Fully updated reference to clinical knowledge and strategies for effective oral healthcare in frail older adultsTaking an evidence-based approach, with theoretical and clinical knowledge underpinned by the literature, Oral Healthcare and the Frail Elder provides a comprehensive reference to management strategies for dental diseases as noncommunicable diseases in older populations. The book presents a global perspective with current guidance for clinicians, addressing the particular challenges of providing dental care for people who are confronting frailty in old age. Reflecting the numerous developments in the discipline since the previous edition was published, this Second Edition has been thoroughly updated throughout with 15 new chapters.The first section covers background information, including demographics, social considerations, and factors affecting oral health in this population. The second half of the book is devoted to clinical management strategies.Some of the new topics discussed in this edition of Oral Healthcare and the Frail Elder include: Theories and significance of oral health in frailty and oral health-related quality of life, and the influence of the life-course on oral health How sugar, tobacco, and alcohol initiate and sustain oral diseases, as with other noncommunicable diseases, into old age Mitigation of dental caries, periodontitis, gingivitis, mucositis, and other non-communicable diseases of the mouth Infection control, communications and tele-dentistry, mobile dental services, and strategies to appraise the usefulness of community-based oral healthcare programs With an emphasis on population and public health in the context of non-communicable disease, the Second Edition of Oral Healthcare and the Frail Elder is an important resource for clinicians dealing with the geriatric population, including dentists, dental hygienists, dental therapists, denturists and dental technicians, nurses, and geriatricians.

Autorentext

The Editors Michael I. MacEntee, LDS(I), Dip Prosth, FRCD(C), PhD, FCAHS, FFDRCSI, is an Emeritus Professor of Prosthodontics and Dental Geriatrics at the University of British Columbia in Vancouver, British Columbia, Canada. Frauke Müller, Dr med dent habil, Dr hc (University of Thessaloniki), is Professor and Chair for Gerodontology and Removable Prosthodontics at the University Clinics of Dental Medicine at the University of Geneva in Geneva, Switzerland. C. Peter Owen, BDS, MChD, MScDent, FCD(SA), is an Emeritus Professor of Prosthodontics at the School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand in Johannesburg, South Africa. W. Murray Thomson, BSc, BDS, MComDent, MA, PhD, FRSNZ, is an Emeritus Professor of Dental Epidemiology and Public Health at the University of Otago in Dunedin, New Zealand.

Inhalt

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 O…