Abstract:The oral cavity is subject to age related processes such as cellular ageing and immunosenescence. The ageing population bears an increased burden of intraoral pathology. In oral medicine, the majority of presenting patients are in their fifth to seventh decade of life. In this review, we discuss the ageing population's susceptibility to mucosal disorders and the increased prevalence of potentially malignant disorders and oral squamous cell carcinoma, as well as dermatoses including oral lichen planus and immun… Show more
“…A recent study in the United Kingdom shows the profound financial impact of persistent orofacial pain on patients’ lives, in which the ‘hidden economical-social cost’ was calculated around 3000 GBP (Great Britain Pound) per year [13]. It has attracted attention and controversy as to HOW we should manage this syndrome in the elderly[14]. In this review, we discuss real-world, useful strategies for the management of patients with BMS, especially the elderly.Fig.…”
Burning Mouth Syndrome (BMS), a chronic intraoral burning sensation or dysesthesia without clinically evident causes, is one of the most common medically unexplained oral symptoms/syndromes. Even though the clinical features of BMS have been astonishingly common and consistent throughout the world for hundreds of years, BMS remains an enigma and has evolved to more intractable condition. In fact, there is a large and growing number of elderly BMS patients for whom the disease is accompanied by systemic diseases, in addition to aging physical change, which makes the diagnosis and treatment of BMS more difficult. Because the biggest barrier preventing us from finding the core pathophysiology and best therapy for BMS seems to be its heterogeneity, this syndrome remains challenging for clinicians. In this review, we discuss currently hopeful management strategies, including central neuromodulators (Tricyclic Antidepressants - TCAs, Serotonin, and Norepinephrine Reuptake Inhibitors - SNRIs, Selective Serotonin Reuptake Inhibitors - SSRIs, Clonazepam) and solutions for applying non-pharmacology approaches. Moreover, we also emphasize the important role of patient education and anxiety management to improve the patients’ quality of life. A combination of optimized medication with a short-term supportive psychotherapeutic approach might be a useful solution.
“…A recent study in the United Kingdom shows the profound financial impact of persistent orofacial pain on patients’ lives, in which the ‘hidden economical-social cost’ was calculated around 3000 GBP (Great Britain Pound) per year [13]. It has attracted attention and controversy as to HOW we should manage this syndrome in the elderly[14]. In this review, we discuss real-world, useful strategies for the management of patients with BMS, especially the elderly.Fig.…”
Burning Mouth Syndrome (BMS), a chronic intraoral burning sensation or dysesthesia without clinically evident causes, is one of the most common medically unexplained oral symptoms/syndromes. Even though the clinical features of BMS have been astonishingly common and consistent throughout the world for hundreds of years, BMS remains an enigma and has evolved to more intractable condition. In fact, there is a large and growing number of elderly BMS patients for whom the disease is accompanied by systemic diseases, in addition to aging physical change, which makes the diagnosis and treatment of BMS more difficult. Because the biggest barrier preventing us from finding the core pathophysiology and best therapy for BMS seems to be its heterogeneity, this syndrome remains challenging for clinicians. In this review, we discuss currently hopeful management strategies, including central neuromodulators (Tricyclic Antidepressants - TCAs, Serotonin, and Norepinephrine Reuptake Inhibitors - SNRIs, Selective Serotonin Reuptake Inhibitors - SSRIs, Clonazepam) and solutions for applying non-pharmacology approaches. Moreover, we also emphasize the important role of patient education and anxiety management to improve the patients’ quality of life. A combination of optimized medication with a short-term supportive psychotherapeutic approach might be a useful solution.
“…1,2 Older individuals are retaining more teeth into old age, however, are at increased risk for caries, periodontitis, hyposalivation and oral mucosal pathology due to the impact of systemic diseases, medication use and side effects, and diminished functional status. [3][4][5][6][7][8][9][10] Furthermore, progression of oral diseases accelerate as the ageing adult transitions into frailty, evidenced by the doubling of the annual dental caries increment in nursing home residents and persons with dementia compared to their healthier community-dwelling counterparts. 11,12 Additionally, a high chronic disease burden in older adults results in challenges imposed by impairments in capacity for consent, mobility, communication ability, cooperation for treatment, swallowing capacity, the ability for oral self-care and medical conditions that impact oral care provision.…”
Section: Introductionmentioning
confidence: 99%
“…Today's dental practitioners continue to confront a rapidly ageing patient demographic, and the dental management of the ageing patient is fraught with complexities 1,2 . Older individuals are retaining more teeth into old age, however, are at increased risk for caries, periodontitis, hyposalivation and oral mucosal pathology due to the impact of systemic diseases, medication use and side effects, and diminished functional status 3–10 . Furthermore, progression of oral diseases accelerate as the ageing adult transitions into frailty, evidenced by the doubling of the annual dental caries increment in nursing home residents and persons with dementia compared to their healthier community‐dwelling counterparts 11,12 .…”
ObjectivesThis study aimed to assess dentists' attitudes toward providing dental care for older adults with disabilities in Singapore and the factors influencing their willingness to provide care.BackgroundDentists face a rapidly ageing patient demographic. Practitioner unwillingness to circumvent the attending challenges of care provision prevents older adults from accessing the dental care necessary for better oral and systemic health. Previous studies have reported on dentists' attitudes toward caring for older adults with disabilities; however, these are mostly limited to dependent older adults and exclude frail, community‐dwelling older persons.MethodsA cross‐sectional study was conducted in 2020 using a self‐administered questionnaire. Quantitative data analysis was presented in the form of descriptive statistics, followed by bivariate analyses.ResultsThere were 193 respondents, a response rate of under 9%. Dentists were less willing, confident and involved in the care of older adults with disabilities as the individual's severity of impairments increased. Less than half of respondents were willing to treat individuals with severe disabilities in cooperation (23.3%), swallowing (30.6%), mobility (33.7%) and communication (45.1%). Dentists with training in geriatric dentistry were more willing to provide care. However, younger dentists, general dental practitioners, private practitioners and public sector dentists had specific restraining and driving forces, which further modulated their willingness to provide care.ConclusionsThe current areas of training needs among Singapore dentists are in severe impairments of swallowing, communication, cooperation and mobility. Further geriatric dentistry training may effectively increase dentists' willingness to provide care; however, additional specific targeted interventions are also needed.
“…The mucosa of the oral cavity is subject to age-related processes such as cellular aging and immunosenescence [3][4][5][6]. For some authors, increasing age, particularly above 60 years, should be considered to be a risk factor for the development of oral squamous cell carcinoma [3,7], although the exact role of aging in the carcinogenic process remains unknown. Gingival and cheek mucosa localizations are more frequent in the elderly [8].…”
Section: Introductionmentioning
confidence: 99%
“…Gingival and cheek mucosa localizations are more frequent in the elderly [8]. Many hypotheses have been put forward, such as an increased mutational load, exposure to carcinogens, diminished awareness, inadequate nutrition, and altered immunity [3].…”
Introduction: Age-related processes in the oral mucosa increase the risk of cancer. The gingiva is the most common localization in the upper aerodigestive tract in the elderly. The aim of this study was to compare the patient and the tumor characteristics, treatments, disease-free survival, and overall survival for gingival squamous cell carcinoma in patients less than and older than 70 years of age.
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