Mucosal Lesions in Older Adults

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Mucosal Lesions in Older Adults
2007
Sol Silverman Jr., DDS, MA
Journal of the American Dental Association

ABSTRACT

Background and Overview. Many oral diseases/conditions associated with aging are complex and can have a significant effect on the quality of life for ambulatory older adults. Among these are oral cancers and premalignant lesions, vesiculoerosive diseases, candidiasis, aphthous ulcers and herpes virus reactivation. The practitioner should establish the diagnosis so that appropriate management can be instituted.

Conclusions. The challenge to the practitioner is to formulate a differential diagnosis from oral mucosal signs and symptoms, arrange tests and referrals as needed, and establish a definitive diagnosis so that appropriate management can be instituted.

Clinical Implications. Recognition of benign and malignant muosal lesions will accelerate proper treatment that will help control a variety of oral diseases and conditions. It also will improve the quality of life for many elderly patients who experience associated pain and altered oral functions.

Key Words: Mucosal lesions; older patients; oral medicine

Abbreviations: EM: Erythema multiforme Ô HPV: Human papillomavirus Ô HSV: Herpes simplex virus Ô LP: Lichen planus Ô MMP: Mucous membrane pemphigoid Ô RAS: Recurrent aphthous stomatitis Ô VED: Vesiculoerosive disease

The specialty of oral medicine provides important services for oral health problems in older adults. These oral health conditions and diseases associated with aging often are complex and can affect the quality of life adversely.

Three of the most common causes for referrals include suspected premalignant and cancerous lesions, oral inflammatory vesiculoerosive changes and candidiasis. The use of medications increases significantly in elderly people; therefore, the clinician must consider a patientÌs potential drug reactions in the differential diagnosis of signs and symptoms. Additionally, when a patient has severe aphthae and herpetic reactivation, the clinician may have difficulty in both recognition and management of the conditions. The practitionerÌs challenge is to establish a diagnosis so that he or she can institute appropriate treatment.

© 2007 American Dental Association

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