Abstract
Systemic gastrointestinal disorders and oral manifestations are well elucidated in current literature. Many chronic disorders such as cardiovascular disease, stroke, brain health, lung disease, and diabetes are associated with oral manifestations. This bi-directional relationship may be a result of inflammatory response to periodontal pathogens. Inflammatory mediators pronounced in the oral cavity may gain access to the circulation resulting in systemic effects. Proper daily oral care, with prevention as the cornerstone, is the most crucial factor in improving oral health in older adults.
References
Abbayya K, Puthanakar NY, Naduwinmani S, Chidambar YS. Association between periodontitis and Alzheimer’s disease. N Am J Med Sci. 2015;7(6):241–8.
Adebayo B, Durey A, Slack-Smith LM. Role of information and communication technology in promoting oral health at residential aged care facilities. Aust J Prim Health. 2017;23:216–21.
Agossa K, Dendooven A, Dubuquoy L, Gower-Rousseau C, Delcourt-Debruyne E, Capron M. Periodontal manifestations of inflammatory bowel disease: emerging epidemiologic and biologic evidence. J Periodontal Res. 2017;52(3):313–324.
American Society for Microbiology. Tongue microbiome research underscores importance of dental health. ScienceDaily. 2018; 15.
American Thoracic Society. Infectious disease Society of America. Guidelines for management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Resp Crit Care Med. 2005;171(1):388–416.
Ayangco L, Rogers RS. Oral manifestations of erythema multiforme. Derma Clin. 2003;21(1):195–205.
Bailey R, Gueldner S, Ledikwe J, Smiciklas-Wright H. The oral health of older adults: an interdisciplinary mandate. J Gerontol Nurs. 2005;31:11–7.
Brosky ME. The role of saliva in oral health: strategies for prevention and management of xerostomia. J Support Oncol. 2007;5:215–25.
Cartsos VM, Zhu S, Zavras AI. Bisphosphonate use and the risk of adverse jaw outcomes: a medical claims study of 714,217 people. J Am Dent Assoc. 2008;139:12,14–5.
Centers for Disease Control and Prevention. Dental visits in the past year by selected years 1997–2016. 2017.
Chazin S. Medicaid adult dental benefits: an overview. Cent Healthc Strateg. 2017
Chen CK, Wu YT, Chang VC. Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched cohort study. Alzheimers Res Ther. 2017;9(56):1–8. https://doi.org/10.1186/s13195-017-0282-6.
Chernoff R. The symbiotic relationship between oral health, nutrition, and aging. Generations. 2016;40(3):32–8.
Chrysanthakopoulos NA, Chrysanthakopoulos PA. Examination of the relation between periodontal disease indices and self-reported coronary heart disease. Balk Mil Med Rev. 2016;19(1):1–9.
Ciancio SG. Medications’ impact on oral health. J Am Dent Assoc. 2004;135:1440–8.
Cueno ME, Ochia K. Gingival periodontal disease (PD) level-butyric acid affects the systemic blood and brain organ: insights into the systemic inflammation of periodontal disease. Front Immunol. 2018;9:1158.
Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of inflammatory bowel disease among adults aged ≥ 18 years – United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65:1166–9. https://doi.org/10.15585/mmwr.mm6542a3.
Daniel SJ, Kumar S. Teledentistry: a key component in access to care. J Evid Base Dent Pract. 2014;14(1):201–8. Figure 1
Darling-Fisher CS, Kanjirath PP, Peters MC, Borgnakke WS. Oral health: an updated resource in managing glycemic control in diabetes and promoting overall health. J Nurs Pract. 2015;11(9):889–96.
Dietrich E, Antoniades K. Molecularly targeted drugs for the treatment of cancer: oral complications and pathophysiology. Hippokratia. 2012;16(3):196–9.
DiFede O, Di Liberto C, Occhipiniti G, et al. Oral manifestations in patients with gastroesophageal reflux disease: a single-center case-control study. J Oral Pathol Med. 2008;37:336–40. https://doi.org/10.1111/j.1600-0714.2008.00646.x.
