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Henry Jones is a 79 year old gentleman who suffered a stroke 6 months ago, leaving him with dense right sided paralysis and slurred speech. Unable to live independently any longer due to his disabilities and lack of local family support, he was forced to move into a nursing care facility. He has overall adjusted well, but has developed a problem with persistent bleeding from his gums.
Robert Henry, DMD, MPH
Henry has developed chronic gingivitis and periodontitis, a common problem for someone in his circumstances. Which of the following factors is least likely to have contributed to his oral condition?
Unfortunately, even though Mr. Jones was eventually able to access dental care through the Veteran’s Administration, his periodontitis led to gum recession and exposed roots on several of his teeth which subsequently developed root caries. His dentist feels that ultimately these teeth may require extraction. Mr. Jones is very interested in keeping his remaining teeth healthy and avoiding future dental problems.
John McDowell, DDS
Which of the following is the most appropriate next step towards better oral health for Mr. Jones?
Mr. Jones has done quite well over the next 3 months in the nursing facility. He is walking better, has improved his speech, and with aggressive occupational therapy has learned to perform many of his activities of daily living despite persistent disabilities from his stroke. He uses the Collis Curve toothbrush shown on the right for his daily oral care. He also uses a salivary substitute to relieve his dry mouth. With professional dental care his periodontal disease is now in control and only the two teeth with severe root caries had to be extracted.
Robert Henry, DMD, MPH
Had Mr. Jones not had the opportunity to address his oral health needs, which of the following complications might he be at risk for?