Advertisement

Aging and Oral Function

  • Saul Kamen
  • Leonard B. Kamen
Part of the Contemporary Geriatric Medicine book series (COGM, volume 2)

Abstract

The impact of oral status on the clinical management of geriatric patients by the physician can seriously compromise progress and alter prognosis. Thus, poor masticatory function may thwart efforts to provide nutritional support for the victim of a stroke, while noncompliance with recommendations for antibiotic prophylaxis of the cardiac patient has been identified as the chief etiologic factor in subacute bacterial endocarditis following dental intervention. Because the vast majority of geriatric patients have at least one major chronic disorder, the medical-dental interactions in their care by both physicians and dentists demand scrupulous attention to the effects of aging on oral function. As ever-increasing numbers of elderly are integrated into dental practice, the physician should also expect that he will be called on more frequently for advice on such diverse aspects of care as the drug profile of the patient and possible contraindications for certain dental procedures; the use of sedative agents to minimize stress or manage the patient with depression or dementia; and management of the patient with iatrogenic oral manifestations. This chapter will focus on critical issues of mutual concern to dentists and allied professionals, and it is our hope that upon completion the reader will be able to
  1. 1.

    identify the effects of aging on the hard and soft tissues of the mouth,

     
  2. 2.

    perform a regional evaluation of the mouth and its adnexae,

     
  3. 3.

    appreciate the oral manifestations of systemic disorders in the medically compromised older patient.

     
  4. 4.

    understand the role of the dental professional in a rehabilitation program for the geriatric patient with physical and mental limitations,

     
  5. 5.

    participate appropriately in the consultative process for antibiotic prophylaxis, sedation, and other aspects of dental management of the high-risk older patient,

     
  6. 6.

    implement standards for oral health care of the institutionalized frail elderly in the long-term care facility,

     
  7. 7.

    counsel the geriatric patient on methods of preventing oral disorders such as caries and periodontal disease.

     

