Podcast
Questions and Answers
What was the total cost of the dental extractions for the 59-year-old male in April 2011?
What was the total cost of the dental extractions for the 59-year-old male in April 2011?
In which demographic group was the highest percentage of 65+ year olds with unfilled caries recorded from 2011-2016?
In which demographic group was the highest percentage of 65+ year olds with unfilled caries recorded from 2011-2016?
Which tooth was specifically mentioned as being extracted in pieces during the April 2011 admission?
Which tooth was specifically mentioned as being extracted in pieces during the April 2011 admission?
What was the main reason for the patient's limited range of motion in the right temporomandibular joint (TMJ)?
What was the main reason for the patient's limited range of motion in the right temporomandibular joint (TMJ)?
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By 2030, what percentage of Non-Hispanic Whites aged 65 and older is projected in the U.S.?
By 2030, what percentage of Non-Hispanic Whites aged 65 and older is projected in the U.S.?
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Which demographic had the lowest percentage of people with unfilled caries according to the data provided?
Which demographic had the lowest percentage of people with unfilled caries according to the data provided?
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What dietary recommendation was given to the patient after the dental extractions?
What dietary recommendation was given to the patient after the dental extractions?
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Which racial group is expected to have an increase in percentage from 2010 to 2030, as per the demographic projections?
Which racial group is expected to have an increase in percentage from 2010 to 2030, as per the demographic projections?
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What impact does the aging population have on dental health care practices?
What impact does the aging population have on dental health care practices?
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Which of the following best describes the principles of geriatric medicine?
Which of the following best describes the principles of geriatric medicine?
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What is a significant characteristic of the population pyramid from 1900 to 2000?
What is a significant characteristic of the population pyramid from 1900 to 2000?
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What is one of the goals of long-term oral health care for the elderly population?
What is one of the goals of long-term oral health care for the elderly population?
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In what aspect is the Seattle Care Pathways most beneficial for geriatrics?
In what aspect is the Seattle Care Pathways most beneficial for geriatrics?
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Which statement is true regarding oral health disparities in the aging population?
Which statement is true regarding oral health disparities in the aging population?
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What is one major aspect of communication with caregivers in geriatric care?
What is one major aspect of communication with caregivers in geriatric care?
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Which of the following is a common chronic disease affecting the older adult population?
Which of the following is a common chronic disease affecting the older adult population?
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What percentage of adults aged 65+ have at least one chronic condition?
What percentage of adults aged 65+ have at least one chronic condition?
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Which chronic condition is reported to affect the highest percentage of adults aged 65+?
Which chronic condition is reported to affect the highest percentage of adults aged 65+?
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Between the age groups of 55-64 and 65+, which has a higher percentage of individuals reporting two or more chronic conditions?
Between the age groups of 55-64 and 65+, which has a higher percentage of individuals reporting two or more chronic conditions?
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In the context of reported depression rates, which age group shows the highest percentage of women experiencing depression?
In the context of reported depression rates, which age group shows the highest percentage of women experiencing depression?
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Which of these conditions has been reported as the least prevalent among adults aged 65+ according to the given data?
Which of these conditions has been reported as the least prevalent among adults aged 65+ according to the given data?
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What percentage of individuals aged 75+ report hearing problems?
What percentage of individuals aged 75+ report hearing problems?
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Which condition accounts for 10% of heart diseases among individuals aged 85+ according to the provided causes of death?
Which condition accounts for 10% of heart diseases among individuals aged 85+ according to the provided causes of death?
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Among the chronic conditions listed, which has the lowest prevalence in adults aged 65+?
Among the chronic conditions listed, which has the lowest prevalence in adults aged 65+?
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What visual symptom is associated with cataracts and corneal disease?
What visual symptom is associated with cataracts and corneal disease?
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What aspect of vision remains unaffected in individuals with macular degeneration?
What aspect of vision remains unaffected in individuals with macular degeneration?
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At what age range is the prevalence of visual sensory impairment highest among older adults?