Donnelly LR. Persons with fixed and removable prostheses. In: Darby ML, Walsh MM, editors. Dental hygiene theory and practice. 4th ed. St. Louis: Elsevier Saunders; 2015. p. 1006–21.
Dye BA, Thorton-Evans G, Li X, Iafolla TJ. Dental caries and tooth loss in adults in the United States, 2011–2012. NCHS No. 197. 2015.
Emami E, Souza RFD, Kabawat M, Feine JS. The impact of edentulism on oral and general health. Int J Dent. 2013;2013:1–7. https://doi.org/10.1155/2013/498305.
Erickson L. The mouth-body connection. J Am Soc Aging. 2016;40(3):25–31.
Feres M, Teles F, Teles R, Figueiredo LC, Faveri M. The subgingival periodontal microbiota of the aging mouth. Periodontol. 2016;72(1):30–53.
Gaffen SL, Hajishengallis G. A new inflammatory cytokine on the block: rethinking periodontal disease and the Th1/Th2 paradigm in the context of Th17 cells and IL-17. J Dent Res. 2008;87:817–28.
Gainza-Cirauqui ML, Nieminen MT, Novak Frazer L, Aguirre-Urizar JM, Moragues MD, Rautemaa R. Production of carcinogenic acetaldehyde by Candida albicans from patients with potentially malignant oral mucosal disorders. J Oral Pathol Med. 2013;42:243–9. https://doi.org/10.1111/j.1600-0714.2012.01203.x.
Gavrilovic IT, Balagula Y, Rosen AC, et al. Characteristics of oral mucosal events related to bevacizumab treatment. Oncologist. 2012;17(2):274–8.
Goldberg D, Mackley H, Koch W, Bann DV, Schaefer EW, Hollenbeak CS. Age and stage as determinants of treatment for oral cavity and oropharyngeal cancers in the elderly. Oral Oncol. 2014;50(10):976–82. https://doi.org/10.1016/j.oraloncology.2014.07.008.
Griffin SO, Griffin PM, Swann JL, Zlobin N. New coronal caries in older adults: implications for prevention. J Dent Res. 2005;84:715–20.
Hammaker BG. Pharmacologic interventions for controlling the inflammatory cascade in periodontal disease. Access. 2010;24:19–20.
Harvard Health. The aging mouth – and how to keep it younger. Harv Health Lett 2010;35(3):4–5.
Haumschild MS, Haumschild RJ. The importance of oral health in long-term care. J Am Med Dir Assoc. 2009;10:667–71.
Haumschild MS, Haumschild RJ. Postmenopausal females and the link between oral bisphosphonates and osteonecrosis of the jaw: a clinical review. J Am Ac Nurse Prac. 2010;22:534–9.
Havales EB. Applied pharmacology for the dental hygienist. 6th ed. Maryland Heights: Mosby Elsevier; 2011.
Havales EB. Applied pharmacology for the dental hygienist. 7th ed. Maryland Heights: Mosby Elsevier; 2016.
Holmstrup P, Damgaard C, Olsen I, Klinge B, Flyvbjerg A, Nielsen CH, Hansen PR. Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician. J Oral Micro. 2017;9(1332710):1–13.
Iamaroon A, Chaimano S, Linpisarn S, Pongsiriwet S, Phoemphutkul K. Detection of helicobacter pylori in recent aphthous ulceration by nested PCR. J Oral Sci. 2003;45:107–10. https://doi.org/10.2334/josnusd.45.107.
Irani FC, Wassall RR, Preshaw PM. Impact of periodontal status on oral health-related quality of life in patients with and without type 2 diabetes. J Dent. 2015;43:506–11.
Iwamoto J, Mizokami Y, Saito Y, et al. Small-bowel mucosal injuries in low-dose aspirin users with obscure gastrointestinal bleeding. World J Gastroenterol. 2014;20(36):13133–8.
