Oral Healthcare and the Frail Elder, 2nd Edition

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