Oral Health, Nutrition, and Geriatric Care Study Guide

A set of 700 flashcards covering geriatric oral health, nutrition, chronic conditions, end of life, and occupational therapy interventions based on transcript notes.

What are the four common oral-health conditions in older adults mentioned in the lecture?

Periodontal disease, dental decay, oral cancer, and dry mouth.

What percentage of adults ages $65-74$ wear dentures?

$$13\%$$

What percentage of adults $75+$ wear dentures?

$$22\%$$

What percentage of adults $65+$ have gum disease?

$$60\%$$

What percentage of adults $65+$ have experienced dental decay?

$$96\%$$

What percentage of adults around age $65$ experience dry mouth?

$$30\%$$

What percentage of adults around age $80$ experience dry mouth?

$$40\%$$

What characterize gingivitis according to the lecture?

Inflammation, redness, and bleeding.

What advanced oral health issues are associated with periodontitis?

Bone loss and gingival recession.

Why is gingival recession a concern for tooth sensitivity?

It may cause sensitivity and increases the risk for root caries.

What is the definition of dental biofilm?

Dental biofilm, or plaque, is an invisible film of living bacteria.

How frequently does dental plaque reform?

Approximately every $12-24$ hours.

What is the definition of calculus or tartar?

Calcified plaque or bacteria that can form within approximately $2$ weeks.

What are the two major strategies for controlling periodontal disease?

Toothbrushing and flossing/interdental cleaning.

What is the recommended frequency for flossing according to the lecture?

$1\times$ per night.

When should flossing be performed in relation to brushing?

Floss before brushing.

What technique is recommended for manipulating floss?

Form the floss into a $C$ shape and use an up-and-down motion.

How many times should the flossing motion be repeated per tooth surface?

Approximately $3-5\times$.

What types of floss are listed in the lecture?

Waxed, unwaxed, and Teflon-coated.

What motor issues might make traditional hand flossing difficult for older adults?

Impaired fine motor control, dexterity, grip, and hand/wrist/arm range of motion.

What are four alternative interdental cleaning devices for those with limited dexterity?

Floss holders/picks, interdental brushes, electric flossers, and water flossers.

What type of toothbrush bristles does the lecture recommend?

Soft or extra-soft.

What toothbrushing motions are suggested for manual brushes?

Circular or roll motions.

For which client population is a power toothbrush particularly useful?

Clients who have difficulty producing repetitive hand/wrist movements.

What are five possible modifications for toothbrushes for clients with limited grip?

Built-up/enlarged handles, electric toothbrushes, alternative-shaped handles, adapted gripping surfaces, and devices reducing hand manipulation.

What is the goal of adapting oral-hygiene ADL devices?

To increase independence.

What is the recommended cleaning routine for dentures?

Brush, rinse, and soak overnight.

What are four negative outcomes proper denture care helps avoid?

Cosmetic changes, fungal infections, mouth sores, and bad breath.

What three strategies are listed for preventing dental decay?

Fluoride, limiting sugary snacks, and plaque removal.

What benefits does stannous fluoride provide according to the lecture?

Reduces gingivitis, plaque, and caries.

What is the regimen for $0.05\%$ NaF mouthrinse?

$1\times$ per day, rinse for $1$ minute, alcohol-free, and no eating/drinking for $30$ minutes afterward.

What is the regimen for $0.02\%$ NaF mouthrinse?

$2\times$ per day, rinse for $1$ minute, alcohol-free, and no eating/drinking for $30$ minutes afterward.

What four ingredients are listed in antimicrobial mouthrinses?

Eucalyptol, menthol, methyl salicylate, and thymol.

According to the lecture, what is the age restriction for certain antimicrobial mouthrinses?

Children under 12\.

How long should an older adult wait to brush or rinse after eating?

$30-60$ minutes.

What is the medical term for dry mouth?

Xerostomia.

What are six potential causes of xerostomia listed in the lecture?

Medications, alcohol/smoking, radiation therapy, chemotherapy, mouth breathing, and foods that lower oral pH.

What type of mouthrinse is strictly recommended for patients with xerostomia?

Alcohol-free mouthrinse.

What are nine strategies for managing dry mouth?

Chew sugar-free gum, use sugar-free mints, sip water, limit caffeine, avoid alcohol mouthrinse, stop tobacco, use saliva substitutes, use specific dry-mouth mouthwash, and humidify air at night.

What are the three properties of baking soda listed in the lecture?

Whitens, neutralizes acids, and has antibacterial properties.

What is the method for oil pulling as described in the lecture?

$1$ tablespoon for $10-20$ minutes, spit into trash, rinse with water, then brush.

What is the relationship between diet and tooth erosion?

Dietary habits and acidic exposures affect oral pH and tooth structure.

What variables of sugar consumption affect oral health?

Type (refined vs. natural), form (liquid, long-lasting, sticky), and timing (between meals).

What is the definition of halitosis?

Bad breath.

What are five warning signs of oral cancer?

Nagging mouth pain, bleeding sore, white or red spot, lump in the neck, and feeling something is caught in the throat.

What six oral lesions or conditions are differentiated in the lecture?

Cold sore, canker sore, black hairy tongue, thrush, and oral cancer.

How can bacteria and the herpes virus be transmitted orally?

Sharing utensils and kissing.

