Abstract
The increasing retention of teeth into advanced age places the present cohort of older people at greater risk for serious dental disease than previous cohorts. With advancing age, older individuals go to the doctor more but to the dentist less. Therefore, physicians caring for older patients need to be aware of common oral diseases in order to suitably advise patients on dental treatment needs and options.
Dental caries, gingivitis, and periodontitis are infectious diseases, because they are caused by transmissible microorganisms; however, their management is generally directed at reversing or restoring the tissue destruction and reducing the numbers of the responsible organisms rather than eradicating them from the patient.
Dental and oral pathogens that progress beyond the teeth and periodontium can seed serious infections in both adjacent soft and bony tissues and, via the bloodstream, distant tissues as well.
Chronic periodontitis is increasingly being implicated as a contributing factor to cardiovascular and cerebrovascular diseases due to the role that elevated, circulating C-reactive protein plays in initiating thrombus formation.
Periodontal pathogens may cause nosocomial pneumonia. More common respiratory pathogens colonize the oral cavity and, like periodontal pathogens, may be aspirated. Trials directed at reducing nosocomial pneumonia in frail elderly through rigorous oral hygiene regimens have been promising.
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Suggested Reading
Selwitz, R.H., Ismail, A.I., & Pitts, N.B. (2007). Dental caries. Lancet, 369:639.
Arduino, P.G., & Porter, S.R. (2008). Herpes simplex virus type 1 infection: overview on Ârelevant clinico-pathological features. Journal of Oral Pathology and Medicine, 37:107–121.
Schmader, K. (2007). Herpes zoster and postherpetic neuralgia in older adults. Clinics in Geriatric Medicine, 23:615–632.
Wilson, W., Taubert, K.A., Gewitz, M., Lockhart, P.B., et al. (2008). Prevention of infective endocarditis: guidelines from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Journal of the American Dental Association, 139:3S–24S.
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Shay, K. (2009). Orofacial and Odontogenic Infections in the Elderly. In: Norman, D., Yoshikawa, T. (eds) Infectious Disease in the Aging. Infectious Disease. Humana Press. https://doi.org/10.1007/978-1-60327-534-7_17
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