Clinical Geriatrics

This issue of Clinical Geriatrics includes a CME article on “Oral Infections in the Elderly,” the second part of a series written by Kenneth Shay, DDS, MS. Primary care physicians caring for the older person must take responsibility for the “whole” patient, and this includes an appropriate history and thorough exami
nation of the oral cavity. Few medical schools include a significant curriculum regarding the oral environment; most physicians believe that this area of the body is better left to the dental expert. While specific problems that are identified may indeed require a dental referral, and preventive care by the dentist is clearly something to be encouraged, a routine medical examination could detect precancerous lesions, poorly fitting dentures that could result in erosive damage to mucosal surfaces or place the individual at risk for harm, as well as other pathology, and even infections.

I urge the readership to re-familiarize themselves, if necessary, with oral anatomy, review how best to examine the salivary glands and lymph nodes in the head and neck, and—most of all—to remember to include an oral examination as part of all routine evaluations. We should take the time to ask the patient to remove dentures, and keep a tongue depressor and light handy to explore areas hidden under the tongue and between the cheeks and gums. Helping the patient maintain good oral health is as important to quality of life as ensuring a good cholesterol level or blood pressure.

Send comments to Dr. Gambert at medwards@hmpcommunications.com.