Chapter 48: The Older Adult Patient

Mrs. Jones is a new patient in your office. She explains that she does not want to have radiographs or a dental examination, just a cleaning. She goes on to say: "I do not want to spend all of that extra money because I am old. You know that people lose their teeth because they get old." What would be the best response for Mrs. Jones? *a) "Tooth loss increases with age, but not because of age." b) "Yes, I could not agree with you more." c) "If you refuse the exam and radiographs, it will save you money." d) "The doctor will get mad if you do not have the exam and radiographs." e) "This happens because older people think fluoride is bad for you." ?Subject: Chapter 48: The Older Adult Patient 2. ?Subject: Chapter 48: The Older Adult Patient 3. All of the following are physiologic changes that occur in the musculoskeletal system due to the normal aging process except one. Which one is the exception? a) Decrease in bone volume (mass) b) Diminished muscular strength and speed c) Curvature of cervical vertebrae d) Loss of elasticity in the ligaments *e) Reduced tolerance to temperature extremes ?Subject: Chapter 48: The Older Adult Patient 4.

a) "Tooth loss increases with age, but not because of age."

A) The need for careful, periodic examination of the oral mucosa from the lips to the throat is especially crucial for the older adult patient because oral cancer occurs with increasing frequency with advancing years. B) Many oral lesions exist with the patient being aware of them. a) Statement A is true and statement B is false. b) Statement A is false and statement B is true. c) Both statements are true. d) Both statements are false.

a) Statement A is true and statement B is false.

A) Xerostomia is prevalent in the elderly but is not a consequence of age. B) Radiation therapy is the most common cause of xerostomia. a) Statement A is true and statement B is false. b) Statement A is false and statement B is true. c) Both statements are true. d) Both statements are false.

a) Statement A is true and statement B is false.

Mrs. Wong is a 65-year-old patient in your periodontal practice. She suffers from osteoporosis and moderate periodontal disease. She walks slowly with stooped posture. She smokes one pack of cigarettes per day, claims that she does not drink, and takes no medications. What appointment management considerations should the clinician consider at this patient's visit? a) The hygienist should provide extra time for positioning and provide cushioning. b) The hygienist should talk the patient into quitting smoking. c) The hygienist should encourage the patient to limit alcohol consumption. d) The hygienist should invite the patient to an exercise class at her health club. e) The hygienist should suggest that the patient take plenty of vitamin D and calcium.

a) The hygienist should provide extra time for positioning and provide cushioning.

Communication with the older adult patient includes all the following, except: a) calling them by their first name. b) allowing sufficient time for reviewing complex histories. c) eliminating distracting background music. d) sitting facing the patient.

a) calling them by their first name.

Common oral changes associated with aging include all the following, except: a) embrasure spaces have full thickness. b) cervical third dental caries. c) decreased saliva production. d) deficient restorations.

a) embrasure spaces have full thickness.

All of the following would be important treatment considerations with Alzheimer patients except one. Which one is the exception? a) Power toothbrushes may improve dental biofilm removal. b) Do not allow the caregiver in the treatment area to avoid distraction. c) Consult with the patient's physician prior to treatment. d) Establish an aggressive preventive program including 3-month recalls. e) Provide repeated reinforcement.

b) Do not allow the caregiver in the treatment area to avoid distraction.

An older person's health status is influenced by many factors that fall under one of four groups. Biologic, environmental, and psychosocial are three of the four groups of factors. Which of the following groups of factors should be added to this list? a) Genetic factors b) Lifestyle factorsc) Inherited factors d) Immunologic factors e) Geographic factors

b) Lifestyle factorsc) Inherited factors

Which of the following disorders is not associated with aging? a) Hypertension b) Muscular dystrophy c) Diabetes mellitus d) Cardiovascular disease e) Dementia

b) Muscular dystrophy

All of the following are atrophic changes in the oral mucosa of the elderly, except: a) thinner tissue. b) increased vascularity. c) loss of elasticity. d) smooth shiny appearance.

b) increased vascularity.

