Taking an evidence-based approach, with theoretical and clinical knowledge underpinned by the literature, Oral Healthcare and the Frail Elder provides a comprehensive reference to management strategies for dental diseases as noncommunicable diseases in older populations. The book presents a global perspective with current guidance for clinicians, addressing the particular challenges of providing dental care for people who are confronting frailty in old age. Reflecting the numerous developments in the discipline since the previous edition was published, this Second Edition has been thoroughly updated throughout with 15 new chapters.
The first section covers background information, including demographics, social considerations, and factors affecting oral health in this population. The second half of the book is devoted to clinical management strategies.
Some of the new topics discussed in this edition of Oral Healthcare and the Frail Elder include: - Theories and significance of oral health in frailty and oral health-related quality of life, and the influence of the life-course on oral health- How sugar, tobacco, and alcohol initiate and sustain oral diseases, as with other noncommunicable diseases, into old age- Mitigation of dental caries, periodontitis, gingivitis, mucositis, and other non-communicable diseases of the mouth- Infection control, communications and tele-dentistry, mobile dental services, and strategies to appraise the usefulness of community-based oral healthcare programs
With an emphasis on population and public health in the context of non-communicable disease, the Second Edition of Oral Healthcare and the Frail Elder is an important resource for clinicians dealing with the geriatric population, including dentists, dental hygienists, dental therapists, denturists and dental technicians, nurses, and geriatricians.
Table of Contents
Foreword xv
Preface xvi
List of Contributors xix
1 Demography of Aging and Frailty, and the Epidemiology of Oral Conditions 1
W. Murray Thomson, Moira B. Smith, Fernando Neves Hugo, and Philippe Mojon
Demography of Aging and Frailty 1
Epidemiology of Oral Conditions in Older People 5
Conclusion 10
References 10
2 Challenges with Noncommunicable Diseases and Frailty 16
Michael I. MacEntee, Paul Allison, Denise Laronde, and Bruce Wallace
Noncommunicable Disease 16
Frailty 18
Noncommunicable Diseases of the Mouth 19
Risks for Noncommunicable Diseases of the Mouth 25
Social Determinants 27
Conclusion 28
References 28
3 Theoretical Perspectives on Frailty, Oral Health-Related Quality of Life, and Well-Being in Old Age 37
Michael I. MacEntee, Dominique Niesten, Mario A. Brondani, and Maha M. Al-Sahan
Health 38
Oral Health 40
Frailty 43
Oral Frailty 44
Managing Ill-Health and Frailty 45
A Clinical Scenario 46
Conclusion 47
References 47
4 Communities and Frail Elders 54
C. Peter Owen, Michael I. MacEntee, Rodrigo Marino, Victor Minichiello, and Gladys Meriting Thokoane
What Is a Community? 54
Culture and Ethnicity 55
Barriers to Equitable Healthcare 57
Equitable Healthcare and Cultural Competence 60
Conclusion 63
References 63
5 Oral Healthcare Policy, Equity, Economics, and Political Action for Aging Populations 68
F.A. Clive Wright, Michael I. MacEntee, Joke Duyck, Moira B. Smith, Bruce Wallace, and C. Peter Owen
Purpose of Policy 68
Categories of Public Health Policy 69
Forming Health Policy 70
Equality and Equity 71
Adopting Health Policy 72
Global Strategy on Oral Health 76
Conclusion 79
References 80
6 The Influence of the Mouth and Mouthcare on the Body-Image and Social Interactions of Frail Elders 87
Leeann Donnelly, Laura Hurd, Alison Phinney, and Michael I. MacEntee
Body-Image and Oral Health 87
Social Isolation, Loneliness, and Depression 88
Clinical Script 90
Conclusion 92
References 92
7 Ethical and Moral Considerations for Oral Healthcare of Frail Elders 96
Michael I. MacEntee, Mario A. Brondani, Nico Creugers, Shafik Dharamsi, and Mary E. McNally
Healthcare Ethics 96
Frailty 97
Ethical Theory and Principles in Healthcare 97
Patient-Centered Care, Care Ethics, Narrative Ethics, and Feminism 98
Elder Abuse 102
An Ethical Framework 104
Clinical Context 105
Clinical Scripts 106
References 109
8 Educating a Workforce for Dental Geriatrics 115
Matana Kettratad- Pruksapong, Shiva Khatami, Linda Slack- Smith, Jirakate Madiloggovit- Lower, Leonardo Marchini, C. Peter Owen, and Michael I. MacEntee
Teaching and Learning Dental Geriatrics 115
Exposure to Frailty 116
Postgraduate Education 116
Cultivating Clinical Reasoning 116
Promoting Compassion 118
Healthcare-Teams 119
Conclusion 120
References 120
