California Dental Hygienist Ebook Continuing Education

INTRODUCTION

Learning outcomes After completing this course, the learner will be able to: Š Describe the demographic characteristics of older adults in the United States. Š Identify the normal biological changes associated with aging. Š Explain the normal oral changes associated with aging. Š Describe the incidence of xerostomia and dental caries in older adults. Course overview The purpose of this course is to help all dental professionals gain an appreciation for the significant opportunities the aging population will bring to their practices, along with the challenges. This course will provide dental professionals with basic knowledge and information in gerontology and geriatric dentistry that will enhance their ability to diagnose and manage older patients who have been affected by age- dependent or age-associated changes. The target audience for this basic-level course is dentists, dental hygienists, and dental assistants of all ages and experience levels. This course is timely because America is graying. There will be an increasing number of older adults seeking dental care in the coming years. Currently, 16% (54.1 million people) of the U.S. population is 65 years old or older (CDC, 2022a). By 2030, the percentage is expected to grow to 20% (Wang, Wolff, & Panchal, 2019), and by 2060 it will have grown to 25% (94.7 million people) (CDC, 2022a). The baby boomer generation began reaching retirement age in 2011. This large cohort of individuals will cause the number of adults age 65 and older in the United States to swell to 74 million by 2030. By 2060, it is predicted that 19 million Americans will be over the age of 85 (Vespa, et al., 2020).

Š Identify the oral-systemic links in the older adult population. Š Describe oral health considerations for the institutionalized older adult. Š Describe access to care and utilization patterns of older adults.

Many dental professionals feel uncomfortable treating older patients and lack the skill set needed to do so. Multiple authors have reported that older adults have difficulty in accessing dental care. Dentists need to be trained to treat the diverse oral health needs of older adults so that optimal oral health can be developed and maintained as a component of systemic health and a optimal quality of life (Tabrizi & Lee, 2021). It is often difficult for dentists and dental hygienists to distinguish between normal aging-related changes in the tissues of the oral cavity and those resulting from pathological changes. Some dental professionals are unaware of appropriate strategies for dealing with patients with cognitive impairments who exhibit care resistance. Additionally, many dental professionals lack knowledge of the biological changes that occur as a part of normal aging and the clinical modifications that should be made in dental practice to accommodate those changes. This course will address these gaps in knowledge and many others. Knowledge gained in this course will help dental professionals prepare for the increased number of older adult patients who require their care now and those who will seek their care in the future.

DEMOGRAPHICS OF AGING

capita for health care than any other country, the average life expectancy of its citizens is not the world’s highest. In fact, according to the Central Intelligence Agency’s World Factbook (n.d.), the average life expectancy in the United States, 79.80 years, ranks 42nd among the life expectancies of other countries around the world. Normal aging involves a certain degree of physiologic decline. Individuals deemed to be successful agers are those who experience minimal physiologic loss. The three key characteristics of successful aging are low risk of disease, high mental and physical function, and active engagement with life (Urtamo, et al., 2019). Scientists have identified regions in the world where there are unusually high concentrations of centenarians – people over the age of 100. These regions, which include Loma Linda, California; Okinawa Island, Japan; and the Italian island of Sardinia, have been termed Blue Zones . The people of these areas have been studied to illuminate the secrets to a long, disability-free life (Davis, 2022 ; Gutman, 2020). Some of the lessons learned about longevity include the importance of: ● Having a purpose in life – something that gives a zest for life. ● Incorporating physical activity into everyday life activities. ● Eating a more plant-based diet, with less meat. ● Having friends and family with whom to share life.

An ability to care for older dental patients begins with understanding basic principles of gerontology , the scientific study of aging and the effects of aging (Merriam-Webster Online, n.d.). For decades there have been many attempts to define old age and to determine when old age begins. The generally accepted terminology for the three general age categories is young-old (age 65 to 74 years), old-old (age 75 to 84 years), and oldest-old (age 85 years and older). Because of great variability within this population group, it is more appropriate to classify older adults based on function rather than chronological age. Independent older adults can live and function successfully in a traditional community setting without assistance. Most older adults fall into this category. Frail older adults may live in the community but require some degree of social support and experience some limitation with activities of daily living (ADLs; e.g., eating, bathing, and dressing). Dependent older adults typically reside in long-term care facilities and rely upon others to meet their needs. Caregivers may assist with or fully provide for the dependent person’s ADLs. Life expectancy has increased in the United States, largely as the result of improvements in health care over the past century. Americans who live to the age of 65 can expect to live another 19.6 years (National Center for Health Statistics, 2022). Although the United States pays more per

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