Ma. Pyle et Gt. Terezhalmy, ORAL DISEASE IN THE GERIATRIC-PATIENT - THE PHYSICIANS ROLE, Cleveland Clinic journal of medicine, 62(4), 1995, pp. 218-226
In the elderly, oral health has a profound impact on general well-bein
g. The ability to quickly identify potentially harmful oral health pro
blems is valuable to the physician, who generally will see an older pa
tient more often than the dentist will. Many medications and condition
s can contribute to xerostomia and, therefore, to the development of d
ental caries and destruction of the teeth. Periodontal disease can als
o lead to increased susceptibility to caries and loss of teeth but is
preventable through regular dental care. Bacteremia originating in ora
l foci can cause serious conditions such as endocarditis, infections o
f prosthetic joints and contamination of vascular access devices, espe
cially in immunocompromised patients. To reduce their risk of bacterem
ia, neutropenic patients should receive broad spectrum antibiotics bef
ore undergoing dental procedures. Oral cancer is easily treated if det
ected early. Patients undergoing cancer chemotherapy have special prob
lems, as chemotherapeutic agents are highly toxic to the oral mucosa.