9 Chronic Orofacial Pain and Movement Disorders in Old Age and Frailty 125
Pierre J. Blanchet, Limor Avivi-Arber, Barry J. Sessle, and Gilles J. Lavigne
Assessing Pain 125
Age-Related Changes in Processing Pain 126
Orofacial Pain 128
Movement Disorders and Orofacial Pain 132
Conclusion 135
References 138
10 Nutritional Consequences of Oral Health in Frail Elders 143
Paula Moynihan, Kazunori Ikebe, and Rena Zelig
Changing Nutritional Needs of Frail Elders 143
Malnutrition/Undernutrition in Elders 145
Diet and Oral Health in Frail Elders 151
References 154
11 Dry Mouth and Medications 160
W. Murray Thomson and Chao Shu Yao
The Salivary System 160
The Role of Saliva 163
What Is Dry Mouth? 165
How Do We Measure Dry Mouth? 165
Prevalence and Impact of Dry Mouth 167
Medications and Dry Mouth 168
Managing and Preventing Dry Mouth 173
Conclusion 175
References 175
12 Dementia, Sleep Apnea, and Dysphagia 180
Michael I. MacEntee, Fernanda Almeida, B. Lynn Beattie, Najla Chebib, and Frauke Müller
Dementia 180
Sleep and Aging 187
Swallowing, Dysphagia, and Pneumonia 189
References 195
13 A Framework for Assessing Oral Healthcare Programs in Residential Care Facilities 200
Matana Kettratad- Pruksapong, Joke Duyck, Michael I. MacEntee, Arminee Kazanjian, and B. Lynn Beattie
Challenges 200
Healthcare Accountability 200
Residential Facilities 203
Conclusion 205
References 205
14.1 Mitigating the Effects of Harmful Commodities on Dental Caries and Periodontal Diseases: Section 1: Dental Caries 208
Alan A. Deutsch, W. Murray Thomson, and Michael I. MacEntee
Caries Through the Life-Course 208
Conclusion 214
References 214
14.2 Mitigating the Effects of Harmful Commodities on Dental Caries and Periodontal Diseases: Section 2: Periodontitis and Gingivitis 217
Jim Yuan Lai, Howard C. Tenenbaum, Michael B. Goldberg, and Elaine Cardoso
Periodontitis as a Noncommunicable Disease 217
Periodontitis and Other Noncommunicable Diseases 218
Conclusion 222
References 223
15 Treatment Planning, and Integrating Oral and General Healthcare 226
C. Peter Owen, Joke Duyck, Barbara Janssens, David MacDonald, Chao Shu Yao, Alan A. Deutsch, and Michael I. MacEntee
Integrating Oral and General Health 226
Assessing the Need for Care 228
Planning Protocols 235
Infections 236
Conclusion 238
References 239
16 Care and Management of Frail and Osteoporotic Elders with Special Emphasis on Minor Oral Surgery 245
Michael M. Bornstein and Pedro Molinero- Mourelle
Minor Oral Surgery for Elders - General Considerations 246
The Osteoporotic Patient 247
Respiratory Conditions 249
Cardiovascular Diseases 251
Diabetes Mellitus 254
Psychological Disorders 255
Cancer 255
Recommendations and Conclusion 255
References 256
17 Oral Rehabilitation of the Frail Elder 260
C. Peter Owen, Shane White, Gerald McKenna, Sabrina Maniewicz, Nico Creugers, Michael I. MacEntee, and Frauke Müller
Endodontic Rehabilitation 261
Restoring Endodontically Treated Teeth 263
Partial Tooth-Loss 265
Removable Dental Prostheses 267
Tooth-Supported Overdentures 268
Complete Tooth-Loss 269
Implant-Supported Prostheses 272
Dental Restorations and Prostheses 275
Digitally Constructed Prostheses 275
Cross-Infection During Dental Treatment 275
Denture Hygiene 276
Sleep Apnea and Denture Use 276
Conclusion 276
References 277
18 Integrating Oral Health in Palliative Medicine 286
Martin Schimmel, Frauke Müller, Chao Shu Yao, Stephen Sonis, and Michael Wiseman
Dentistry in Palliative Care 286
Oral Health in Palliative Care 288
Therapies 289
Oral Health and Terminal Illness 290
Nausea and Vomiting 295
Dentistry 296
Conclusion 296
References 297
19 Mobile Dental Services 303
Murali Srinivasan, Barbara Janssens, David MacDonald, and Frauke Müller
Preferences of Frail Elders 304
Service Models 304
Setting-up Mobile Dental Services 308
Scope of Mobile Services 310
Cost-Effectiveness 311
Challenges 311
Conclusion 313
References 313
20 Communications and Teledentistry 316
Chris Wyatt, Mario A. Brondani, Leeann Donnelly, Nicholas Tong, and Shunhau To
Introduction 316
Principles of Communication 316
Person-Centered Communication 317
Medical and Dental Records 321
Teledentistry 322
Teledentistry Referrals 322
Conclusion 325
References 325
21 Oral Healthcare for Frail Elders in Low- Income Communities 329
C. Peter Owen, Matana Kettratad- Pruksapong, Matshediso Mothopi- Peri, Frankie Hon Ching So, F.A. Clive Wright, and Michael I. MacEntee
Global Expenditures on Health 329
Appropriatech 330
Responses to Constrained Resources 332
Australia and New Zealand 332
Canadian Indigenous Communities 333
Hong Kong 335
South Africa 335
Thailand 336
Conclusion 336
References 336
22 Summary 340
Michael I. MacEntee
Index 341
