OT 504 week 7 LG 2 Nutrition, Feeding, and Oral Health, in Older Adulthood

Why is daily oral hygiene considered an important occupation?

It is a vital grooming and self-care activity that supports essential human functions like eating, speaking, and maintaining self-esteem

What factors make daily oral care more difficult for older adults?

Compromised general health and a reduced physical or cognitive capacity for independent self-care .

What is a major issue regarding daily oral care in nursing homes?

It is frequently inadequate due to limited staff training, understaffing, and resident behaviors that resist personal care.

Is oral hygiene an ADL or IADL?

Oral hygiene is considered an IADL (Instrumental Activity of Daily Living) because it requires more complex decision-making and planning compared to basic personal care.

What are some specific reasons why older adults might have difficulty participating in and performing oral health care?

physical limitations, cognitive decline, inadequate access to dental care, medications that cause xerostomia, and lack of assistance from caregivers.

What percentage of adults ages 65–74 wear dentures?

13%.

What percentage of adults age 75 and older wear dentures?

22%.

What percentage of adults age 65+ have gum disease?

60%.

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

96%.

What percentage of adults age 65 have dry mouth?

30%.

What percentage of adults age 80 have dry mouth?

40%.

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

Periodontal disease, Dental decay, Oral cancer, Dry mouth

What is gingivitis?

Inflammation of the gums characterized by: Redness, Bleeding

What is periodontitis?

Advanced periodontal disease causing: Bone loss, Gingival recession, Root sensitivity Increased risk for root caries

what is root caries?

A type of dental decay that occurs on the roots of teeth, often associated with gum recession. It can lead to sensitivity and further tooth damage if not treated.

What is the major oral-systemic connection with periodontitis?

Inflammation.

What is plaque?

A dental biofilm composed of living bacteria.

Is plaque visible?

No—it is invisible.

How quickly does plaque form?

Every 12–24 hours.

What is calculus (tartar)?

Calcified plaque (calcified bacteria).

Why is calculus harmful?

It harbors plaque and bacteria.

How long does it take calculus to form?

Approximately 2 weeks.

What are the two main methods of plaque removal?

Toothbrushing and Flossing

What two diseases are prevented by plaque removal?

Gingivitis and Dental decay

How often should patients floss?

Once every night.

Should flossing occur before or after brushing?

Before brushing.

What shape should floss make around the tooth?

A C-shape.

What motion is recommended when flossing?

Up-and-down motion.

How many strokes should be used per tooth surface?

3–5 strokes.

What are common types of floss?

Waxed, Unwaxed, Teflon-coated

Why may traditional hand flossing not be ideal for some older adults?

Limited hand strength, dexterity, arthritis, or decreased ROM.

What are alternatives to traditional floss?

Floss picks, Interdental brushes, Electric flossers,Water flossers

What type of toothbrush is recommended?

Soft or extra-soft.

What brushing motions are recommended?

circular and roll motion

What brushing directions may also be used?

vertical and horizontal

what is the cons of vertical and horizontal brushing?

They may cause gum recession and are less effective in cleaning.

How is a power toothbrush used?

Hold it in place and allow it to do the work.

What are some adaptive toothbrush options for patients with limited hand function?

Enlarged handles, Triple-head toothbrushes, Electric toothbrushes, Foam or tennis-ball handle adaptations

According to the lecture, what is the recommended sequence?

Floss first → Brush second.

What is the best time to floss?

At night before brushing.

What are the three steps of denture cleaning?

1. Brush

2. Rinse

3. Soak overnight

Why should dentures be soaked overnight?

To prevent:

• Cosmetic changes

• Fungal infections

• Mouth sores

• Bad breath

What four factors contribute to dental caries?

• Microorganisms

• Cariogenic diet

• Salivary factors

• Tooth resistance

How can dental decay be prevented?

• Fluoride

• Plaque removal

• Limiting sugary snacks

What ingredient reduces gingivitis, plaque, and cavities?

Stannous fluoride.

Four common oral health conditions?

