“I think I’m just going to tie my tooth to a string and slam the door,” said one of my first patients, a kind and hilarious 83-year-old woman. We got an oral surgery consultation that cleared her extraction after considering her multiple comorbidities, and it was then I realized the unique challenges geriatric patients face in obtaining dental care.
Adults over the age of 65 will make up 20 percent of the total U.S. population by 2030, according to data published by the Federal Interagency Forum on Aging-Related Statistics. With the aging population growing and increasingly retaining their natural teeth, new challenges are arising in the management of geriatric oral health. Of my patients who are older adults, most suffer from comorbid conditions and take multiple medications. The health status of an older adult can range from functionally independent to cognitively impaired. As patients age, cognitive and physiological impairments can affect a patient’s ability to receive care.
Patients may experience physiological impairments such as age-related hearing or loss, osteoarthritis, limited mobility and decreased muscle mass. In general, local anesthetic is considered safe in older patients, but patients with declines in liver and kidney function may require a lower maximum dose of anesthetic. With analgesics, NSAIDS should be administered with caution to patients with history of renal disease and significant cardiovascular disease. For mild to moderate pain, the drug of choice for these patients is acetaminophen.
Read the rest of this article in the August 2018 issue of Contour magazine.
~Lindsey Janof, Boston ’19, District 1 Trustee
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