Jajam M, Bozzolo P, Niklander S. Oral manifestations of gastrointestinal disorders. J Clin Exp Dent. 2017;9(10):1242–8. https://doi.org/10.4317/jced.54008.
Kanasi E, Ayilavarapu S, Jones J. The aging population: demographics and the biology of aging. Periodontology 2000. 2016;72(1):13–8. https://doi.org/10.1111/prd.12126.
Kantarci A, Hasturk H, Van Dyke TE. Host-mediated resolution of inflammation in periodontal diseases. Perio. 2006;40:144–63.
Kaur T, Uppoor A, Naik D. Parkinson’s disease and periodontitis – the missing link? A review. Gerodontology. 2016;33:434–8.
Kelly MC, Caplan DJ, Bern-Klug M, Cowen HJ, et al. Preventive dental care among Medicaid-enrolled senior adults: from community to nursing facility residence. J Pub Hea Dent. 2018;78(1):86–91.
Kumar KP, Nachiammai N, Madhushankari GS. Association of oral manifestations in ulcerative colitis: a pilot study. J Oral Maxilofaci Pathol. 2018:199–203. https://doi.org/10.4103/jomfp.JOMFP_223_16.
Lamster IB, Asadourian L, Carmen TD, Friedman PK. The aging mouth: differentiating normal aging from disease. Periodontol. 2016;72(1):96–107. https://doi.org/10.1111/prd.12131.
Lankarani KB, Sivandzadeh GR, Hassanpour S. Oral manifestations in inflammatory bowel disease: a review. World J Gastroenterol. 2013;19(46):8571–9.
Larsen K, Johansen J, Reibel J, et al. Oral symptoms and salivary findings in oral lichen planus, oral lichenoid lesions and stomatitis. BMC Oral Health. 2017;17:103.
LeBeau GB, Sorci R. Commentary on an innovative interprofessional dental practice for 2026. J Evid Base Dent Prac. 2016;16(1):11–9.
Liang SC, Tan X, Luxenberg DP, et al. Interleukin IL-22 and IL-17 are co-expressed by Th17 cells and cooperatively enhance expression of antimicrobial peptides. J Exp Med. 2006;203:2271–9.
Lockhart PB, Bolger AF, Papapanou PN, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012;125:2520–44.
Luo HL, Bell R, Wright W, Wu Q, Wu B. Trends in annual dental visits among US dentate adults with and without self-reported diabetes and prediabetes. 2004-2014. JADA. 2018;149(6):460–9.
MacEntee MI, Nolan A, Thomason JM. Oral mucosal and osseous disorders in frail elders. Gerodontology. 2004;21:78–84.
Makski R, Moeller J. Barriers to oral health across selected European countries and the United States. Int Dent J. 2017;67:133–8.
Marshall S, Cheng B, Northridge M, et al. Integrating oral and general health screening at senior centers for minority elders. Am J Public Health. 2013;103(6):e1–4.
Mergulha OP, Magro F, Pereira P, et al. Gingival hyperplasia as a first manifestation of Crohn’s disease. Dig Dis Sci. 2005;50:1946–9. https://doi.org/10.1007/s10620-005-2965-2.
Minic I, Pejcic A, Kostic M, Krunic N, Mirkovic D, Igic M. Prevalence of oral lesions in the elderly. West Indian Med J. 2016;65(2):375–8. https://doi.org/10.7727/wimj.2014.329.
Mortazavi H, Safi Y, Baharvand M, Rahmani S. Diagnostic features of common oral ulcerative lesions: an updated decision tree. Int J Dent. 2016;2016:7278925.
Muhvic-Urek M, Tomac-Stojmenovic M, Mijandrusic-Sincic B. Oral pathology in inflammatory bowel disease. World J Gastroenterol. 2016;22(25):5655–67. https://doi.org/10.3748/wjg.v22.i25.5655.
Myers-Wright N, Lamster IB. A new approach for oral health professionals. J Evid Base Dent Pract. 2016;16(1):43–50.
