สุขภาพช่อง ปาก : สุขภาพผู้สูงอายุ พญ. สิรินทร ฉันศิริกาญจน หน่วยเวชศาสตร์ผู้สูงอายุ ภาควิชา อายุรศาสตร์ คณะแพทยศาสตร์ โรงพยาบาล รามาธิบดี

Contents Demographic Thai geriatric population Age-related physiologic changes Complication of tooth lose –Local complication –Systemic complication Odontogenic complication

Geriatric Population Definition WHO > 60 Europe + North Amer. > 65

Population in Thailand พ. ศ m = 5.58 % พ. ศ m = 6 % พ. ศ m = 15.7 %

จำนวนและร้อยละของผู้สูงอายุไทย อายุ 60 ปีขึ้นไป จำนวน ( ล้าน ) ร้อยละ ปี + ร้อยละ

2503 ชาย หญิง ลักษณะประชากรของประเทศไทย 2503

ชายหญิง ลักษณะประชากรของประเทศไทย 2523

ชาย หญิง ลักษณะประชากรของประเทศไทย

ชาย หญิง ลักษณะประชากรของ ประเทศไทย

Characteristics of Aging Patients Physiologic functions diminished Accumulation of life’s stresses, diseases, and environmental hazards “ Classic ” signs and symptoms of disease possibly absent, delayed, or altered

Geriatric Medicine11 Characteristics of Aging Patients Physical disease may present as psychiatric syndrome Psychiatric illness may present as a medical complaint Multiple medical, psychiatric, and social problems in the same patient Drug effects more pronounced and adverse reactions more common

EATING AND NORMAL AGING Taste sensation but not discrimination is diminished:  Tendency to add more salt and sweetener (especially sugar) to food  Can still discriminate sweet from salty Diminished olfactory function further impairs taste sensation

CHEMOSENSORY PERCEPTION Olfactory function declines with age Changes in perceived degree of saltiness and sweetness Complaints of taste and smell dysfunction are common in older adults Drugs may adversely affect smell and taste

COMMON BUT NOT NORMAL Xerostomia (but salivary function not significantly reduced with aging) Reduced chewing efficiency and efficacy with loss of multiple teeth Esophageal dysmotility

ORAL CAVITY Dysfunction and disease in the mouth may be important risk factors for nutritional impairment Increasing age and history of prior restorative dentistry make teeth less sensitive, thereby predisposing to unnoticed and more possibly irreparable tooth destruction Dry mouth, decay, missing teeth, and periodontal disease are common but do not represent normal aging

TOOTH LOSS Most common causes of tooth loss:  Inability or unwillingness to access and pay for preventive/restorative dental treatment  Loosening of teeth from periodontal disease  Removal of healthy teeth in preparation for dental prosthesis Diminished chewing efficiency and efficacy, and reduced range of preferred foods, are associated with loss of multiple teeth

Tooth lose : local complications Increase bone lose at the pulp Teeth fall Maxillary bone lose Ill- fixing denture Not so smart Poor pronunciation

Tooth lose : systemic complications Lose of confidence, isolation, depression Under nutrition – protein, fruit & vegetable Fraility Obese, dyslipidemia

Tooth lose : systemic complications Constipation –Bloating, lose of appetite –Fecal impact –Diverticulosis, diverticulitis and complication –Cancer of colon

Tooth lose : systemic complications –Low immune – increase risk of infection Periodontitis Root abscess Soft tissue at floor of mouth : Lugwig’s angina Brain abscess Infected abdominal aortic aneurysm

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