The Medically and Physically Compromised PatientChapter 29 Lesson 29.1Learning ObjectivesLearning ObjectivesThe Rights of a PatientRole of the Dental AssistantThe Aging PopulationDentally Related Aging ChangesFig. 29-3 Periodontal conditions of an older patient.Fig. 29-4 Root caries of in an older patient.Fig. 29-5 Darkened teeth associated with secondary dentin and aging.Fig. 29-6 Bone resorption with loss of teeth and alveolar ridge.The Medically Compromised PatientNeurologic DisordersSlide 15Slide 16Slide 17Cardiovascular DisordersSlide 19Slide 20Slide 21Chapter 29 Lesson 29.2Slide 23Pulmonary DisordersSlide 25Slide 26Blood DisordersMuscular DisordersEndocrine DisordersSlide 30Behavioral and Psychiatric DisordersThe Physically Compromised PatientThe Medically The Medically and Physically and Physically Compromised PatientCompromised PatientChapter 29Chapter 29Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Chapter 29Chapter 29Lesson 29.1Lesson 29.1Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Learning ObjectivesLearning ObjectivesPronounce, define, and spell the Key Terms.Pronounce, define, and spell the Key Terms.Describe the type of dental management a Describe the type of dental management a medically compromised patient would medically compromised patient would receive.receive.Describe the stages of aging in the older Describe the stages of aging in the older population.population.Describe orally related conditions affecting Describe orally related conditions affecting the older patient.the older patient.(Cont’d)(Cont’d)Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Learning Objectives Learning Objectives (Cont’d)(Cont’d)Describe the importance of the medical Describe the importance of the medical history in the medically compromised patient.history in the medically compromised patient.Describe the major medical disorders that Describe the major medical disorders that can affect a patient’s oral health.can affect a patient’s oral health.Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.The Rights of a PatientThe Rights of a PatientAmericans with Disabilities Act Americans with Disabilities Act Provides a clear, strong, enforceable standard Provides a clear, strong, enforceable standard addressing discrimination against people with addressing discrimination against people with disabilitiesdisabilitiesAmerican Dental Association American Dental Association Supports:Supports:•Title I: employment discriminationTitle I: employment discrimination•Title II: access for the disabledTitle II: access for the disabled•Title III: public accommodationsTitle III: public accommodations•Title IV: telecommunications services Title IV: telecommunications services Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Role of the Dental AssistantRole of the Dental AssistantAid the dentist in providing treatment.Aid the dentist in providing treatment.Act as a source of information to the patient Act as a source of information to the patient and family.and family.Provide comfort to the patient.Provide comfort to the patient.Help reduce anxiety.Help reduce anxiety.Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.The Aging PopulationThe Aging PopulationAging is the irreversible and inevitable Aging is the irreversible and inevitable changes that occur with time.changes that occur with time.Stages of the older population:Stages of the older population:Young/old: People 65 to 74 years old, better educated and Young/old: People 65 to 74 years old, better educated and more demanding of health services, retain more of their more demanding of health services, retain more of their natural teeth.natural teeth.Old: People 75 to 84 years old, beginning to have multiple Old: People 75 to 84 years old, beginning to have multiple health problems, have more fixed and removable prostheses.health problems, have more fixed and removable prostheses.Old/old: People 85 years old or older have fewer natural Old/old: People 85 years old or older have fewer natural teeth, believe that tooth loss is inevitable, and have medical teeth, believe that tooth loss is inevitable, and have medical conditions reflected in their oral health.conditions reflected in their oral health. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Dentally Related Aging ChangesDentally Related Aging ChangesXerostomia is a condition, resulting from certain disorders Xerostomia is a condition, resulting from certain disorders and medications, that involves decreased flow of saliva. and medications, that involves decreased flow of saliva. Periodontal disease is an increasing problem in the older Periodontal disease is an increasing problem in the older population. The tissues of older patients may be slower to population. The tissues of older patients may be slower to heal. heal. Dental decay increases in the form of coronal and root Dental decay increases in the form of coronal and root caries and recurrent decay around defective restorations. caries and recurrent decay around defective restorations. Dark and brittle teeth result from deposition of secondary Dark and brittle teeth result from deposition of secondary dentin that have gradually reduced the size of the pulp dentin that have gradually reduced the size of the pulp chamber. chamber. Bone resorption results in loss of the alveolar ridge. Bone resorption results in loss of the alveolar ridge. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Fig. 29-3 Periodontal conditions of an older patient.Fig. 29-3 Periodontal conditions of an older patient.Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Fig. 29-4 Root caries of in an older patient.Fig. 29-4 Root caries of in an older patient.Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Fig. 29-5 Darkened teeth associated with Fig. 29-5 Darkened teeth associated with secondary dentin and aging.secondary dentin and aging.Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.Fig. 29-6 Bone resorption with loss of teeth and Fig. 29-6 Bone resorption with loss of