Nasseth K, Vujicic M. HPI research brief – dental care utilization steady among working age adults and children, up slightly among the elderly. American Dental Association. http://www.ada.org/~/media/ADA/Science and Research/HPI/Files/HPIBrief_1016_1.pdf?la=en. Published Oct 2016
Naughton D. Expanding oral care opportunities: direct access care provided by dental hygienists in the United States. J Evid Base Dent Pract. 2014;14(1):171–82.
Padmavathi BN, Sharma S, Astekar M, Rajan Y, Sowmya GV. Oral Crohn’s disease. J Oral Maxilofaci Pathol. 2014;18(1):139–42. https://doi.org/10.4103/0973-029X.141369.
Park DS. Challenges of delivering oral health care to older adults. N Y State Dent J. 2009;75:36–40.
Petersen PE, Yamamoto T. Improving the oral health of older people: the approach of the WHO Global Health Programme. Community Dent Oral Epidemiol. 2005;33:81–92.
Ponder A, Long MD. A review of recent findings in the epidemiology of inflammatory bowel disease. Clin Epidemiol. 2013;5:237–47. https://doi.org/10.2147/CLEP.S33961.
Porter SR, Mercadante V, Fedele S. Oral manifestations of systemic diseases. BDJ. 2017;223:683–91.
Poudel P, Griffiths R, Wong VW, Arora A, George A. Knowledge and practices of diabetes care providers in oral care and their potential role in oral health promotion: a scoping review. Diabetes Res Clin Pract. 2017;130:266–77.
Preshaw PM, Taylor JJ. How has research into cytokine interactions and their role in driving immune responses impacted our understanding of periodontitis? J Clin Periodontol. 2011;38(11):60–84.
Ranjan R, Dhar G, Sahu S, Nayak N, Mishra M. Periodontal disease and neurodegeneration: the possible pathway and contribution from periodontal infections. JCDR. 2018;12(1):1–5; DE01-DE05
Rodrigues WF, Miguel CB, Mendes NS, Freire Oliveira CJ, Ueira-Vieira C. Association between pro-inflammatory cytokine interleukin-33 and periodontal disease in the elderly: a retrospective study. J Indian Soc Periodontol. 2017;21:4–9.
Rosenblum R. Oral hygiene can reduce the incidence of and death resulting from pneumonia and respiratory tract infection. JADA. 2010;141:117–9.
Sabine O, Geerts VL, Charpentier J, et al. Further evidence of the association between periodontal conditions and coronary artery disease. J Periodontol. 2004;31:402–11.
Schmitz-Parr L. Alzheimer’s link with perio: oral health infections lead to a systemic link associated with memory loss. RDH. 2017;37(10):28–32.
Scully C, Ettinger RL. The influence of systemic diseases on oral health care in older adults. J Am Dent Assoc. 2007;138(Suppl):S7–S14.
Shelley D, Russell S, Parikh NS, Fahs M. Ethnic disparities in self-reported oral health status and access to care among older adults in NYC. J Urban Health. 2011;88(4):651–62. https://doi.org/10.1007/s11524-011-9555-8.
Ship JA, Mohammad AR. Geriatric oral medicine. http://wwwlgeriatricoralhealth.org/topics/topic02/default.aspx. Accessed 7 Aug 2010.
Silk H. The future of oral health care provided by physicians and allied professionals. J Dent Educ. 2017;81(8):S171–8.
Skrepnek GH, Seal B, Tangirala M, et al. Adverse events and intravenous versus oral bisphosphonate use in patients with osteoporosis and cancer in the US. Gen Dent. 2010;58:484.
Suttagul K. Diabetes mellitus type 2 and oral health in context to Thailand: an updated overview. J Int Dent Med Res. 2018;11(1):342–6.
