Geriatricdentistry 211201192628

Geriatric
Dentistry
Supervised by: Dr. Ali H. Fahad
Presented by:
Ahmed Faeq / Zahraa Saddam
Mujtaba Ali / A’laa Haidar
Yousif Alaa
2 Contents
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
• References
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
• Geriatric population / classification 4
• The population of people aged 60 and over is
growing faster than any other younger age group.
• According to Ettinger and Beck ( 1984 ) :
• Classified population into three functional

categories to reflect their ability to seek
dental services:
Ettinger-Beck classification
5
Functionally independent Frail
Frail Functionally dependent
Can access without help. No longer access without

help of others. unable to move and fully
May present some
They require a greater dependent on continuous
understanding of medicine assistance.
and pharmacology.
Age-related changes
Physiological
Psychological Thinner and wrinkled skin
Depression, anxiety, Diminution of senses
schizophrenia or
dementia
Organs / Systems
Decrease in efficiency
Chronic diseases
Hypertension, DM, heart Bones /Joints

diseases, or cancer
Bones tend to become less
dense, Arthritis .
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.
TMJ:
• Partial or complete disc
displacement.
• Disc degeneration
8
9
Salivary glands:
• Salivary flow ↓/dryness of mouth.
• An Iraqi study, consisted of 83 patients

found that Hyposalivation was the
main oral symptom with rate 72% .
• Xerostomia
Oral mucosa:
Loss of sensitivity.
48% of the
 (In the same last study)
total elderly people have oral

mucosal lesions (O.M.Ls).
at i t i s
•Cancer ur e S t om
Dent
10
Tooth’s structure changes
•The Enamel:
• Attrition / dental erosion.
• Discolouration
• Permeability ↓
•The Dentine:
• continues to be produced
• (secondary dentine)
• Permeability ↓.
11
•The Pulp: 12
•Decreased sensitivity to
stimuli, and reduced blood
supply.
•The Cementum:
Hypercementosis Cementicles
13
Geriatric Dentistry as
Specialty
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.
14
• Brazil was the first country in the
15
world to recognise and establish the
specialty of Geriatric Dentistry in
2001.
• It also has been recognised by the

Dental Board of Australia as
“Special needs dentistry”.
Objectives of Geriatric
Dentistry
• Recognize & relieve oral health issues
• Restoration & preservation of

function
• Maintain ideal health & function of masticatory

17 system
• Geriatric Dentist / Required Competencies
• Biology, physiology, psychology & sociology of aging

Knowledge • Pharmacology drug interactions
• • General medicine / systemic diseases
Skills • Ability to communicate.

• Management and treatment planning.
Attitude • Empathy , understanding , caring, respect &

flexibility in treatment planning
18
• THE ROLE OF DENTAL 19
CARE PROVIDERS:
✓ Responsibility.
✓ Using Proper chairs with arms

for support.
✓ Providing adequate lighting.
✓ Portable dental equipment.
✓ Wheelchair accessible clinic.

• DOMICILIARY OR HOME CARE 20
 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).
Treatment Considerations and Management of Elderly 21
Patients
Capability
Systemic
C
Autonomy
factors
S A
Oral O R Reality
factors
OSCAR
approach to treatment planning
for older adults ,
which stands for.
Polypharmacy 22
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).
• Periodontal disease • Candidiasis infection . • Root caries.

CARE OF SOFT TISSUES: 23
- 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
• One of the problems facing dentist is • Geriatric patients reinforcement is
communication specially with geriatric important, this can be done by:
patients, to avoid that:
• Home care
• Look at patient when talking. • Tooth brush instructions
• Talk slowly and carefully. • Flossing
• Body language is important. • Well balanced diet
• Use a sense of humor.
24
Thanks
for listening
Do you have any
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questions?
References
• Holm-Pedersen P, Walls AW, Ship JA. Textbook of geriatric dentistry: John Wiley & Sons; 2015.
•Textbook of geriatric medicine & gerodontology J.C Brochehurst, Churchil, Livingstone.
•Medical problems in dentistry- Crispian Scully
•Community dental health, Anthony W. Jong.
•Textbook of preventive medicine, B.K. Mahajan
•Hebling E, Mugayar L, Dias Pv. Geriatric Dentistry a new specialty in Brazil.
•Textbook of community dentistry, Sateesh Chandara
•Ettinger RL Beck JD, Geriatric dental curriculum the needs of elderly.
• Marchini L, Ettinger RL, Chen X, et al. A description of gerodontology education in a selection of high middle , and low-
income countries on five continents. Unpublished manuscript.
• Ettinger RL . The development of geriatric dental education programs in Canada: an update.
• Eyison J, Mann J, Holtzman JM, Mersel A. A comparative study of the attitude of dental students towards the elderly.
•Glick M, Exploring our role as health care providers,J Am dent Assoc2005
•Yellowitz,J, A 2006 Geriatric health and functional issues.The ADA practice guide to patients with medical conditions.
• "Dental Board of Australia – Registration Standards". www.dentalboard.gov.au. Retrieved 2019-08-19
• "Dental Specialties". www.ada.org. Retrieved 2019-08-19.
•Papas, A. S., Niessen, L. C., & Chauncey, H. H. (1991). Geriatric dentistry: aging and oral health.
•Fiske J, Lewis D . Domiciliary dental care. In Nunn J (ed) Disability and oral care. 1st ed. pp 143–158. International Association for
Disability and Oral Health & FDI World Dental Press Ltd, 2000.
•British Dental Journal (Br Dent J)
•The study sample consisted of 83 patients of both genders with age range from (65 – 80) referred to the college of dentistry,
university of Baghdad, from November 2005 to June 2006, The sample consisted of 83 patients and there were 43 (51.8%) males
and 40 (48.1%) females. The mean age of the total sample 71.1 years and the mean age for males was 71.1 and for females 71.5
years. Https://www.iasj.net/iasj/article/1318

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Geriatric

• Many of whom require diagnosis,

• According to Ettinger and Beck ( 1984 ) :

• Classified population into three functional

Can access without help. No longer access without

Hypertension, DM, heart Bones /Joints

• Resorption due teeth loss

• May appears in shape of a

• An Iraqi study, consisted of 83 patients

total elderly people have oral

• It also has been recognised by the

• Restoration & preservation of

• Maintain ideal health & function of masticatory

• Biology, physiology, psychology & sociology of aging

Skills • Ability to communicate.

Attitude • Empathy , understanding , caring, respect &

✓ Using Proper chairs with arms

✓ Providing adequate lighting.

✓ Portable dental equipment.

✓ Wheelchair accessible clinic.

 Access issues, lighting, lack of time,

 Prosthetic procedures & check-up

• Periodontal disease • Candidiasis infection . • Root caries.

1) Stain, plaque, etc are removed

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