Oral health for aging adults

what is good oral health required for?

mastication, speech, and protection

poor oral health conditions-

tooth loss, dental caries (tooth decay)

periodontal (gum) disease and chronic disease

diminished salivary flow

oral and pharyngeal cancers

oral pathogens

improved oral hygiene = enhanced _________ control

metabolic

consequences of poor oral health-

increases the risk of upper respiratory infection

aspiration pneumonia

febrile episodes

rheumatic fever

bacterial endocarditis

glomerulonephritis

diabetes

cardiovascular disease

cerebral and myocardial infarction

pain

age related changes in oral health-

tooth loss

untreated dental caries

periodontal disease

xerostomia

candidiasis infection

wears dentures

orofacial pain TMJ

facial oral sores, toothache, burning mouth

Occupational therapy practice considerations for oral health, changes in client factors

decreased memory

changes in perception

decreased tactile sensations

increased neuromusculoskeletal pain

decreased joint mobility

decreased muscle power

skills involved in oral care-

motor skills- grips and manipulates, upper extremity strength, coordination, stabilizing head position

process skills- locates and organizes items for oral care, sequences tasks

social skills- requests assistance appropriately

performance patterns involved in oral care-

habits- how they perform oral care

routine- a set schedule for oral care

environmental factors to consider when it comes to oral health-

physical environment

access to the bathroom to perform oral care

social expectations to perform oral care by caregiver

occupational therapy interventions to assist in oral care-

assistive technology

large-handle toothbrush

toothpaste dispenser

occupational therapy outcomes for oral care interventions-

improvement in oral health and prevention of negative oral health impacts

perform oral care with setup or AEs

decrease joint pain with ATs

increase self-efficacy

stages of swallowing-

preparatory stage

oral phase

pharyngeal phase

esophageal phase

barriers to oral hygiene-

inability to complete plate to mouth pattern

unable to hold or sense toothbrush in their hand

drooling or pocketing in the oral cavity

aspiration on toothpaste

loss of mobility and bolus control

delayed swallowing

inability to remain properly positioned during teeth brushing

OT assessments of oral health-

facial expression- lift your eyebrows and suck in your cheeks

lip control- smile or pucker

jaw control- open mouth as wide as possible

Intra-oral assessments-

tongue protrusion

tongue lateralization

tipping- touch your tongue to the roof

behaviors that indicate a person is non-adherent-

decreased saliva

decreased denture use

reduced access to dental care

mucosal lesions

gingival bleeding and inflammation

managing oral hygiene using threat reduction (MOUTH)

using cues

bridging actions

gestures

triggering- using praise to prompt completion of task

stage 1 of dementia and oral care-

absent minded, mild STM deficits

indecisive

decreased concentration

misplaces objects

performs basic ADLs

Stage II of dementia and oral care-

more alert in the morning

may be aggressive and hostile, combative

expressive or receptive aphasia

agnosia

hides items

does not recognize written work

safety is a concern

stage III of dementia and oral care-

reduced oral intake

risk of dysphagia

does not recognize caregiver

maximum assistance for basic ADLs

oral considerations when providing oral care to an individual with dementia (across all the stages)

bed bound

altered tone and position

primitive reflexes and paratonia

reduced oral intake

risk for dysphagia

dependent for oral care

helpless

unresponsive

when do you use a moistened toothette for oral care?

when an individual is high risk for dysphagia and other swallowing complications but are also max A for tooth brushing