Teledentistry. Retrieved from: https://www.bing.com/images/search?q=free+teledentistry+pictures&id=2AA293864917CD08553232C2F7D2BB4F14D91F75&FORM=IQFRBA. Image 1
Tonetti MS, Van Dyke TE, and on behalf of working group 1 of the joint EFP/AAP workshop. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the joint EFP/AAP workshop on periodontitis and systemic diseases. J Clin Periodontol. 2013;40(14):S24–9. https://doi.org/10.1111/jcpe.12089.
Tonetti MS, Greenwell H, Korman KS. Staging & grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89(1):S159–72.
Towle JH. The elderly patient. In: Wilkins EM, editor. Clinical practice of the dental hygienist. 10th ed. Baltimore: Lippincott, Williams, & Wilkins; 2009. p. 818–31.
Troiano G, Dioguard M, Limongelli L, et al. Can inspection of the mouth help clinicians diagnose Crohn’s disease? A review. Oral Health Prev Dent. 2017;15(3):223–7.
Tynan A, Deeth L, McKenzie D. An integrated oral health program for rural residential aged care facilities; a mixed methods comparative study. BMC Health Serv Res. 2018;18(515):1–12.
Valerio MA, Kanjirath PP, Klausner CP, Peters MC. A qualitative examination of patient awareness and understanding of type 2 diabetes and oral health care needs. Diabetes Res Clin Pract. 2011;93:159–65.
Van Dyne EA, Henley SJ, Saraiya M, Thomas CC, Le M, Benard VB. Trends in human papillomavirus-associated cancers – United States, 1999-2015. MMWR Morb Mortal Wkly Rep. 2018;67:918–24. https://doi.org/10.15585/mmwr.mm6733a2.
Veitz-Kennan A, Ferraiolo DM. Oral care with chlorhexidine seems effective for reducing for incidence of ventilator-associated pneumonia. EB Dent. 2017;18(4):113–4.
Wall T, Vujicic M. HPI research brief – emergency department use for dental conditions continues to increase. American Dental Association. http://www.ada.org/~/media/ADA/Science and Research/HPI/Files/HPIBrief_0415_2.ashx. Published Apr 2015.
Weiner RC, Wu B, Crout R, et al. Hyposalivation and xerostomia in dentate older adults. J Am Dent Assoc. 2010;141:279–84.
Wilkins EM. The teeth. In: Wilkins EM, editor. Clinical practice of the dental hygienist. 10th ed. Baltimore: Lippincott, Williams, & Wilkins; 2009. p. 264–80.
Willink A, Schoen C, Davis K. Dental care and Medicare beneficiaries: access gaps, cost burdens, and policy options. Health Aff. 2016;35(12):2241–8. https://doi.org/10.1377/hlthaff.2016.0829.
Woo VI. Oral manifestations of Crohn’s disease: a case report and review of the literature. Case Rep Dent. 2015:830472. https://doi.org/10.1155/2015/830472.
Wyatt CL, So FH, Williams PM, Mithani A, Zed CM, Yen EH. The development, implementation, utilization and outcomes of a comprehensive dental program for older adults residing in long-term care facilities. J Can Dent Assoc. 2006;72:419–27.
Wyche C. The patient who is homebound. In: Wilkins EM, et al., editors. Clinical practice of the dental hygienist. 11th ed. Baltimore: Lippincott, Williams, & Wilkins; 2013. p. 875–6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Book Chapter Quiz Questions: Oral Health in Older Adults
Book Chapter Quiz Questions: Oral Health in Older Adults
-
1.
Which of the following best describes as to why older adults usually fail to seek adequate preventive dental care?
-
a.
Lack of mobility
-
b.
Poor value judgment
-
c.
Inadequate insurance coverage
-
d.
Barriers in access to care
Discussion/Rationale: Dental insurance is typically provided as a benefit for working individuals; therefore, retired persons on fixed incomes are not likely to have dental insurance coverage. In addition, Medicare and Medicaid do not cover dental procedures. The rising costs of prescription drugs cause retired individuals to make a choice about where they will spend their healthcare dollars. Access to care may be affected by several barriers. Among the most common are high costs associated with dental care, transportation to dental clinics, and disabilities that affect mobility.