Keywords

Oral Health Periodontal Disease Oral Cancer Oral Mucosa Geriatric Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Gift, H. D., 1979, The seventh age of man: Oral health and the elderly, J. Am. Coll. Dent. 46: 204.PubMedGoogle Scholar
  2. 2.
    Baum, B. J. and Bodner, L., 1983, Aging and oral motor function: Evidence for altered function among older persons, J. Dent. Res. 62: 2–16.PubMedCrossRefGoogle Scholar
  3. 3.
    Wayler, A. H., Muench, M. F., Kapur, K. K., and Chauncey, H. H., 1984, Masticatory performance and food acceptability in persons with removable partial dentures, full dentures, and intact dentition, J. Gerontol. 39 (3): 284–289.PubMedGoogle Scholar
  4. 4.
    Weisfuse, D., Catalanotto, F., and Kamen, S., 1981, Sex differences in suprathresh- old taste scaling ability in the geriatric population, J. Dent. Res. 60: 561.Google Scholar
  5. 5.
    Henkin, R. I. and Smith, F. R., 1971, Hyposmia in acute viral hepatitis, Lancet 1: 165.Google Scholar
  6. 6.
    Sonies, B. C., Baum, B. J., and Shanker, T. H., 1984, Tongue motion in elderly adults: Initial in situ observations, J. Gerontol. 39 (3): 279–283.PubMedGoogle Scholar
  7. 7.
    Baum, B. J., 1981, Current research on aging and oral health, Spec. Care Dent. 1: 105–109.CrossRefGoogle Scholar
  8. 8.
    Kamen, S., 1983, Oral care of the geriatric patient, in: Care of the Geriatric Patient 6th ed. ( F. V. Steinberg, ed.), C. V. Mosby Company, St. Louis, pp. 388–405.Google Scholar
  9. 9.
    Massler, M., 1983, Geriatric dentistry: The problem, J. Prosth. Dent. 40(3): 324, 325.Google Scholar
  10. 10.
    Massler, M., 1980, Geriatric dentistry: Root caries in the elderly, J. Prosth. Dent. 44 (2): 148–149.Google Scholar
  11. 11.
    Wei, S. H. Y., 1983, Report of symposium—Root surface caries. Council on Dental Research and Council on Dental Therapeutics, J. Am. Dent. Assoc. 106: 496.Google Scholar
  12. 12.
    Kronfeld, R. 1937, Dental Histology and Comparative Dental Anatomy, Lea & Febiger, Philadelphia.Google Scholar
  13. 13.
    Thomas, B. O. A., 1946, Gerodontology—The study of changes in oral tissues associated with aging, J. Am. Dent. Assoc. 33: 207–213.PubMedGoogle Scholar
  14. 14.
    Grant, D. A. and Bernick, 1969, Age changes as seen in human specimens, J. Dent. Res. ( Abstract 291 ).Google Scholar
  15. 15.
    Bastai, P., 1955, The biologischen grundlagen des alterns, Z. Altenforsch 9: 21, 219.Google Scholar
  16. 16.
    Ries, W., 1961, Aging and the capillary system, Dtsch. Gesundheitives 16: 580–585.Google Scholar
  17. 17.
    Jones, H. B., 1951, Molecular exchange and blood perfusion through tissue regions, Adv. Biol. Med. Physics 2: 5, 3–77.Google Scholar
  18. 18.
    Bernick, S. and Sobin, S. S., 1982, Lymphatic and blood vessels of the aged human gingiva, Gerodontology 1 (2): 65 — 71.CrossRefGoogle Scholar
  19. 19.
    Doyle, J. L., Hollander, W., Goldman, H. N., and Rubin, M. P., 1969, Experimental atherosclerosis in the periodontium, J. Periodont. 40: 350.PubMedGoogle Scholar
  20. 20.
    Grant, D. A. and Bernick, S., 1972, The periodontium of aging humans, J. Periodont. 43: 660–667.PubMedGoogle Scholar
  21. 21.
    Wentz, F. M., Mayer, A., and Orban, B., 1952, Age changes in sex differences in the clinically normal gingiva, J. Periodont. 23: 13.CrossRefGoogle Scholar
  22. 22.
    Douglas, C., Gillings, D., Sollecito, W., and Gammon, 1983, The potential for increase in the periodontal diseases of the aged population, J. Periodont. 54 (12):721– 730.Google Scholar
  23. 23.
    Gray, P. G., 1970, Adult dental in England and Wales in 1968, Br. Dent. J. 129: 156–163.PubMedCrossRefGoogle Scholar
  24. 24.
    Saunders, R. H., Solomon, E. S., and Handelman, S. L., 1982, Relationship of age to tooth loss in a chronic care facility, Spec. Care Dent. 2 (1): 25–30.CrossRefGoogle Scholar
  25. 25.
    Vital and Health Statistics, 1978–79, series 10, no. 138, Public Health Service, U.S. Government Printing Office, Washington, D.C.Google Scholar
  26. 26.
    Gordon, S. R. and Jahnigan, D. W., 1983, Oral assessment of the edentulous elderly patient, J. Am. Geriatr. Soc., pp. 797–801.Google Scholar
  27. 27.
    Halstead, C. L., Blozis, G. G., Drinnan, A. J., and Gier, R. E., 1982, Physical Evaluation of the Dental Patient, C. V. Mosby Company, St. Louis, pp. 92–97.Google Scholar
  28. 28.
    Nyanist, G., 1952, Study of denture sore mouth, Acta Odontol. Scand. 10 (Suppl.): 111–154.Google Scholar
  29. 29.
    Fisher, A. K. and Rashid, P. J., 1952, Inflammatory papillary hyperplasia of the palatal mucosa, Oral Surg. 5 (2): 191–198.PubMedCrossRefGoogle Scholar
  30. 30.
    Shafer, W. G., Hine, M. K., and Levy, B. M., 1974, A Textbook of Oral Pathology, 3rd ed., W. B. Saunders Company, Philadelphia.Google Scholar
  31. 31.
    Kimball, H. D., 1954, Factors to be considered in the control and elimination of chronic tissue soreness beneath denture, J. Prosth. Dent. 4 (3): 298–311.CrossRefGoogle Scholar
