Exam 1 Review (week 1-3)
MOUTH:
Normal findings in elderly mouth/pharynx:
■ The lips have increased vertical markings and appear dryer.
■ The buccal mucosa is thinner, less vascular, and less shiny
■ Tongue may appear more fissures, and veins on its ventral surface
■ Oral tissues may be dryer (xerostomia) especially with medications
■ Natural teeth may be worn down, shortening the crown, and altering enamel thickness.
General findings in elderly mouth/pharynx:
Chronic disease increases the burden of oral disease, predisposing older adults to oral
microbial infections, pain, altered taste, difficulty chewing and speaking, and dysphagia.
Poor oral health can lead to weight loss
○ Periodontal disease is the 6th leading complication of diabetes and can inhibit glycemic
control and poor glycemic control can contribute to periodontal disease
○ Xerostomia (dry mouth) impairs oral function, promotes tooth decay, exacerbates
periodontal disease which can be caused by many medications.
○ Oral cancer is the 8th most common cancer in men and 7x more likely in older adults
○ Aspiration pnumonia is a major cause of hospitalization and results in 20-50% mortality,
oral hygiene can decrease this incidence.
○ 23% have untreated cavities and 70 % periodontal disease
○ 1/3 are fully edentulous (missing all their natural teeth) or average 19 or less remaining
teeth
○ 17% have orofacial pain, facial, oral sores, burning mouth, and toothache
Abnormal findings in elderly mouth/pharynx:
■ Gingivitis: which is associated with plaque, hormonal changes, or foreign-body response
■ Periodontal disease is associated with DM, PVD, cerebrovascular disease, & CV disease
which could be due to inflammation. This is marked by loss of alveolar bone around teeth: Oral
abx and chlorhexidine can slow it but may need root surface debridement.
■ 59% of those 60-69 and 72% of those 70+ have less than 20 teeth remaining which can
impact nutritional status. Dentures does not decrease the malnutrition.
■ Dental caries is an infection. This can spread to other organs. The use of high-fluoride
toothpaste can be beneficial. Dental caries may be present or deterioration of dental
restorations present.
■ Teeth may appear longer due to reabsorption of the gum and bone progresses which
reveals the teeth root.
■ Dental malocclusion may be caused by the migration of remaining teeth after extractions.
, EARS:
Otitis Media with Effusion:
■ Initial symptoms: sticking or cracking sound on yawning or swallowing; no signs of
dizziness
■ Pain: discomfort, feeling of fullness
■ Discharge: none
■ Hearing: conductive loss as middle ear fills with fluid
■ Inspection: tympanic membrane retracted or bulging, impaired mobility, yellowish; air-
fluid level and/or bubbles
MOUTH:
Normal findings in elderly mouth/pharynx:
■ The lips have increased vertical markings and appear dryer.
■ The buccal mucosa is thinner, less vascular, and less shiny
■ Tongue may appear more fissures, and veins on its ventral surface
■ Oral tissues may be dryer (xerostomia) especially with medications
■ Natural teeth may be worn down, shortening the crown, and altering enamel thickness.
General findings in elderly mouth/pharynx:
Chronic disease increases the burden of oral disease, predisposing older adults to oral
microbial infections, pain, altered taste, difficulty chewing and speaking, and dysphagia.
Poor oral health can lead to weight loss
○ Periodontal disease is the 6th leading complication of diabetes and can inhibit glycemic
control and poor glycemic control can contribute to periodontal disease
○ Xerostomia (dry mouth) impairs oral function, promotes tooth decay, exacerbates
periodontal disease which can be caused by many medications.
○ Oral cancer is the 8th most common cancer in men and 7x more likely in older adults
○ Aspiration pnumonia is a major cause of hospitalization and results in 20-50% mortality,
oral hygiene can decrease this incidence.
○ 23% have untreated cavities and 70 % periodontal disease
○ 1/3 are fully edentulous (missing all their natural teeth) or average 19 or less remaining
teeth
○ 17% have orofacial pain, facial, oral sores, burning mouth, and toothache
Abnormal findings in elderly mouth/pharynx:
■ Gingivitis: which is associated with plaque, hormonal changes, or foreign-body response
■ Periodontal disease is associated with DM, PVD, cerebrovascular disease, & CV disease
which could be due to inflammation. This is marked by loss of alveolar bone around teeth: Oral
abx and chlorhexidine can slow it but may need root surface debridement.
■ 59% of those 60-69 and 72% of those 70+ have less than 20 teeth remaining which can
impact nutritional status. Dentures does not decrease the malnutrition.
■ Dental caries is an infection. This can spread to other organs. The use of high-fluoride
toothpaste can be beneficial. Dental caries may be present or deterioration of dental
restorations present.
■ Teeth may appear longer due to reabsorption of the gum and bone progresses which
reveals the teeth root.
■ Dental malocclusion may be caused by the migration of remaining teeth after extractions.
, EARS:
Otitis Media with Effusion:
■ Initial symptoms: sticking or cracking sound on yawning or swallowing; no signs of
dizziness
■ Pain: discomfort, feeling of fullness
■ Discharge: none
■ Hearing: conductive loss as middle ear fills with fluid
■ Inspection: tympanic membrane retracted or bulging, impaired mobility, yellowish; air-
fluid level and/or bubbles