-
a.
-
2.
Which of the following systemic illnesses do not have a known or suspected bi-directional relationship with oral health?
-
a.
Epstein-Barr
-
b.
Diabetes
-
c.
Pneumonia
-
d.
Crohn’s disease
Discussion/Rationale: Chronic systemic disease and oral disease share common risk factors. There are over 100 systemic diseases that have oral manifestations, such as cardiovascular disease, stroke, chronic respiratory disease, diabetes, and nutritional deficiencies. This is a bi-directional relationship, the link being inflammation. Periodontal pathogen and inflammatory mediators that are pronounced in the oral cavity may access the circulation and have systemic effects. Stroke patients may have impaired manual dexterity; therefore, oral hygiene will usually deteriorate on the affected side. Epstein-Barr is causative or contributory in various viral infections and in itself is not a true systemic illness.
-
a.
-
3.
Which of the following oral hygiene aids would be helpful for patients with arthritis or recovering from a stroke?
-
a.
Oral irrigator
-
b.
Power toothbrush
-
c.
Adaptive floss aids
-
d.
All of the above
Discussion/Rationale: Patients may all benefit from using adaptive floss aids, power toothbrushes, and oral irrigators. Pictures and a 2-minute egg timer ensure that the patient will be brushing long enough with the proper 45-degree angle at gumline to remove the bacterial plaque. In addition, a caregiver may need to assist with proper oral care. However, although an oral irrigator is an extremely useful preventive instrument, it does require reasonable dexterity to operate, limiting its usefulness in a patient with severe arthritis or recovering from a stroke.
-
a.
-
4.
The primary reason why caries rates among older adults are growing faster than in children is best explained by which of the following?
-
a.
Dietary considerations
-
b.
Insufficient water fluoridation
-
c.
Increased retention of plaque biofilm
-
d.
Repositioning of gumline with increased age
Discussion/Rationale: Longitudinal data for older adults suggest that they may have more caries (decay) than children, although the latter are the primary recipients of caries prevention services. Currently, water fluoridation is the main caries prevention program that affects older adults. Because of gum recession, older adults are more prone to have decay on the exposed root area next to the gumline. This area lacks the protective hard enamel coating; therefore, it is softer and more affected by the plaque biofilm and resulting gingival inflammation. The primary reason for increased caries rates in all populations centers around retention of plaque on the dentition. This fact is due to the bacterial component in biofilm that converts carbohydrates to acids capable of decaying calcified tooth structure. Older adults may struggle with dexterity issues that further complicate adequate biofilm removal. For further decay prevention, older individuals should limit the frequency and amount of carbohydrate exposure.
-
a.
-
5.
What is the most effective way to ensure that institutional barriers in dental access to care for older adults are being more adequately addressed?
-
a.
Provide improved oral hygiene training of nursing staff by expert dental hygienists
-
b.
Directly utilize more dentists within the facility
-
c.
Change laws and statutes to improve language in access to care
-
d.
Employ more nursing staff dedicated to dental health needs
Discussion/Rationale: Studies have found that nursing staff needs more training by expert dental hygienists and recommend that long-term care facilities consider hiring dental hygienists to assess oral health and oversee oral care. In addition, policymakers and insurance companies need to come together to increase oral health policies and provide reimbursement for older adult dental patients. Standards and protocols need to be implemented to ensure that oral care goals are met. Steps to improve a nursing staff’s performance in addressing the patient’s preventive dental needs would undoubtedly have a positive impact; mid-level dental hygiene professionals are ideally poised to oversee oral care in an institutional setting.
-
a.
-
6.
All of the following are conditions that are common to the aging mouth except one. Which one is the exception?
-
a.
Increased oral cancer risk
-
b.
Increased salivary function
-
c.
Increased caries risk
-
d.
Increased periodontal disease prevalence
-
e.
Increased periodontal disease severity
Discussion/Rationale: Decreased salivary function is common to aging. The elderly have approximately half the salivary flow of other age groups, atrophy of the acinar glands, and high rates of xerostomia.
