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JADA Continuing Education

Background and Overview. Systemic diseases are more common in older adults than in younger people, even among those who are functionally independent. Dentists should understand how these diseases can affect the dental care of their aging patients. The authors review some of the management issues associated with selected systemic diseases common in older adults who are functionally independent.

Conclusions. To provide good oral health care, dental professionals must understand the special needs of older people and their ability to undergo and respond to care; they should work closely with the rest of the health care team; and they should be prepared to manage emergencies.

Clinical Implications. Many older people have a variety of systemic diseases that have an impact on their oral health care. The dentist may need to consult with the patient’s physician to develop an appropriate treatment plan.

Key Words: Oral health; older adults; systemic disease; medications; arthritis; head and neck cancer; chronic obstructive pulmonary disease; diabetes; heart disease; hypertension; mental health; osteoporosis; Parkinson disease; stroke

Abbreviations: BP: Blood pressure • CNS: Central nervous system • COMT: Catechol-O-methyltransferase • COPD: Chronic obstructive pulmonary disease • CPR: Cardiopulmonary resuscitation • GA: General anesthesia • IMRT: Intensity-modulated radiotherapy • INR: International normalized ratio • LA: Local anesthesia • MAOIs: Monoamine oxidase inhibitors • MI: Myocardial infarct • NSAIDs: Nonsteroidal anti-inflammatory drugs • ONJ: Osteonecrosis of the jaws • RA: Rheumatoid arthritis • TCAs: Tricyclic antidepressants.