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Dent Clin North Am [journal]
- Geriatric dentistry. [Editorial]
- Dent Clin North Am 2014 Oct; 58(4):xi-xiii.
- Innovations in dental care delivery for the older adult. [Journal Article]
- Dent Clin North Am 2014 Oct; 58(4):845-55.
Access to and reducing disparities in oral health for older adults is a complex problem that requires innovative strategies. In addition to offering dental services in alternative settings, such as senior centers, places that are familiar to older adults, and where physical limitations can be better accommodated, alternatives to the traditional provider should be considered. Many states are changing laws and practice acts to allow dental hygienists to provide preventive services without the supervision of a dentist. Also, collaborations between dental and non-dental professionals can be a successful strategy for increasing access to oral health care for this high-risk population.
- Integrating Oral Health into the Interdisciplinary Health Sciences Curriculum. [REVIEW]
- Dent Clin North Am 2014 Oct; 58(4):829-843.
Oral health inequities for older adults warrant new models of interprofessional education and collaborative practice. The Innovations in Interprofessional Oral Health: Technology, Instruction, Practice and Service curricular model at Bouvé College of Health Sciences aims to transform health professions education and primary care practice to meet global and local oral health challenges. Innovations in simulation and experiential learning help to advance interprofessional education and integrate oral health care as an essential component of comprehensive primary health care. The Program of All-Inclusive Care for the Elderly clinic is an exemplary model of patient-centeredness and interprofessional collaborative practice for addressing unmet oral health needs of its patient population.
- Cognitive impairment in older adults and oral health considerations: treatment and management. [Journal Article]
- Dent Clin North Am 2014 Oct; 58(4):815-28.
Worldwide incidences of degenerative cognitive diseases are increasing as the population ages. This decline in mental function frequently causes behavioral changes that directly affect oral health. The loss of interest and ability to complete the simple tasks of brushing and flossing can cause a rapid development of hard and soft tissue diseases that result in decreased function and increased dental pain. The challenge for the dental community is to understand and to identify the early signs of cognitive dysfunction so as to develop a rational treatment strategy that allows patients to comfortably maintain their teeth for as long as possible.
- Systemic Diseases and Oral Health. [REVIEW]
- Dent Clin North Am 2014 Oct; 58(4):797-814.
The US population is at the beginning of a significant demographic shift; the American geriatric population is burgeoning, and average longevity is projected to increase in the coming years. Elder adults are affected by numerous chronic conditions, such as diabetes, hypertension, osteoarthritis, osteoporosis, cardiovascular diseases, and cerebrovascular diseases. These older adults need special dental care and an improved understanding of the complex interactions of oral disease and systemic chronic diseases that can complicate their treatment. Oral diseases have strong associations with systemic diseases, and poor oral health can worsen the impact of systemic diseases.
- Oral implications of polypharmacy in the elderly. [Journal Article, Research Support, Non-U.S. Gov't]
- Dent Clin North Am 2014 Oct; 58(4):783-96.
One of the major side effects of medications prescribed to elderly patients is the qualitative and quantitative alteration of saliva (salivary hypofunction). Saliva plays a pivotal role in the homeostasis of the oral cavity because of its protective and functional properties, including facilitating speech, swallowing, enhancing taste, buffering and neutralizing intrinsic and extrinsic acid, remineralizing teeth, maintaining the oral mucosal health, preventing overgrowth of noxious microorganisms, and xerostomia. With salivary hypofunction, a plethora of complications arise, resulting in decreased quality of life. The anticholinergic effects of medications can be overcome, and the oral cavity can be restored to normalcy.
- Oral Health Disparities in Older Adults: Oral Bacteria, Inflammation, and Aspiration Pneumonia. [REVIEW]
- Dent Clin North Am 2014 Oct; 58(4):771-782.
Poor oral hygiene has been suggested to be a risk factor for aspiration pneumonia in the institutionalized and disabled elderly. Control of oral biofilm formation in these populations reduces the numbers of potential respiratory pathogens in the oral secretions, which in turn reduces the risk for pneumonia. Together with other preventive measures, improved oral hygiene helps to control lower respiratory infections in frail elderly hospital and nursing home patients.
- Oral Health Disparity in Older Adults: Dental Decay and Tooth Loss. [REVIEW]
- Dent Clin North Am 2014 Oct; 58(4):757-770.
Progress has been made in reducing dental caries and edentulism in older adults, but disparities continue to exist related to race, ethnicity, socioeconomic level, and sex. Lack of training in treating medically complex patients, economic factors including absence of coverage for oral health services in Medicare and as a required service for adults in Medicaid, and attitudinal issues on the part of patients, caregivers, and providers contribute to barriers to care for older adults. In addition to the impact of oral health on overall health, oral health impacts quality of life and social and employment opportunities.
- Treatment Planning Considerations in Older Adults. [REVIEW]
- Dent Clin North Am 2014 Oct; 58(4):739-755.
The older patient often presents with clinically challenging dental problems combined with complex medical, social, psychological, and financial barriers to oral health. Through careful consideration, the clinician can design a thoughtfully sequenced treatment plan that addresses dental conditions and facilitates improved oral health. Several models serve to guide the clinician with this endeavor. Treatment planning for a medically complex patient with xerostomia and dementia involves a great deal of uncertainty, which may be attenuated by flexibility and good communication with the patient and all involved parties.
- Physiology of Aging of Older Adults: Systemic and Oral Health Considerations. [REVIEW]
- Dent Clin North Am 2014 Oct; 58(4):729-738.
This article reviews the concepts of physiologic reserve, the principles of the normative aging process as exemplified by the cardiovascular, neurologic, and musculoskeletal systems. How these principles apply to oral health, and age-related changes in the oral cavity itself, is reviewed and suggests how they may affect disease management by oral health care providers. It does not focus on diseases related to aging, but rather aims to explore the normal physiologic changes associated with aging dentition and systemic changes related to age, thus enabling clinicians to obtain a better understanding of the presentation of older adults and how it may change their approach to diagnosis and treatment.