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A focus often exists in dental practice on the maintenance and management of the dentition and the periodontium, however, conditions of the oral mucosa and orofacial pain can cause significant problems for older patients. Oral mucosal conditions are more prevalent in older patients and many orofacial pain disorders, such as burning mouth syndrome and trigeminal neuralgia, are more common in patients over the age of 50 years. Although these conditions may not be routinely managed in general practice, identification of these patients in primary care and appropriate referral will lead to more prompt and effective treatment.
Clinical Relevance: Dental practitioners need to be able to identify what is considered to be within the normal physiological limits of the ageing oral tissue and hence what is abnormal and requires further investigation to facilitate appropriate referral.
Article
Age-related changes in the oral mucosa are similar to those found in the skin. The tissue becomes less elastic owing to the increase in collagen cross-linkages in the dermis and a loss of elastin. A reduction in effective blood flow to the oral tissues is also seen due to the stiffening of the collagenous walls of blood vessels and the decrease in their diameter as lipid is deposited.1 The oral epithelium has been reported to become thinner with age, resulting in decreased tissue regeneration and reduced disease resistance.2 This may lead to an increased susceptibility to trauma and infection, a trend enhanced by the poorer response of the immune system to new challenges.
The prevalence of oral mucosal disease has been found to be higher in older individuals.3–5 Associations have been reported between oral mucosal disorders and ageing. Wolff et al state that the ageing process in isolation has no substantial effect on the oral mucosa or its protective defence mechanisms if the individual is in good health. The authors conclude that reported age-associated oral mucosal disorders are related more to the following than simply to chronological ageing:6
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