Rosenthal ch35.tex
V1 - March 27, 2006
6:18 P.M.
Page 473
35
Oral Conditions Jude A. Fabiano
CLINICAL PEARLS 473
DEMENTIA 488
EVALUATION OF THE ORAL CAVITY 474
CONCLUSION 488
DENTAL DECAY (CARIES) 476
CLINICAL PEARLS
PERIODONTAL DISEASE 478 ■
DIET AND NUTRITION 480 ■
XEROSTOMIA 480 ■
OROFACIAL PAIN 481
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ORAL MEDICINE AND THE ELDERLY 482
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ORAL CANCER 482
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ORAL MUCOSITIS 484
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ORAL CANDIDIASIS 484 TRAUMATIC LESIONS 485 BURNING MOUTH SYNDROME (STOMATOPYROSIS) 486 ORAL CONDITIONS AND SYSTEMIC DISEASE 486 PERIOPERATIVE CONSIDERATIONS 486 ATHEROSCLEROSIS, CARDIOVASCULAR DISEASE, AND STROKE 487 DIABETES 487 ASPIRATION PNEUMONIA/CHRONIC OBSTRUCTIVE PULMONARY DISEASE 487
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Oral health is intimately associated with general health and well-being. Poor oral health negatively affects nutrition and systemic health. Dental caries and periodontal disease are preventable. Xerostomia can have devastating effects on the health of the hard and soft tissues of the oral cavity. Root surface dental decay, often a secondary effect of xerostomia, has an increased incidence in older adults. Medications with xerostomic side effects should be avoided when possible. Diagnosis of orofacial conditions in elderly persons may be confounded by coincident medical and dental conditions, multiple medications, and vague histories. The 5-year survival rate of oral cancer has not improved over the past 30 years. Early diagnosis is crucial. Proper oral hygiene in older adults prevents several life-threatening systemic conditions. Follow current recommendations regarding antibiotic prophylaxis and anticoagulant therapy as they relate to dental procedures.
Good oral health has emerged as a critical factor in maintaining general health in geriatric individuals. The oral cavity provides an entrance to the body for every nutrient necessary for life except oxygen. Over the past several decades, the number of older adults who have retained some or all of their natural teeth has dramatically increased. While this has resulted in improved masticatory function and self-image, the risk for acute and chronic oral disease persists later in life. Periodontal disease, dental caries, root surface caries, infections, oral cancer, malocclusion, missing
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