Cover -- Title Page -- Copyright -- Contents -- Notes on contributors -- Preface Third edition, 2015 -- Preface Second edition, 1996 -- Preface First edition, 1986 -- Chapter 1 Demography - impact of an expanding elderly population -- Introduction -- Causes and consequences of population aging -- Relationship between individual aging and population aging -- Population aging and geriatric dentistry -- Further reading -- Chapter 2 Biological and physiological aspects of aging -- What is aging and why does it occur? -- Aging of cells: molecular mechanisms of aging -- Somatic mutation and DNA damage theories -- The oxidative stress theory of aging -- The role of mitochondria in aging -- Cell renewal and the telomere loss theory -- Aging of organ systems -- Age-related changes occurring in the oral environment -- Immunological changes with aging -- Conclusions -- References -- Chapter 3 Aging of bone and muscle -- Summary -- Bone loss in aging -- Defining osteopenia and osteoporosis -- Bone remodelling -- Molecular mediators of remodelling -- Mineral metabolism and bone -- Osteopenia and osteoporosis in men -- Bone loss in the craniofacial skeleton -- Sarcopenia -- Loss of cardiac and smooth muscle -- Sarcopenia in the jaw musculature -- Immobilization and muscle and bone loss -- References -- Chapter 4 Sensory changes and communication in the practitioner- aged patient relationship -- The importance of dental communication -- Elements of communication -- Sensory changes with aging -- Changes in visual function -- Changes in auditory function -- Memory and learning in old age -- Implications of sensory and cognitive declines for the dental practitioner -- Compensating for visual and auditory decline -- Compensating for cognitive decline -- Nonverbal communication -- Communicating with elders who have dementia.

Communicating with caregivers of elders with dementia -- Cultural differences and cultural competence -- Experience with the dental care system -- Age-related changes in oral-sensory functions -- Conclusions -- Further reading -- Chapter 5 Aging from a psychological perspective -- Background -- Historical overview -- The lifespan and life course perspectives -- Ageism -- Cognitive processes and aging -- Intellectual function -- Memory -- Decision-making and reasoning with age -- Personality and adjustment -- Constancy and change -- Stress and coping -- Coping mechanisms in old age -- Conclusion -- Insights for clinicians -- References -- Chapter 6 The impact of social and environmental forces on aging -- Introduction -- Older adults in the community -- The importance of social networks and social support -- Social supports and family relations in traditional cultures -- Patterns of intergenerational assistance -- Interventions to improve social supports -- Role changes and productivity in old age -- Retirement as a time of productivity -- Leisure roles in old age -- Voluntary associations and the volunteer role in old age -- Benefits of volunteering -- Adapting to role changes in the later years -- Community resources -- References -- Chapter 7 Clinical assessment of the elderly patient -- Introduction -- Principles of geriatric medicine -- Patient behaviour -- Patient assessment -- Medical examination and assessment -- Oral examination and assessment -- Conclusion -- References -- Chapter 8 Medical issues in the dental care of older adults -- The elderly patient -- The medical history -- Introduction -- History taking -- Common medical problems in the elderly with consequences for oral health care delivery -- I. Allergy -- II. Bleeding disorders -- III. Cancer -- IV. Cardiovascular disorders -- V. Cerebral vascular disease.

VI. Drug abuse and addiction -- VII. Endocrine disorders -- VIII. Liver disease -- IX. Renal disorders -- X. Neurological and neuromuscular disorders -- XI. Pulmonary diseases -- XII. Rheumatological diseases, osteoarthritis, osteoporosis and prosthetic joints -- Further reading -- The elderly patient -- The medical history -- Common medical problems in the elderly with consequences for oral health care delivery -- III. Cancer -- IV. Cardiovascular disorders -- V. Cerebral vascular disease -- VI. Drug abuse and addiction -- VII. Endocrine disorders -- VIII. Liver disease -- IX. Renal disorders -- X. Neurological and neuromuscular disorders -- XI. Pulmonary diseases -- XII. Rheumatological diseases, osteoarthritis, osteoporosis and prosthetic joints -- Chapter 9 Psychiatric disorders in old age - implications for the dental practitioner -- Introduction -- Psychiatric and neurological disorders in the elderly -- 1. Affective disorders -- 2. Anxiety disorders -- 3. Late-life delusional and paranoid psychoses -- 4. Confusion and delirium -- 5. Dementia -- Oral health in patients with psychiatric disorders -- 1. Oral health in patients with affective disorders -- 2. Oral health in patients with psychotic disorders -- Risk factors/indicators for oral diseases in patients with psychiatric conditions -- Dental management of patients with psychiatric disorders -- Further reading -- Affective, psychotic disorders and dementia -- Alzheimer's disease -- Oral health in psychiatric patients -- Chapter 10 Disability in old age - the relationship with oral health -- The disablement process -- The main pathway to disability -- Risk factors for disability -- Measures of disability -- Functional ability in an older population -- Selection due to mortality -- Gender differences in the disablement process -- The main pathway to oral disability.

