Dental care for elderly patients

According to the elderly exist in the physical and psychological characteristics of elderly patients for dental care in depth is to ensure that the prerequisite for successful treatment.

1 the characteristics of elderly patients
1.1 Oral diseases characterized by old age: with age, older oral tissue corresponding changes in the specific performance of oral tissues to increase susceptibility to disease and reduced ability to repair and lead to the corresponding diseases. Elderly because of the oral cavity salivary glands of the degenerative change, reduce the secretion of saliva flow rate slow erosion of the teeth and the self-cleaning capacity decreased, while periodontal physiological or pathological atrophy and shrink the gap widened teeth, food impaction and food residue can remain, to the mouth pathogens provided favorable conditions for breeding, easily lead to the incidence of dental caries and following the occurrence of dental caries in the elderly the main reason for medical treatment in addition often elderly and have hypertension, diabetes may cause circulation disorder, blood sedimentation, malnutrition, periodontal tissue, metabolite accumulation, so that the incidence of periodontal disease increased the permeability of enamel to reduce elderly because, to reduce moisture and organic ingredients, fragility, causing the destruction of enamel, while long-term process of mechanical chewing of wear, occlusal wear, the appearance of tooth wear more common. In addition, the elderly, because dentin exposed to cold, heat, acid and mechanical stimulation are sensitive, easy to cause of dentin hypersensitivity. Thus, changes in the body in elderly patients This has led to a certain age and characteristics of oral diseases increases.

1.2 in elderly patients with physical and psychological characteristics: is affected by many factors, the psychological characteristics of older people a series of changes, and these changes often lead to psychological treatment delays; First, stubborn temperament, is not easy to accept the advice of others, for medical treatment do not understand; Second, there is tension or fear that dental phobia, especially newly diagnosed patients, mainly due to the fear stems from the treatment equipment and lower pain threshold, according to our survey, about 50% of elderly patients presence of dental phobia, and in all treatments, the most fear is the fear of tooth extraction and dental drill above factors, coupled with the presence of the elderly mobility, many patients in the hospital early in the disease not to delay or even abandon treatment, missed the best time of treatment, making it difficult to treat disease, can not achieve the best results.

2 With increasing age, older people with other diseases also rate the relative increase in the elderly dental patients, dental treatment affect the main comorbidities of hypertension, coronary heart disease and diabetes.

2.1 Hypertension: Hypertension is common old age, as older people in varying degrees of arterial sclerosis, and treatment of dental fear and other effects, will enable the process of medical treatment of hypertension in patients with symptoms in addition hypertension due to vascular poor flexibility, reflex sympathetic regulation of vascular reduced, the treatment can cause a long lie down after the occurrence of orthostatic hypotension.

2.2 Coronary heart disease: coronary heart disease more acute, dangerous, including angina pectoris, the pain may radiate to the jaw, even as medical symptoms, and treatment of dental pain and other factors may become acute incentives.

2.3 Diabetes: In recent years dental patients with diabetes on the rise, with diabetes as protein, fat metabolism disorders, high blood sugar beneficial bacteria, white blood cell movement and phagocytosis was inhibited, combined with vascular disease, poor nutrition, tissue, granulation tissue formation poor, resulting in wound healing, while significantly increased susceptibility to inflammation, and incidence of periodontal disease has a close relationship.

3 dental clinic nursing of elderly patients
3.1 Psychological care: the elderly have more intense psychological treatment, mainly for treatment by the medical staff do not understand the attitude and influence, it should first be treated with a good attitude, patient and meticulous process of interpretation of the treatment, reduce the patient's mental burden of dental phobia oral elderly patients sometimes become an obstacle to the decisive factor in medical treatment, to establish good good nurse-patient relationship, strengthen good and effective psychological care is to reduce the psychological barriers to effective means, with love, care, sincerity to help patients successfully complete course of treatment. Links to free download http://www.hi138.com 3.2 to help with mobility: the elderly to move slowly, its arm to the teeth to help chair, abdominal strength and because the elderly poor-ups more difficult, suction fluid therapy may be used, or transferred to the dental chair for sitting on the spit saliva or mouth rinse.

3.3 features senile dental care: the elderly temporomandibular joint ligament laxity, the treatment should be controlled mouth opening. Pharyngeal reflex slow the elderly, should be taken to avoid inhalation or ingestion of foreign bodies, dental chair can be transferred into the ground into 30 to 50 °.

3.4 Treatment of care: to ensure good treatment of the anesthetic effect can effectively reduce the psychological stress of patients, while surgery may be appropriate to transfer the patient's attention. Elderly poor tolerance to the body, fatigue, treatment may be appropriate to enable patients to rest moment, to reduce fatigue caused by long mouth.

3.5 Postoperative care: the treatment of patients after timely notice to relieve the tension of feeling. Pre-surgery may explain the phenomenon and the emergence of some common precautions.

3.6 Oral health guidance: It is recommended oral elderly patients to eat more foods rich in fiber, multi-line to produce more saliva to chew easy to remove food residue.

4 comorbidities of care when treatment
4.1 Care of patients with hypertension: blood pressure should be monitored before treatment and records, strict control of surgical contraindications, early hypertension, the proper treatment, control of blood pressure at 160/95 mmHg, and for oral treatment tooth preparation patients, should do the preparatory work, 1 hour before surgery to give the right amount of tranquilizers, to ensure that extraction should be painless, the local anesthetic lidocaine is appropriate to use. the heart, brain, kidney patients have damage to late , the larger the risk of tooth extraction, there may be cerebral hemorrhage, heart failure or kidney failure, tooth extraction should be suspended in the injection of local anesthetic after the changes in blood pressure should be closely observed for patients with longer treatment time, sit up slowly after the end of treatment to prevent the occurrence of orthostatic hypotension was observed after 10min of no symptoms before leaving.

4.2 Care of patients with coronary heart disease: the recent June had angina or myocardial infarction within the patients, dental treatment should be appropriate delay, the initial medical examination and treatment for coronary heart disease without contraindications in patients receiving dental treatment , the need to expand routine with cardiovascular drugs, oxygen and the necessary rescue equipment and drugs.

4.3 diabetes care: diabetes because of poor tolerance for surgery, prone to water, electrolyte imbalance and acidosis, complicated by postoperative infection in outpatient surgery patients before surgery should check to see blood sugar levels, blood glucose control, regular antibiotics. Care should be strictly aseptic operation, to prevent unnecessary infection appear. to guide treatment in patients with diabetes diet eat strictly, to prevent the occurrence of low blood sugar treatment, clinic 50% of normal glucose ready for emergencies. Links to free download http://www.hi138.com