What is the priority OT clinical reasoning for oral hygiene?

Matching the person's motor abilities to the oral-care device.

What three macronutrients are highlighted in the lecture?

Carbohydrates, protein, and fats.

What is the recommended percentage of total calories from carbohydrates?

$$50-60\%$$

What is the recommended percentage of total calories from protein?

$$15-20\%$$

What is the recommended percentage of total calories from fat?

$$30\%$$

What age-related change is associated with dysphagia, reflux, and constipation?

Neurodegeneration of the gut nervous system.

Why are older adults at increased risk for dehydration?

Decreased sensitivity of thirst mechanisms.

What effect does decreased gastric secretions have on nutrition?

May contribute to malabsorption and nutrient deficiencies.

What is 'anorexia of aging'?

Decreased appetite and intake leading to weight loss in older adults.

What differentiates pathological weight loss from normal aging changes?

Pathological weight loss results from factors other than normal aging.

What are five consequences of weight loss in older adults?

${\downarrow}$ bone mineral density, ${\downarrow}$ muscle mass, poor activity tolerance, ${\uparrow}$ fall risk, and frailty.

What are three risk factors for vitamin deficiencies in older adults?

Reduced caloric intake, reduced food variety, and medications.

What risk is associated with Vitamin D deficiency in seniors?

Worsening bone loss and risk of osteopenia or osteoporosis.

What are the associations given for folate deficiency?

Certain cancers (colon), cognitive impairment, and depression.

What is the normal fluid recommendation presented in the lecture?

$6-7$ eight-ounce glasses of water/fluid.

What is the purpose of the skin turgor test?

Hydration screening.

What are the two methods of dietary assessment mentioned?

$24$-hour recall and $7$-day food record.

Which nutrition tool is used for adults over $65$ and assesses weight, mobility, and illness?

MNA-SF (Mini-Nutritional Assessment Short Form).

What does the 'D' in the DETERMINE checklist stand for?

Disease.

What does the 'T' in the DETERMINE checklist stand for?

Tooth loss.

What does the 'M' in the DETERMINE checklist stand for?

Multiple medicines.

What does the 'E' in the DETERMINE checklist stand for in the context of age?

Elder years above age $80$.

What is the definition of aspiration?

Entry of a foreign substance into the lungs.

What is the definition of dysphagia?

Difficulty with any stage of swallowing or eating.

What is 'pocketing' in the context of feeding?

Keeping food between the teeth and cheek.

What is 'silent aspiration'?

Aspiration without coughing or choking.

What is the key exam phrase for assessing a meal?

Observe an entire meal in the setting in which the individual usually dines.

Which liquid consistency is 'slightly thicker than water'?

Nectar-like.

Which liquid consistency is the most viscous?

Spoon-thick.

List the order of liquid consistencies from least to most viscous.

Thin, Nectar-like, Honey-like, Spoon-thick.

What food consistency involves 'homogeneous, pudding-like foods requiring little chewing'?

Pureed.

What is the correct seated position for feeding?

Hips, knees, and feet at $90^{\circ}$, with the trunk/body at $90^{\circ}$ vertical.

What is the recommended distance from mouth to plate during feeding?

$10-15$ inches.

What adaptation is suggested for an impaired grip on utensils?

Plastic built-up handles.

What is the purpose of a universal cuff?

Allows self-feeding without having to grip a utensil.

What device is used for individuals who cannot extend their neck while drinking?

Nosey cup.

How do weighted utensils assist someone with tremors?

May reduce the intensity of tremors.

What is the purpose of a rocker knife?

Allows cutting with reduced wrist and grip demands.

What adaptation helps a person with the use of only one hand for eating?

Easy-cut plate and suction cups/nonskid mats.

What does the Rome IV criteria for constipation require regarding symptom duration?

Symptoms ongoing for at least $3$ months during the previous $6$ months.

What are two clinical symptoms required for Rome IV constipation diagnosis?

Straining (${\ge} 25\%$), Lumpy/hard stools (${\ge} 25\%$), or Incomplete evacuation (${\ge} 25\%$).

What is the frequency criterion for constipation in the Rome IV criteria?

$<3$ defecations per week.

What type of fiber is 'gel-like' and recommended for diarrhea?

Soluble Fiber.

What type of fiber attracts water and is recommended for constipation?

Insoluble Fiber.

Give examples of insoluble fiber foods.

Whole-grain bread, brown rice, nuts, green beans, berries, and spinach.

What is the definition of Stress Incontinence?

Involuntary sudden urine loss due to increased intra-abdominal pressure (e.g., coughing).

What is the definition of Urge Incontinence?

A sudden compelling urge to void followed by involuntary leakage.

What is a key sign of Overflow Incontinence?

Continuous dribbling.

What causes Functional Incontinence?

Physical or cognitive limitations that prevent reaching the toilet in time.

What is the definition of Nocturia?

Waking during the night to urinate ${\ge} 2$ times.

What is the target interval goal for bladder training?

$2.5-3$ hours between voids.

What is the protocol for Pelvic Floor Muscle Training (PFMT)?

$15$ contractions, hold for $10$ seconds, $3\times$ per day.

How should a person with Urge Incontinence react when an urge occurs?

Sit, relax, and perform $3-4$ quick pelvic-floor contractions; do not rush.