Deep, red or bluish nodular dilated vessels on the ventral surface of the tongue in the elderly are called: a) sublingual carunculae. b) sublingual varicosities. c) sublingual veins. d) submandibular lymph nodes. e) sublingual fossae.

b) sublingual varicosities.

Which of the following oral manifestations is a result of normal aging? a) Stomatitis b) Glossitis c) Attrition d) Xerostomia e) Periodontitis

c) Attrition

A) The nutritional needs of older persons vary from those of younger persons. B) The dietary needs of the elderly require an increased need for calcium, vitamin D, and folate. a) Statement A is true and statement B is false. b) Statement A is false and statement B is true. c) Both statements are true. d) Both statements are false.

c) Both statements are true.

Angular cheilitis is often found in the elderly patient. Although it is not an age-related lesion, the etiology is believed to be which of the following? a) Xerostomia b) Polypharmacy c) Candidiasis and vitamin B deficiency d) Increased vertical dimension e) Use of anticalculus toothpaste

c) Candidiasis and vitamin B deficiency

Which of the following barriers to care is most often seen in the elderly? a) Fixed income after retirement b) Transportation problems c) Lack of perceived need d) Functional disabilities affecting mobility

c) Lack of perceived need

Mrs. Wong is a 65-year-old patient in your periodontal practice. She suffers from osteoporosis and moderate periodontal disease. She walks slowly with stooped posture. She smokes one pack of cigarettes per day, claims that she does not drink, and takes no medications. Mrs. Wong would like to know if osteoporosis can have an effect on her gum disease. What would be the best answer to give this patient? a) Osteoporosis has no effect on the bone in the oral cavity. b) The increased bone density can have an effect on gum disease. c) Periodontal microorganisms can more easily break down osteoporotic bone. d) There is evidence of residual ridge resorption in the mandible. e) Exercise and medications have a beneficial effect on bone mass.

c) Periodontal microorganisms can more easily break down osteoporotic bone.

Which age category does "oldest old" indicate? a) 55 years and older b) 65 years and older c) 75 years and older d) 85 years and older e) 95 years and older

d) 85 years and older

The older population has more of which type of caries than any other age group? a) Occlusal b) Proximal c) Lingual d) Root e) Deciduous

d) Root

All of the following are associated with vitamin B deficiency, except: a) atrophic glossitits. b) burning tongue. c) angular cheilitis. d) gingivitis.

d) gingivitis.

Mrs. Wong is a 65-year-old patient in your periodontal practice. She suffers from osteoporosis and moderate periodontal disease. She walks slowly with stooped posture. She smokes one pack of cigarettes per day, claims that she does not drink, and takes no medications. Your employer has asked you to contact this patient's physician to see if any particular medications have been suggested/prescribed. All of the following are possible medications used in the treatment of osteoporosis except one. Which one is the exception? a) Calcitonin b) Parathyroid hormone c) Selective estrogen receptor modulator (SERM) d) Bisphosphonate e) Calcium channel blocker

e) Calcium channel blocker

All of the following approaches to instruction of the elderly are recommended except one. Which one is the exception? a) Carefully assess the patient's ability to perform each technique. b) Base the instruction on the patient's functional status. c) Work from what the patient already knows. d) Allow sufficient time to give proper instructions. e) Make changes quickly.

e) Make changes quickly.

All of the following are physiologic changes that occur in the musculoskeletal system due to the normal aging process except one. Which one is the exception? a) Decrease in bone volume (mass) b) Diminished muscular strength and speed c) Curvature of cervical vertebrae d) Loss of elasticity in the ligaments e) Reduced tolerance to temperature extremes

e) Reduced tolerance to temperature extremes

Candidiasis is associated with all of the following except one. Which one is the exception? a) Head and neck radiation b) Chemotherapy c) Immunosuppressive drugs d) Use of antibiotics e) Sialolith

e) Sialolith