics of North America 1997: 41: 633-49

  10. DENTAL CARIES IN THE ELDERLY Reduced manual dexterity: poor oral hygiene Dry mouth: often drug-induced Sweet diet

  11. TOOTHBRUSHING

  12. PERIODONTAL DISEASES A group of diseases affecting the marginal periodontium, representing an inflammatory and immune reaction to the presence of microbial plaque.

  13. ADVANCED CHRONIC PERIODONTITIS

  14. ORAL HEALTH AND NUTRITIONAL STATUS

  15. THE DENTURE WEARER

  16. DENTURE CARE • High level of denture hygiene essential • Dentures removed and cleaned out of • the mouth • Dentures cleaned daily • Encourage patients to remove their own • dentures if possible

  17. MAINTAIN DENTURE HYGIENE?

  18. ORAL CANDIDOSIS ‘A disease of the diseased’

  19. PSEUDOMEMBRANOUS CANDIDOSIS Non-adherent white plaques

  20. DENTURE STOMATITIS

  21. ANGULAR CHEILITIS Candida spp Staphylococcus aureus

  22. CARE OF DENTURES

  23. VIRAL INFECTIONS

  24. HSV REACTIVATION

  25. HSV REACTIVATION – COMPROMISED HOST Often intra-oral Clinically atypical Painful High index ofsuspicion

  26. STAPHYLOCOCCAL MUCOSITIS

  27. Aspiration risk  pneumonia

  28. ORAL HEALTH AND SYSTEMIC DISEASE • Respiratory tract infections • Septicaemia • Septic arthritis • Endocarditis • Cardiovascular disease

  29. PNEUMONIA IN THE ELDERLY • Fourth overall leading cause of death • Leading infectious cause of death in • the elderly • Most cases of bacterial pneumonia are • caused by micro-aspiration of • colonised oropharyngeal flora Chan ED, Welsh C. Geriatric Respiratory Medicine Chest 1998; 114: 1704-1733

  30. OTHER COMMON PROBLEMS

  31. FIBROEPITHELIAL POLYP

  32. DENTURE-INDUCED HYPERPLASIA

  33. DENTURE-INDUCED HYPERPLASIA

  34. ATROPHIC GLOSSITIS

  35. IRON TABLET BURN  septicaemia

  36. LICHEN PLANUS

  37. ORAL CANCER

  38. EARLY SCC TONGUE

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