Dental Treatment of Geriatric (Old) Patients
Aging is the process by which a person grows old, irrespective of the tune required. It includes the complex interactions of biologic, psychologic and sociologic processes over time. The historically accepted chronologic landmark of old age is 65 years. The geriatric literature refers to the following categories, functionally dependent elderly (with illness or impairment), frail and institutionalized elderly, young old—65 to 70 years of age (healthy and vigorous), Old—75 to 85 years of age and old—85 years of age and above.
Socio-economic status seems to play a role, as do functional dependence and poor health status.
Many elderly patients become frustrated easily, especially in the anxiety-provoking dental environment. On the other hand, many geriatric patients may respond well to therapy and be tolerant of long procedures. The dentist must be cognizant of treating individuals who have unique life experiences, expectations and needs.
Oral Hygiene Instruction
Before beginning oral hygiene instruction, the practitioner should consider the special needs of the geriatric patient. The clinician should speak clearly, establish good eye contact, not raise his or her voice (especially into a hearing aid) and adapt to the patient. The following should be included in oral hygiene instruction :
1. The patient should establish a daily routine.
2. Fluoride dentitrices should be used.
3. Instruction can be adapted as needed :
• Toothbrushes can be bent under hot water.
• Handless can be customised with acrylic coating, a bicycle grip or a rubber ball to enhance the grip for patients with arthritis or other disorders.
• The patients can use electrical brushes or interproximal brushes as needed.
Treatment of Dental Disease
Elderly patients categorized as frail, functionally dependent, of emotionally or psychologically not amenable to surgical periodontal therapy may require scaling, root planning and frequent monitoring, rather than surgical intervention. The treatment plan depends on the goal of therapy and the patient’s medical status, attitude, degree of support and ability to maintain adequate oral hygiene. The range of care options includes palliative therapy, radical therapy (extraction) or tooth retention therapy.
In conclusion the geriatric population is expanding, and their needs for periodontal services are becoming specialized. The variety of intraoral, medical, social, mental and physical problems encountered provide unlimited challanges to the clinician. If the needs of the geriatric patients are to be met, clinicians must be willing to care for each individual with patience. The mouth must be viewed as a reflection of the systemic condition, and treatment should be approached accordingly.
HIV Infection and AIDS
The epidemic, human immuno-deficiency virus (HIV) infection and the subsequent Acquired Immune Deficiency Syndrome (AIDS) is spreading like wild fire across the world. There is no discrimination with regard to age, sex, race, colour and nation.
HIV Infection
It is defined as the period between initial exposure to and infection by HIV and development of an HIV and of HIV-specific antibody response.
AIDS
It is the final stage of HIV disease meaning the second stage and HIV infection.
Can an HIV-positive surgeon or dentist infect his patients?
This fear has gripped many people ever since AIDS struck the world. The answer is absolutely not.
Even in our fight against AIDS, self help is probably our best help. Studies of HIV-positive people who continue to have an effective immune system show that cells called CD8+T cells can slow down the spread of the virus in the body.