-
a.
-
7.
All of the following increase the risk of aspiration pneumonia of the elderly living in nursing homes. Which one is associated with the greatest risk?
-
a.
Poor oral care
-
b.
Dysphagia
-
c.
Feeding problems
-
d.
Decreased functional status
Discussion/Rationale: Due to increased bacteria in the mouth
-
a.
-
8.
A patient with a removable prosthesis should be advised to not do which of the following?
-
a.
Soak prosthesis in water and a cleansing solution at night
-
b.
Use an abrasive powder to remove stains
-
c.
Rinse prosthesis with water after an overnight soaking
-
d.
Place container with prosthesis and cleaning solution away from bedside
Discussion/Rationale: Avoid abrasive products, which increase scratches and encourage more staining
-
a.
-
9.
In 2015, HPV-related oropharyngeal squamous cell lesions were most commonly found in which group?
-
a.
Females aged ≤70 years
-
b.
Females aged ≥70 years
-
c.
Males aged ≤ 70 years
-
d.
Males aged ≥70 years
Discussion/Rationale: Males aged 60–69 have the highest rate of HPV-related oropharyngeal squamous cell lesions
-
a.
-
10.
All of the following oral conditions may be helpful in diagnosing patients with Crohn’s disease except one. Which is the exception?
-
a.
Gingival hyperplasia
-
b.
Dental caries
-
c.
Aphthous ulcers
-
d.
Erythematous lesions on the uvula
Discussion/Rationale: Erythematous lesions on the uvula may be an indication of GERD
-
a.
-
11.
Which of the following gastrointestinal medications is associated with causing erythema multiform lesions intraorally?
-
a.
Histamine-2 blockers
-
b.
Proton pump inhibitors
-
c.
Interferons
-
d.
Sulfas
Discussion/Rationale: The appearance of erythema multiform lesions is somewhat rare but has occasionally been confirmed in cases of patients taking long-term proton pump inhibitors. In some cases, clinically observable oral ulcerations will actually precede the clinical diagnosis of lesions appearing elsewhere in the GI system. Since many medications routinely prescribed for various gastrointestinal condition are known to cause intraoral lesions, it is imperative for clinicians to carefully debrief patients regarding all medications (prescription and over the counter) being taken at each diagnostic, treatment, or wellness care appointment.
-
a.
-
12.
According to the content here, which of the following services are typically included in Medicare, Medicaid, and private supplemental insurance policies?
-
a.
Dental exams
-
b.
Prophylaxis
-
c.
Periodontal treatment
-
d.
Extractions
-
e.
Caries treatment
Discussion/Rationale: Medicare, Medicaid, and private supplemental insurance policies typically do not cover routine dental examinations, prophylaxis (cleanings), periodontal treatment, or fluoride. They usually cover extractions.
-
a.
-
13.
Which of these is not considered a barrier to adopting teledentistry?
-
a.
Patient privacy issues
-
b.
Practice laws regarding supervision of dental hygienists
-
c.
Dentist and patient are in close proximity to each other
-
d.
Technical issues and training
Discussion/Rationale: The main reason that teledentistry is used is because the dentist and patient are far away from each other.
-
a.
-
14.
Which is not considered a benefit of teledentistry?
-
a.
Health equality for vulnerable populations
-
b.
Early detection
-
c.
Access to care in rural remote settings
-
d.
Increased time for the patient
Discussion/Rationale: Teledentistry has been shown to decrease time for the patient because they do not need to travel to the location of the dentist provider.
-
a.
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this entry
Cite this entry
Haumschild, M.S., Hammaker, B., Pino, I., Woods, K., Dickey, N. (2021). Oral Health in Older Adults. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_58
Download citation
DOI: https://doi.org/10.1007/978-3-030-30192-7_58
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-30191-0
Online ISBN: 978-3-030-30192-7
eBook Packages: MedicineReference Module Medicine