  32. 32.
    Miller, E. L., 1975, Denture induced inflammation, J. Dent. Assoc. Africa 30: 89–93.Google Scholar
  33. 33.
    Butz-Jorgenson, E., 1978, Clinical aspects of Candida infections in denture wearers, J. Am. Dent. Assoc. 96 (3): 474–479.Google Scholar
  34. 34.
    Renner, R. P., 1979, The role of C. albicans in denture stomatitis, Oral Surg. 47 (4): 323–328.PubMedCrossRefGoogle Scholar
  35. 35.
    Tucker, K. M. and Heget, H. S., 1976, The incidence of papillary hyperplasia, J. Am. Dent. Assoc. 93 (3): 610–613.PubMedGoogle Scholar
  36. 36.
    Burket, L. W., 1977, Burket’s Oral Medicine—Diagnosis and Treatment, 7th ed. ( M. A. Lynch, ed.), J. B. Lippincott Company, Philadelphia.Google Scholar
  37. 37.
    Ettinger, R. L., Beck, J. D., and Jakobsen, J., 1984, Removable prosthodontic treatment needs, a survey, J. Prosth. Dent. 51: 419–427.CrossRefGoogle Scholar
  38. 38.
    Bloehm, T. J., Razoog, M. E., Chamberlin, B. B., and Lang, B., 1984, Efficacy of toothbrushing as measured by the prosthodontic tissue index, Spec. Care Dent. 4 (2): 70–76.CrossRefGoogle Scholar
  39. 39.
    Kirkpatrick, C. H. and Alling, D. W., 1978, Treatment of chronic and oral candidiasis with clotrimazole troches—A controlled clinical trial, N. Engl. J. Med. 229: 1201–1203.CrossRefGoogle Scholar
  40. 40.
    Mitchell, E. W., 1984, Secretary council on dental therapeutics, J. Am. Dent. Assoc. 108.Google Scholar
  41. 41.
    Pogrel, M. A., 1983, Carcinoma arising in erosive lichen planus in the midline of the dorsum of the tongue, Oral Surg. 55: 62.PubMedCrossRefGoogle Scholar
  42. 42.
    Cawson, R. A., 1980, Management of oral lichen planus, in: Current Therapy in Dentistry ( R. E. McDonald, W. C. Hart, H. W. Gilmore, and R. A. Middleton, eds.), W. B. Saunders Company, Philadelphia, Vol. 7.Google Scholar
  43. 43.
    Zegarelli, D. J., 1980, Topical and intralesional steroid therapy of oral lichen planus, N.Y. State Dental J., 47 (4): 43–436.Google Scholar
  44. 44.
    Cancer Statistics 1981, American Cancer Society, Inc., New York.Google Scholar
  45. 45.
    Harris, R., 1982, Aging of the cardiovascular system, in: Lectures on Gerontology, (A. Viedik, ed.), Academic Press, London, Vol. IB, Chapter 8.Google Scholar
  46. 46.
    Harris, R., 1980, Evaluation of chest pain in the old age patient, Ann. Intern. Med. Specialist, 92: 871.Google Scholar
  47. 47.
    Sonis, S., Fazio, R., and Fang, L., 1982, Principles and Practice of Oral Medicine, W. B. Saunders Company, Philadelphia.Google Scholar
  48. 48.
    Shulman, S. T., et al. 1984, Prevention of bacterial endocarditis, Circulation 70: 1123.Google Scholar
  49. 49.
    Jones, J. H., 1980, Cardiovascular and renal disease, in: Oral Manifestations of Systemic Disease, ( J. H. Jones and D. K. Mason, eds.), W. B. Saunders Company, Philadelphia.Google Scholar
  50. 50.
    Pisanty, S. and Garfunkel, A., 1970, Kaposi’s sarcoma, J. Oral Med. 25: 89–92.PubMedGoogle Scholar
  51. 51.
    Shklar, G. and Meyer, J., 1965, Vascular tumors of mouth and jaws, Oral Surg. Oral Med. Oral Pathol. 19: 335–358.CrossRefGoogle Scholar
  52. 52.
    Dreizen, S., Levy, B. M., Stern, M. H., and Bernick, 1974, Human lingual atherosclerosis, Arch. Oral Biol. 19: 813–816.CrossRefGoogle Scholar
  53. 53.
    Roberts, J. and Maurer, K., 1977, Blood pressures levels of persons 6–74 years U.S. 1971–1974, Vital Health Statistics ( 11 ). Public Health Service, U.S. Government Printing Office, Washington, D.C.Google Scholar
  54. 54.
    Fingerhut, L., 1980, Changes in mortality among the elderly. Vital and Health Statistics series 3, no. 22, DHHS Publ. No. (PHS) 82-1406, Public Health Service, U.S. Government Printing Office, Washington, D.C.Google Scholar
  55. 55.
    Posner, J. D., Gorman, K. M., and Woldow, A., 1984, Stroke in the elderly, J. Am. Geriatr. Soc. 32 (2): 95–102.PubMedGoogle Scholar
  56. 56.
    Newman, R. D. and Calne, D. B., 1984, Diagnosis and management of Parkinson’s disease, Geriatrics 39 (5): 87–96.PubMedGoogle Scholar
  57. 57.
    Too Old, Too Sick, Too Bad: Nursing Homes in America, 1977, Aspen, Rockville, Maryland.Google Scholar
  58. 58.
    Kamen, S., 1981, Skills training in geriatric dentistry, N.Y. State Dent. J. 47(4):202– 205.Google Scholar
  59. 59.
    Lavelle, C. L. B., 1977, Hypertension and the dentist, J. Hosp. Dent. Tract. 2 (1): 7.Google Scholar
  60. 60.
    Cohen, L., 1975, The dental management of patients with medical problems, N.Y. State Dent. J. 41: 470.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • Saul Kamen
    • 1
    • 2
  • Leonard B. Kamen
    • 3
  1. 1.Jewish Institute for Geriatric CareNew Hyde ParkUSA
  2. 2.School of Dental MedicineState University of New York at Stony BrookStony BrookUSA
  3. 3.Department of Physical Medicine and RehabilitationTemple University Health Sciences CenterPhiladelphiaUSA

Personalised recommendations