2. Learning Objectives
1. Explain normal changes of aging in the
mouth and oral cavity.
2. Identify common diseases of older
persons in the mouth and oral cavity.
3. List common nursing diagnoses of
older persons related to oral problems.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
3. Learning Objectives
4. Recognize nursing interventions that
can be implemented to assist the
aging patient with oral problems.
5. Identify medications that may cause or
aggravate oral problems.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
4. Introduction
• Oral assessment and care are
important responsibilities of
gerontological nurses caring for older
adults.
• The oral cavity consists of the lips,
palate, cheeks, tongue, salivary glands,
and teeth.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
5. Normal Changes of Aging
• It becomes more difficult to maintain
good oral hygiene because of multiple
factors:
– The number and condition of dental
restorations
–Changing alignment between adjacent
teeth due to recession of the gums
– Impaired visual acuity
Gerontological Nursing, Third Edition
Patricia A. Tabloski
6. Normal Changes of Aging
• It becomes more difficult to maintain
good oral hygiene because of multiple
factors:
– Possible loss of manual dexterity,
restricted range of motion
– The effects of medications on oral health
Gerontological Nursing, Third Edition
Patricia A. Tabloski
7. Normal Changes of Aging
• With tooth loss and malocclusion, the
older person may avoid eating healthy
foods high in fiber such as fruits and
vegetables, causing further problems
related to poor nutrition.
• Social isolation may occur when older
people lose self-esteem due to cracked
or missing teeth.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
8. Common Diseases of Aging Related
to the Mouth and Oral Cavity
• Oral diseases and conditions are
common to those older people who
grew up without the benefit of
community water fluoridation and other
fluoride products.
• Older Americans with the poorest oral
health are those who are economically
disadvantaged, lack insurance, and are
members of racial and ethnic
minorities.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
9. Common Diseases of Aging Related
to the Mouth and Oral Cavity
• Medicare does not cover routine dental
care or most dental procedures such as
cleanings, fillings, tooth extractions, or
dentures.
• Medicaid funds dental care in some
states, but reimbursement rates are so
low that it is often difficult to locate a
dentist who will accept Medicaid
patients.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
10. Common Diseases of Aging Related
to the Mouth and Oral Cavity
• Most older Americans take prescription
and over-the-counter medications that
can decrease salivary flow and result in
xerostomia, or dry mouth.
• Decreased salivation is associated with
increased oral disease as saliva
contains antimicrobial components and
minerals that help rebuild tooth enamel
attacked by decay-causing bacteria.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
11. Barriers to Mouth Care
• Barriers to mouth care include lack of
training and knowledge about the
importance of oral hygiene, lack of
perceived need for oral care, heavy
workloads, and resistance by older
persons with dementia.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
12. Barriers to Mouth Care
• Nurses have a responsibility to monitor
and supervise nursing assistants to
ensure appropriate technique and
behavioral approaches so that oral care
that meets accepted standards can be
provided to those in need of assistance.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
13. Negative Effects of Poor Oral Care
• Consequences of poor oral care include
the following:
–Social isolation and depression
–Systemic illness such as aspiration
pneumonia, heart disease, and stroke
– Periodontal disease, which can
negatively affect glycemic control in
persons with diabetes
Gerontological Nursing, Third Edition
Patricia A. Tabloski
14. Negative Effects of Poor Oral Care
• Consequences of poor oral care include
the following:
–Malnutrition, vitamin deficiencies
– Pain, halitosis, tooth loss, dental caries,
periodontal disease
–Denture stomatitis
Gerontological Nursing, Third Edition
Patricia A. Tabloski
15. Nursing Assessment of Oral
Problems
• A complete oral cavity assessment
includes examination of the lips, teeth,
interior of the buccal mucosa, anterior
and base of the tongue, gums, soft and
hard palate, and back of the throat.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
16. Common Oral Problems
• Common problems of the mouth that
occur with aging include xerostomia,
oral candidiasis, oral pain, stomatitis,
oral cancer, and gingival disease.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
17. Nursing Diagnoses
• The presence of acute and chronic pain
and nutrition problems would also be
noted.
• The presence of infection,
communication difficulties, and self-esteem
problems should also be
indicated.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
18. QSEN Recommendations Related
to the Mouth and Oral Cavity
• The Quality and Safety Education for
Nurses (QSEN) project addresses the
challenge of preparing future nurses
with the knowledge, skills, and
attitudes (KSAs) to continuously
improve the quality and safety of the
healthcare systems in which they work.
Gerontological Nursing, Third Edition
Patricia A. Tabloski
