The Influence of Systemic Diseases on Oral Health Care in Older Adults

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The Influence of Systemic Diseases on Oral Health Care in Older Adults
2007
Crispian Scully, CBE, MD, PhD, MDS, MRCS, FDSRCS, FDSRCPS, FFDRCSI, FDSRCSE, FRCPath, FMedSci, FHEA, DSc and Ronald L. Ettinger, BDS, MDS, DDSc, DABSCD
Journal of the American Dental Association

ABSTRACT

Background and Overview. Systemic diseases are more common in older adults than in younger people, even among those who are functionally independent. Dentists should understand how these diseases can affect the dental care of their aging patients. The authors review some of the management issues associated with selected systemic diseases common in older adults who are functionally independent.

Conclusions. To provide good oral health care, dental professionals must understand the special needs of older people and their ability to undergo and respond to care; they should work closely with the rest of the health care team; and they should be prepared to manage emergencies.

Clinical Implications. Many older people have a variety of systemic diseases that have an impact on their oral health care. The dentist may need to consult with the patientÌs physician to develop an appropriate treatment plan.

Key Words: Oral health; older adults; systemic disease; medications; arthritis; head and neck cancer; chronic obstructive pulmonary disease; diabetes; heart disease; hypertension; mental health; osteoporosis; Parkinson disease; stroke


Abbreviations: BP: Blood pressure Ô CNS: Central nervous system Ô COMT: Catechol-O-methyltransferase Ô COPD: Chronic obstructive pulmonary disease Ô CPR: Cardiopulmonary resuscitation Ô GA: General anesthesia Ô IMRT: Intensity-modulated radiotherapy Ô INR: International normalized ratio Ô LA: Local anesthesia Ô MAOIs: Monoamine oxidase inhibitors Ô MI: Myocardial infarct Ô NSAIDs: Nonsteroidal anti-inflammatory drugs Ô ONJ: Osteonecrosis of the jaws Ô RA: Rheumatoid arthritis Ô TCAs: Tricyclic antidepressants.


Older adults in the United States are diverse and heterogeneous, and their health and health-related behaviors vary greatly. Many of these people have a variety of systemic diseases that will have an impact on their oral health care. To provide good oral health care, dental professionals must understand the complexities of older people, their special needs and their ability to undergo and respond to care.1 Dentists should work closely with the rest of the health care team2 and be prepared to manage emergencies that more commonly occur in older people.

In this article, we review some of the management modifications for oral health care for the 10 most common systemic diseases seen in functionally independent older adults living in the developed world. We also will discuss the needs and ways dental professionals should adapt their practices to safely treat these patients. Special descriptions about these diseases are available elsewhere.3,4
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© 2007 American Dental Association

Complete article may be viewed online.