Consequences of disabilities for use of oral health services -- Conclusions -- Further reading -- Chapter 11 Nutrition and oral health for the older person -- Introduction -- Nutritional requirements with age -- Energy requirements -- Protein intake -- Micronutrient intakes -- The role of nutrition in the aetiology of major systemic disease that may be of relevance to oral health -- Obesity -- Diabetes mellitus -- Cancer -- Cardiovascular disease -- Nutrition and oral health -- Oral mucosa -- Dental caries -- Erosive or acid-mediated dissolution of tooth tissue -- Periodontal disease -- Oral health and foods choice -- Chewing efficiency, digestion and foods choice -- Masticatory efficiency -- Prevention of dietary change -- Taste and smell -- Taste perception with age -- Perception of smell with age -- Texture -- Summary -- Further reading -- Chapter 12 Pharmacology and aging -- Pharmacology and aging: introduction -- Medication as an indicator of medical conditions -- Current medical conditions and medications as they impact dental care -- Oral side effect of medications -- Pharmacodynamics as it impacts dental management -- Current medical conditions and medications as they impact dental prescribing -- Non-compliance to medication use -- Conclusion -- Further reading -- Chapter 13 Preventive oral health care for elderly people -- Prevention of plaque induced diseases -- Mechanical cleaning -- Chemical plaque control -- Prevention of dental erosion -- Prevention of oral mucosal diseases -- Prevention of xerostomia and burning mouth -- Prevention of oral cancer -- Prevention of bone loss -- Prevention of temporomandibular dysfunction and myofascial pain -- Planning preventive services -- Barriers to prevention in older populations -- Examples of prevention in practice -- Role of the oral health team in promoting healthier lifestyle.

Consequences for geriatric preventive services -- References -- Chapter 14 Treatment planning for the geriatric patient -- Geriatric dental practice is different to providing care in traditional practice -- Who are the geriatric patients? -- Fundamentals of treatment planning for the older adults -- Ethical issues -- Use evidence to evaluate alternatives -- Accurate data and diagnoses are key elements of effective treatment planning -- The plan -- Treatment -- Looking carefully at each of the treatment options -- Prosthodontic care -- Periodontal care -- Implants -- Examples of geriatric patient treatment plans -- Conclusion -- References -- Chapter 15 Caries in the older person -- Introduction -- Epidemiology -- Reporting caries in epidemiological studies -- Coronal caries -- Root caries -- Risk factors -- Tissues exposed -- Caries history -- Periodontal disease -- Plaque and microflora -- Diet -- Saliva -- Fluoride -- Clinical appearance of root caries -- Lesion activity -- Histopathology of root caries and pulp dentine complex reactions -- Caries affecting cementum -- Initial and advanced root dentine caries -- Arrested root caries -- Caries diagnosis -- Conventional visual and radiographic examination -- Presence of plaque -- What constitutes root caries? -- Location of the lesion -- Caries detection tools -- Prevention of caries -- Identification and reduction of risk Bacteria -- Diet -- Oral hygiene -- Operative management -- Summary -- Further reading -- Chapter 16 Pathology and treatment of diseases of the pulp -- Introduction -- Age-related changes in the dentine/pulp complex -- Physiological age-changes -- Responses of the dentine/pulp complex to injury -- Cementum changes -- Clinical challenges of the aged tooth -- Pulp symptoms and reaction patterns -- Operative dental procedures -- Pulp breakdown and old teeth -- Root canal treatment.

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