At what age range is the prevalence of visual sensory impairment highest among older adults?
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Which statement regarding average life expectancy at birth from 1900 to 2018 is accurate?
Which statement regarding average life expectancy at birth from 1900 to 2018 is accurate?
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What is indicated by the presence of a central scotoma in macular degeneration?
What is indicated by the presence of a central scotoma in macular degeneration?
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What percentage of individuals aged 80 and above experience balance sensory impairment?
What percentage of individuals aged 80 and above experience balance sensory impairment?
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What does the successful aging curve shifted to the right indicate?
What does the successful aging curve shifted to the right indicate?
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What factor affects communication with other providers in geriatric medicine?
What factor affects communication with other providers in geriatric medicine?
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Which statement reflects the primary goal of long-term oral health care in older adults?
Which statement reflects the primary goal of long-term oral health care in older adults?
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What was the primary outcome of Japan's '80:20' campaign?
What was the primary outcome of Japan's '80:20' campaign?
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What is the typical life expectancy increase at age 65 from historical data?
What is the typical life expectancy increase at age 65 from historical data?
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Which of the following best describes the concept of 'functional reserve'?
Which of the following best describes the concept of 'functional reserve'?
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What does the bell curve shape of the 'usual' aging process represent?
What does the bell curve shape of the 'usual' aging process represent?
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What percentage of people aged 65 and older who have 25+ teeth reported experiencing pain?
What percentage of people aged 65 and older who have 25+ teeth reported experiencing pain?
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Which demographic group has the highest prevalence of severe periodontitis among those aged 65+?
Which demographic group has the highest prevalence of severe periodontitis among those aged 65+?
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In analyzing the top causes of death in older adults, which demographic shows the highest increase in mortality risk?
In analyzing the top causes of death in older adults, which demographic shows the highest increase in mortality risk?
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In which scenario are people more likely to report avoiding certain foods?
In which scenario are people more likely to report avoiding certain foods?
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Sir Ferguson Anderson's quote implies which of the following about health in older adults?
Sir Ferguson Anderson's quote implies which of the following about health in older adults?
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Which of the following factors is NOT associated with the communication needs for caregivers in geriatric medicine?
Which of the following factors is NOT associated with the communication needs for caregivers in geriatric medicine?
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What proportion of individuals with untreated caries experienced embarrassment related to oral health?
What proportion of individuals with untreated caries experienced embarrassment related to oral health?
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What factor has been associated with higher prevalence rates of periodontitis and oral health issues?
What factor has been associated with higher prevalence rates of periodontitis and oral health issues?
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What percentage of people with no teeth reported finding it difficult to relax?
What percentage of people with no teeth reported finding it difficult to relax?
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Which group is least likely to have severe periodontitis based on income level?
Which group is least likely to have severe periodontitis based on income level?
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What is the percentage of elders reporting that life is less satisfying due to oral impacts?
What is the percentage of elders reporting that life is less satisfying due to oral impacts?
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Study Notes
Required Readings
- Pretty et al. (2014) - Seattle Care Pathways - Gerodontology - DOI: 10.1111/ger.12098 - https://frailty-guide.fdiworlddental.org/
- Mukherjee et al. (2017) - Informed consent in dental care and research for older adults - JADA - https://doi.org/10.1016/j.adaj.2016.11.019
- Metcalf et al. (2011) - A systems perspective for dental health in older adults - AJPH - DOI: 10.2015/AJPH 2011.300321
- Foley et al. (2017) - Systematic Review of oral health status for people with dementia - JDR Clin Transl Res - DOI: 10.1177/2380084417714789
Geriatrics-Focus on Person-Centered Care
- Focus on Geriatrics (10/30/2024) with Judith Jones, DDS, MPH, DScD, [email protected]
Geriatrics Objectives
- Describe the demographics of aging and its impact on dental practice.
- Describe the prevalence of chronic diseases in older adults.
- Describe oral health disparities in the aging population.
- Describe the principles of geriatric medicine.
- Describe functional declines in older adults.
