Oral healthcare is an integral part of overall health and well-being, and it is a significant and increasing challenge as people grow frail. Incidence of caries and gingivitis among residents of long-term care facilities are on the rise, and daily oral hygiene is often difficult for patients who are frail or in need of assistance.Oral Healthcare and the Frail Elder: A Clinical Perspective provides dentists, dental hygienists, and other healthcare professionals with comprehensive, practical instruction on managing the multifaceted oral healthcare needs of frail elders. By discussing background information and relevant literature, the book provides a holistic approach to clinical issues such as oral pain, dry mouth, and periodontal disease.

Edited by experts in the field,Oral Healthcare and the Frail Elder enhances clinical application with thorough reviews of pertinent social and ethical issues, access to care issues, and the practicalities for overcoming these in order to provide high-quality oral healthcare to an aging population.

Michael I. MacEntee, PhD, LDS(I), Dip. Prosth., FRCD(C) is Professor of Prosthodontics and Dental Geriatrics at the University of British Columbia. He established the ELDERS (Elders' Link with Dental Education, Research and Service) Group with colleagues at UBC to provide administrative structure to the service needs of our aging population and to the educational needs of dentists and dental students within an overall context of research. His research addresses oral health and quality of life in old age, with a particular focus on frailty and the psychosocial impact of oral prostheses.

Associate Editors:

Frauke Müller, Dr. med. dent. habil., is Professor and Chair of Gerodontology and Removable Prosthodontics at the University of Geneva, Switzerland.

Chris Wyatt, BSc, DMD, MSc, Dip Pros, FRCDC, is Associate Professor and Chair of Prosthodontics& Dental Geriatrics at the University of British Columbia. He is also Director of the Geriatric Dentistry Program.

Contributor List vii

Preface: The challenge of frailty xv

1 Theories and significance of oral health in frailty 3
Joanie Sims-Gould, Mario A. Brondani, S. Ross Bryant, and Michael I. MacEntee

2 Ethical considerations for the oral healthcare of frail elders 13
Mary E. McNally, Shafi k Dharamsi, S. Ross Bryant, and Michael I. MacEntee

3 Oral pain and movement disorders in aging 31
Pierre J. Blanchet, Barry Sessle, and Gilles Lavigne

4 Dry mouth and medications 51
W. Murray Thomson, Kazunori Ikebe, June M. Tordoff, and A. John Campbell

5 Dietary consequences of oral health in frail elders 73
Paula Moynihan, Jane Bradbury, and Frauke Müller

6 Management of periodontal and gingival diseases and other oral disorders in frail elders with cardiovascular disease or diabetes 95
Jim Yuan Lai, H.C. Tenenbaum, and Michael B. Goldberg

7 Oral health, dysphagia, and aspiration pneumonia 111
Marcia Carr, Lynda McKeown, and Michael I. MacEntee

8 Periodontal diseases in frail elders 127
G. Rutger Persson

9 Caries and frail elders 147
Chris Wyatt, Athena S. Papas, and Michael I. MacEntee

10 Contexts of body image and social interactions among frail elders 161
Leeann Donnelly, Laura Hurd Clarke, Alison Phinney, and Michael I. MacEntee

11 Communications and education for palliative care 173
Ronald L. Ettinger, Shiva Khatami, and Michael I. MacEntee

12 Prevention of oral diseases for a dependent population 187
Heather Frenkel, Debora C. Matthews, and Ina Nitschke

13 Prosthodontics, endodontics, and other restorative care for frail elders 211
George Zarb, Shane N. White, Nico H.J. Creugers, Frauke Müller, and Michael I. MacEntee

14 Ethnocultural diversity 237
Stella Kwan, Rodrigo Mariño, H. Asuman Kiyak, Victor Minichiello, and Michael I. MacEntee

15 Palliative care and complications of cancer therapy 255
Martin Schimmel, Michael A. Wiseman, Stephen T. Sonis, and Frauke Müller

16 A framework for assessing the outcome of oral healthcare in long-term care facilities 273
Matana Kettratad-Pruksapong, Arminée Kazanjian, B. Lynn Beattie, and Michael I. MacEntee

Appendix: Quality assessment worksheets 285
Matana Kettratad-Pruksapong, Arminée Kazanjian, B. Lynn Beattie, and Michael I. MacEntee

Index 289