Older patients’ oral health critical prior to surgery

By: Erin Archer, R.N. from DrBicuspid.com

Elderly patients presenting for surgery may be harboring undetected oral infections that could lead to expensive and life-threatening complications, according to a study in the Journal of the American Geriatrics Society (June 1, 2010).

The entire medical team — including oral care providers — needs to be aware of these risks and conduct preoperative oral assessment in this vulnerable population, according to Jeffrey Yasny, D.D.S., lead author and an assistant professor of both dentistry and anesthesiology at Mount Sinai Medical Center.

“Dental infections are often overlooked in preoperative screening,” he told Dr.Bicuspid.com. “They need to be included with any other sources of infection.”

The geriatric mouth has elements that are particularly concerning perioperatively:

• Decreased immunity leaves the geriatric mouth more prone to candidiasis and other fungal infections of the mouth.
• Decreased salivation leads to a decrease in saliva‘s buffering effects and an increase in caries, particularly root caries.
• As people age and the gingiva recedes, they are more prone to root caries; 50% of people 75 years and older have been found to have root caries, which can lead to periodontal or endodontal infection and increased risk of tooth fracture.