- Describe goals for long-term oral health care.
- Explain Seattle Care Pathways.
- Discuss communication with other providers, including caregivers.
Why I Went Into Geriatrics
- Humorous cartoon about wrestling with screamers not being compatible with long hair
The Wave of Baby Boomers
- Image of a large wave, representing the large generation of Baby Boomers.
Total Population by Age and Sex
- Graph depicting total population by age and sex: 1900, 1950, and 2000
- Shows a change in population distribution across different age groups over time
Percentage of Americans Aged 65+ and 85+
- Graph displaying percent change from 1900-2060 in the population aged 65+ and 85+
- Data reveals significant and continuous growth for both age groups
Why Showing These Graphs
- Graphs explain demographics of aging.
- There are more older people than ever before.
- There are more older adults with teeth than ever before.
- Older adults are more complex due to various factors.
- Discuss four reasons for the increasing complexity among older adults.
Average Life Expectancy Increased Since 1900
- Table illustrating the increased average life expectancy at birth, age 65 and age 85, (1900-2018).
Average Life Expectancy Varies by Sex, Race, and Ethnicity, 2015
- Table showing average life expectancy varies by: Sex, Race (non-Hispanic Black, non-Hispanic White, Hispanic), and ethnicity (F/M).
Common Chronic Conditions for Adults 65+
- Chart summarizing the presence of 10 common chronic conditions in adults above 65.
Percentage of US Adults with One or More Chronic Conditions, 2008
- Graph showing increasing trend in chronic conditions across different ages (55-64, 65+,1-3+ chronic conditions)
Percent of People with Depression by Age, US, 2014
- Graph displaying percentage of people with depression by age group (85+, 80-84, etc), comparing men and women.
Hearing and Vision Problems Common in Older Age Groups, USA, 2016
- Bar graph showing percent of hearing and vision impairments among different age groups (45-64, 65-74, and 75+).
Visual and Hearing Impairments
- Tips for communicating with people who have visual or hearing impairments
- Speak slowly and lower in pitch.
- Don't backlight.
- Ask if the individual can hear/read.
Diabetic Retinopathy
- Discusses leaking of retinal blood vessels, advanced/long-term diabetes, macula/entire retina and vitreous.
- Emphasizes that not all diabetics experience this.
Glaucoma
- Discusses chronic elevated eye pressure
- Early detection and close medical monitoring can help reduce complications
- In more advanced cases print will appear faded, and words will be hard to read
Cataracts
- Discusses opacity of the lens reducing acuity.
- No scotoma.
- Vision is hazy, especially with bright light.
Macular Degeneration
- Discusses deterioration of the macula
- Visual distortions in print
- Peripheral vision largely unaffected.
Visual Impairments
- Illustration of visual impairments, focusing on the aspects that affect everyday life.
Older Patients and Sensory Impairments, USA 1999-2006
- Chart illustrating the growing trend of sensory impairment in older people(70-79, 80+), comparing vision, hearing, balance and loss of feeling in their feet
Feb 2011: 59-Year-Old Male Patient
- Patient case study with identified demographics, chief complaints, medical history, and social history.
April 2011: 59-Year-Old White Male Patient
- Patient case study with patient's history, treatment details, and associated expenses.
Percentage 65+ Year Olds with Unfilled Caries
- Report details including demographics(NH White, NH Black, Mexican American, <200% FPL, >=200% FPL) percent of 65+ year olds with unfilled tooth cavities from 2011-2016
Complete Tooth Loss, 2011-2016 U.S.
- Results of studies of complete tooth loss in certain demographics(NH White, NH Black, Mexican American, ages 65-74, and 75+)
Percent Aged 65+ who Report 6+ or complete tooth loss, By Income, U.S., 2014
- Relationship between income and the occurrence of tooth loss in persons aged 65+ (incomes range from less than $15,000 per year to greater than $50,000)
Percent Aged 65+ who Report 6+ or complete tooth loss, By Education, U.S., 2014
- Relationship between education level and the occurrence of loss of 6 or more teeth or complete tooth loss in adults aged 65+
Why Is This Important?
