Dental Care For Geriatric Patients

Proper dental care must be regularly supervised. If the condition simply left untreated, dental disease can rapidly progress and contribute to a host of other medical problems facing older patients. Regular proper cleanings and examinations should be scheduled as part of routine dental wellness programs for geriatric patients.

As the most common dental problem, the dental clinics face a number of challenges with periodontal disease. While providing the best possible oral care, such as regular professional cleanings and home care, can minimize long term problems, often the dental clinics are faced with patients that have had years of accumulative effects from both the bacteria associated with periodontal disease, as well as the own response of the host, that can lead to loss of periodontal supportive tissues. This attachment loss in the dental part is often progressive if left untreated for long, and with significant destruction of gingival tissue, periodontal ligament and alveolar bone, teeth can be lost or require extraction. Even fair amounts of attachment loss can be severe and challenging, particularly when deeper periodontal pockets develop.

One of the best ways to try to fight this dental attachment loss is by addressing the agents that initially cause the perio-dontal infection, the bacteria found in tooth plaques that sticks to the tooth surfaces and develops below the gumline. As soon as the oral bacteria on the tooth surface contact the gingiva, inflammation and infection can occur. If the plaque is not removed immediately with regular brushing, it will become mineralized, and turn into calculus or tartar. Then more amount of plaque can be deposited, more tartar is formed, and this biofilm can begin to encroach upon the deeper layers down the root of the tooth, wearing away at the gingiva, periodontal ligament and alveolar bone. If this protective material would stay on the tooth surface, the damage would not be severe, and it would be easily addressed with scaling or cleaning of the crown. But with the oral biotic assault, often pockets start to form, allowing bacteria deeper into the tissues, where more virulent, gram-negative colonies may form. Now if left untreated, the periodontal disease will progressively get worse, cause more attachment loss, and even special problems such as oronasal fistulation at the palatal aspect of the maxillary canine or substantial bone loss at the lower first molars that can predispose the pet to mandibular fractures.

Now if the oral or dental problems were not enough on their own, the bacteria associated with periodontal disease is in direct contact with the vasculature of the oral cavity, and with every oral movement, from chewing to therapeutic manipulation, showers of bacteria can erupt into the bloodstream, causing a bacteremia that may eventually have significant effects on distant organs, particularly if the pet already has a medical condition that compromises its health. This is of significant consequence in the geriatric patients, where the predisposition to hepatic, renal, cardiac and respiratory disease puts these individuals at higher risk for complications, often with the possibility of a direct correlation to the oral infection.

• Juliana Breckinridge
• 26/01/2009, 2:59 AM
• 0 Comments