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

Gingivitis vs. periodontitis?

• Gingivitis: Redness, inflammation, bleeding.

• Periodontitis: Bone loss, recession, root sensitivity, root caries risk.

Plaque forms in how long?

12–24 hours.

Calculus forms in approximately how long?

2 weeks.

Flossing recommendations?

Once nightly, before brushing, C-shape, up/down motion, 3–5 strokes per surface.

Best toothbrush recommendation?

Soft or extra-soft toothbrush.

How should dentures be maintained?

Brush, rinse, and soak overnight.

what is the recommended fluoride amount for Nano-Hydroxyapatite/ Fluoride Free toothpaste?

15%

What is the recommendation for nonprescription fluoride mouthrinses(0.05% sodium fluoride (NaF)?

Use once daily (1×/day) Swish for 1 minute

What is the recommendation for nonprescription fluoride mouthrinses (0.02% NaF)?

Use 2 times per day (2×/day) Swish for 1 minute

What are the recommendations for nonprescription antimicrobial mouthrinses?

• Active ingredients:

  • Eucalyptol

  • Menthol

  • Methyl salicylate

  • Thymol

• Use 2 times/day

• Swish for 30 seconds

• pH: 4.1–5.5

How long should you wait to brush or rinse after meals?

• Wait 30–60 minutes

• Depends on what you eat (especially acidic foods/drinks).

What are common causes (etiologies) of dry mouth (xerostomia)?

• Medications

• Alcohol

• Smoking

• Radiation therapy

• Chemotherapy

• Mouth breathing

• Foods that lower pH

How can dry mouth (xerostomia) be relieved?

• Chew sugar-free gum or use sugar-free mints

• Sip water frequently

• Limit caffeine intake

• Avoid mouthrinses containing alcohol

• Stop tobacco use

• Use over-the-counter saliva substitutes

• Use mouthwash designed for dry mouth

• Add moisture to the air at night (humidifier)

What type of mouthwash is not recommended for patients with dry mouth (xerostomia)?

Alcohol-containing mouthrinses, because they can worsen dry mouth.

Recommended instead: Use an alcohol-free mouthwash or one specifically formulated for dry mouth (xerostomia)

What is the recommended technique for oil pulling?

• Use 1 tablespoon of oil.

• Swish for 10–20 minutes.

• Spit into the trash (not the sink).

• Rinse with water and brush your teeth afterward.

What is the claimed benefit of oil pulling?

It is claimed to reduce the bacterial load in the mouth.

Does the evidence support oil pulling for preventing tooth erosion or improving oral health?

No. Although there are many studies on oil pulling, there is currently no strong evidence supporting its effectiveness for preventing tooth erosion or providing significant oral health benefits.

Why are sugary snacks harmful to oral health?

They lower the pH in the mouth, creating an acidic environment that increases the risk of tooth decay (caries) and tooth erosion.

What three factors about sugar affect the risk of dental decay?

• Type of sugar (refined vs. natural)

• Form of sugar (liquid, sticky, or long-lasting)

• Time of consumption (especially between meals)

Which forms of sugar are most harmful to teeth?

• Sticky

• Long-lasting

• Liquid (especially sugary drinks that bathe the teeth)

When is eating sugary snacks most harmful to teeth?

Between meals, because it exposes the teeth to acid attacks more frequently without the protective effects of saliva and mealtime stimulation.

Is it better to eat sugary foods with a meal or between meals?

With a meal. It is better to eat sweets all at once during a meal than to snack on them throughout the day because:

• Saliva production increases during meals, helping neutralize acids.

• Eating sugar in one sitting causes fewer acid attacks than multiple sugary snacks between meals.

• The frequency of sugar exposure is more harmful than the total amount consumed

Which is worse for teeth: eating one candy bar with lunch or eating small pieces of it throughout the afternoon?

Eating small pieces throughout the afternoon is worse because it repeatedly lowers oral pH and exposes the teeth to multiple acid attacks, increasing the risk of tooth decay.

what are mouth lesions?