- Tooth loss and dental carries are linked with poor general health.
- Relationship between dental problems and poor self-reported health
Oral Impacts more Common in Seniors with Poor General Health
- Presentation on how oral health issues affect and are affected by senior general health.
How Much Pain and Distress?
- Graph demonstrating degree of pain and distress based on number of teeth (25+, 11-24, 0-10)
Found it Difficult to Relax
- Graphic demonstrating different levels of difficulty relaxing during dental procedures based on the number of teeth remaining (25+, 1-24, 0)
Percent avoiding foods
- Report demonstrating a decreased ability to eat specific foods across different age demographics based on the number of remaining teeth (25+, 11-24, 0-10)
Avoid Going Out
- Graph displaying the degree of avoidance of social outings due to oral health issues (25+ teeth, 11-24 teeth plus dentures, 0-24 teeth, no denture)
Periodontal Disease
- Image showing signs of periodontal disease.
Periodontitis Prevalence, 2009-2014, U.S.
- Results identifying the prevalence of periodontitis among different demographics (65+, men, Mexican Americans, low-income, tobacco users)
Prevalence of Severe Periodontitis among 65+ Year Olds USA, 2009-2014
- Graph displaying the prevalence rates of severe periodontitis in older adults, differentiated by demographics, focusing on smoking status and income levels (Mexican, other, non-hispanic white, non-hispanic black, <100% FPL, >= 100% FPL, smoker, non-smoker)
Oral Cancers
- Images illustrating different types of oral cancer.
Oral and Pharyngeal Cancer
- Graph comparing oral and pharyngeal cancer incidence and death rate in different demographics (White males, Black males, Black females, White females, ages 65-69, 65+), (2011-2015).
Oral CA Screening
- Data on Oral Cancer Screening in Michigan, highlighting Wayne County having the highest incidence rates, focusing on the demographics of NH White, NH Black, NH Other, Hispanic , and the relationship to their adjusted rate per 100,000, which varies from "Suppressed" rates of 7.1-8.9 to rates above 25.2 .
So What!
- Summary that inequities are present in oral health disparities and access, dental problems decline seniors' health
- Dental issues lead to negative health outcomes, impact social/mental well-being, and lead people to avoid certain foods, socialize less, and experience shame.
Questions
- Inquiry about the reasons oral health inequities are happening.
- Inquiry about potential solutions to address oral health inequities
- Inquiry about the ways in which one can help others involved in oral health inequities
- Inquiry about interventions that can be applied to the oral health inequities issue
Social Determinants of Health
- Definition of social determinants of health as factors that influence health outcomes.
- Factors including: income, working conditions, literacy, and access to healthcare.
World Health Organization
- Conceptual framework illustrating how social determinants influence health and health inequalities, with a focus on socioeconomic, political and intermediary factors, along with the role of health care systems
Our "Urban Context"
- Presentation of statistics and demographics for the city of Detroit, compared to the entire US population (2011-2016 data)
Cost per Beneficiary by 65+ year Olds
- Chart showing costs associated with health care services by demographics (by source)
Policy Implications
- Suggest that funding for dental care should be supported for all elders.
- Proposed Medicare policy changes to include dental coverage for eligible individuals.
- Suggest Part B physicians services, making that all elders are eligible for oral care services
Objectives: Geriatrics
- Objectives regarding the demographics of aging, the impact on their practice, the epidemiology of chronic diseases in older adults, and oral health disparities in the aging population
Objectives: Next Time
- Future objectives to be addressed regarding geriatric medicine principles, functional and oral health declines, goals for long-term oral health care.
- Including communication between providers and caregivers.
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Description
This quiz explores various aspects of dental health related to geriatric patients, focusing on demographic impacts from 2011 to 2030. It covers costs, treatment outcomes, and dietary recommendations for older adults. Test your knowledge about dental extractions and the aging population's effect on health care practices.
