Dental Treatment of Geriatric Patients
Back to Basics: Considerations in the Dental Treatment of Geriatric Patients In recent years, worldwide population statistics have shown a trend towards an ageing population in developed and developing countries. There is an increase in the life expectancy of people who have become more conscious about their oral health. These oral health-conscious people aim to preserve most if not all their natural teeth or aim to replace that which has been lost, in order to maintain function and esthetics. Due to the growth in the number of aged patients, it is crucial for dentists to remember considerations in the treatment of them.
Geriatric dentistry deals with the treatment of the aged - a population where the major dental problems include being edentulous, rampant root caries, periodontal disease, oral mucosal lesions, and salivary dysfunction. These problems cause difficulty in speech, chewing, and swallowing, which consequently affects the quality of life of the aged. Dentists should aim to preserve these functions or restore them, while also considering esthetics, which has become a big concern these days for people of any age.
It is common knowledge that scheduling an elderly patient in the morning is best, so that the patient is well-rested. However, consider that some patients take medications in the morning that cause drowsiness and therefore these patients are better to be scheduled later in the day. Elderly patients also tire more easily and therefore treatments chosen should be quick or if possible, stretched out for several short appointments. However, consider that some patients have difficulty returning and therefore the several short appointments may not be acceptable to them. The appointment time best for an elderly patient is when the patient is well-rested, has eaten, has taken any maintenance medications and is not experiencing any side effects of medications. The schedule should be discussed with the patient or the patient’s care giver before any procedures are started.
In the clinic, consideration must be given to the patient’s comfort during treatment. Geriatric patients tend to have more difficulty breathing, being in a supine position, and sitting and keeping their mouth open for extended periods of time. One way to make the patient more comfortable in the chair is by using pillows or rolled towels placed underneath the knees, neck, or back to prevent muscle spasm. When adjusting the chair, it is advisable to inform the patient before moving it and to frequently ask if the patient is still comfortable. Avoid quick position changes, such as abruptly moving from a supine to an upright position, as these may trigger orthostatic hypotension in the elderly patient. Give the patient time to rest in between procedure steps and at the end, to regain their balance prior to leaving the operatory
For some patients, discomfort in the dental chair is aggravated because they are anxious at simply being at your practice. It should therefore be the goal of the dentist to help the geriatric patient be relaxed even before entering the clinic. For example, the dentist may opt to meet the patient at the door and begin casual conversation while lending an arm for support as the patient walks. This may distract the patient from thinking of the dental treatment and may move the patient to see the dentist as a friend rather than a threat.
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