Nagging mouth pain, Bleeding sore, white or red spot, lump in the neck, feeling that something is caught in the throat

what are 5 types of oral lesions?

cold sore, canker sore, black hairy tongue, and thrush, and oral cancer

what is oral cancer?

Oral cancer refers to malignant growths that occur in the tissues of the mouth, throat, or lips. It can manifest as sores, lumps, or discolored patches, and is often linked to risk factors such as tobacco use and heavy alcohol consumption.

what is thrush?

a fungal infection caused by an overgrowth of Candida species, often appearing as white patches in the mouth and throat. It commonly occurs in individuals with weakened immune systems or those using certain medications, such as antibiotics.

what is black hairy tongue?

A benign condition characterized by the elongation and discoloration of the filiform papillae on the tongue, often resulting in a black or dark appearance.

what is a cold sore?

A viral infection typically caused by herpes simplex virus type 1 (HSV-1), appearing as painful, fluid-filled blisters on or around the lips. Cold sores are contagious and often recur due to stress, illness, or sun exposure.

what is a canker sore?

A type of ulcer that occurs inside the mouth, characterized by painful, round sores with a white or yellow center and a red halo. Canker sores are not contagious and can be triggered by stress, injury, or certain foods.

How are oral lesions transmittted?

sharing utensil and kissing

what disease could be transmitted through sharing utensils and kissing?

Bacteria, herpes, and virus

Out of thrush, canker sore, oral cancer, black hairy tongue, and cold sore, which is contagous?

A cold sore is contagious and typically caused by the herpes simplex virus. Unlike canker sores, cold sores can be spread through direct contact.

what is bad breath called?

Halitosis

what is bad breath usually treated by?

tongue brushing, therabreath mouthwash, and flossing.

Why is oral hygiene considered an occupation?

It is an ADL involving grooming and self-care.

Why is daily oral care often difficult for older adults?

Compromised general health and reduced capacity for self-care.

Why is oral care often inadequate in nursing homes?

Assisted brushing and denture cleaning are frequently insufficient.

What are OT's two major roles in oral health?

• Screen and refer to dental specialists

• Evaluate and intervene to improve oral hygiene performance

What performance skills should OT assess for oral care?

• Strength

• Fine motor skills

• Gross motor skills

• Vision/perceptual skills

• Sensation

• Cognition

Name five common oral health concerns in older adults.

• Dentures

• Periodontal disease

• Dental decay

• Oral cancer

• Dry mouth

what two screenings are use to assess oral health?

 ADLs (Katz-ADL) and BOHSE

What do OT interventions for oral health primarily depend on?

1. What is the issue?
2. Why is it happening?

What should an OT determine before choosing an oral health intervention?

The underlying cause of the oral health problem, not just the symptom.

What OT intervention is appropriate if a client forgets the steps of brushing their teeth?

Sequencing and practice.

What OT intervention is appropriate if a client has difficulty holding a toothbrush due to weak grip or arthritis?

Adapting equipment (e.g., built-up handle or electric toothbrush).

What does education and training include for oral health?

Teaching proper brushing/flossing techniques, denture care, and establishing healthy oral hygiene habits.

When are external memory aids used in oral health interventions?

When cognitive changes cause clients to forget oral hygiene routines.

Give examples of external memory aids for oral care.

Checklists, calendars, alarms, phone reminders, or picture cue cards.

A client with dementia frequently forgets to brush their teeth. Which OT intervention is most appropriate?

Use external memory aids to compensate for cognitive deficits.

A client knows they should brush their teeth but cannot coordinate the steps. Which intervention is best?

Sequencing and practice.

A client has Parkinson's disease and difficulty gripping a toothbrush. Which intervention is most appropriate?

Adapting equipment, such as a built-up grip or electric toothbrush.

What are micronutrients?

Nutrients the body needs in small amounts for normal growth, metabolism, and body function.

What are the three types of micronutrients?

• Essential vitamins

• Minerals

• Trace elements