Video Geriatric dentistry
Geriatrics
Geriatrics is a branch of medicine that is concerned with the illnesses of old age and their treatment . Geriatrics derives from the Greek word g?ras meaning old age, and iatros meaning doctor. Typically, geriatric medical treatment starts from the age of 65 years old.
Geriatric dentistry is the delivery of dental care to older adults involving diagnosis, prevention, management and treatment of problems associated with age related diseases
Maps Geriatric dentistry
Geriatric health
Dental Health of Geriatric Population
The geriatric population are an ever growing section of the community with rapidly changing dental needs. In 2020 it is predicted that more than 25% of the population in developed countries will be over the age of 65 . Due to improvements in oral health over the past 60 years, a decrease in the rate of edentulism is evident and therefore an increase in the number of natural teeth present is present
In 1979, 60% of Australians over the age of 65 had no natural teeth. In 1989, 44% had no teeth and it is expected by 2019, this figure will drop to 20%. This prediction was exceeded in 2013, with 19% of those over the age of 65 had no natural teeth.
Although there is a decrease in the rate of edentulism, geriatric patients typically have high levels of plaque, calculus and debris, as they are functionally dependent on others or have lost the capacity to complete tasks such as toothbrushing thoroughly. Consequently, this results in an increased caries prevalence . Dental caries is a process in which enamel is dissolved by acids producing bacteria. In 2004-2006, the average DMFT (decayed, missing and filled teeth) for adults in Australia over the age of 65 was found to be 23.7%. An individual's caries risk is influenced by their sugar intake, frequency of eating, oral hygiene levels, saliva flow and function and recession. Gingival recession is a significant finding in older adults because the exposed root surface is more susceptible to root caries and therefore increases the risk for the patient. In 2015, 95.2% of Australians over the age of 75 had at least one site with gingival recession . Additionally, periodontal disease prevalence was also great as 26.0% of the geriatric population was diagnosed with active periodontal disease.
Medical Conditions affecting Oral Health
Oral changes
Dental care in residential aged care facilitates
Elderly people in residential care facilities are considered to have some of the poorest oral health in Australia, and are some of our most vulnerable and disadvantaged population groups.
Elderly people who are functionally dependant and residing in residential care facilities, are particularly vulnerable to oral health issues. Their dependence on staff to assist them with daily oral hygiene care often results in minimal hygiene being provided . Oral health requirements are often overshadowed by more important things such as feeding, toileting and bathing. Other barriers that care staff in residential aged care facilities experience to providing oral care included lack of oral health policies, and ongoing education and training .
Barriers to effective cleaning
As people age and become frail, disabled or functionally dependant, their oral health is put at great risks . This can be due to diminished eyesight, dexterity, dietary requirements and limited access to professional oral health care.
Historically there has been a reluctance with dental professionals to attend residential aged-care facilities . When combined with the difficulty experienced for residents to access dental care themselves, their options have been limited. Therefore, the need for regular onsite professional dental care is urgently required , to address early detection, prevention and treatment of oral health problems.
Conditions such as Dementia and Alzheimers provided exceptionally difficult oral health hurdles for staff to overcome, due to uncooperative behaviour that resulted from confusional states . Elderly that are visually impaired are disadvantaged, as they are unable to detect and recognise early oral disease, and are unable to take action on it unless they are informed of the situation
Dentures and edentulism
Practical suggestions
References
Source of the article : Wikipedia