Geriatric dentistry is the branch of dentistry concerning with the prevention, diagnosis and treatment of dental problems in older people. As age progresses, these persons might have many issues, which can lead to many problems if not treated. One of the such problem is the presence of root caries & attrition.

Root caries: This problem is caused due to the infections, which can be caused due to bacterial proliferation and associated damage. The food debris, if kept for a long time can be subjected to fermentation by bacteria. This fermenting effect results in the production of acid, that can damage the tooth structure. The presence of root caries is considered as one of the common disorders throughout the world.

There are many people who are not aware if they have root caries or not. The prime reason behind this is because such a condition occurs below the gum line. In addition to this, the warning signs may not be present so that people can diagnose the issue. The presence of root caries, in most cases, is found out by a dental professional. In diagnosing such a problem, imaging tests like X-rays, OPG etc can be really helpful.

Attrition: In geriatric dentistry, attrition means tooth loss that occurs due to the negative effect of the mechanical forces exerted by the opposing teeth. Initially, this phenomenon is said to affect the enamel first. As time progresses, this phenomenon occurs to the other portions of the tooth/set of teeth.

Some of the warning signs of this phenomenon include the following:

• Back teeth flattening.
• Front teeth shortening.
• Increased wear & tear.
• General increase in tooth sensitivity.

As mentioned before, the main cause dental attrition is bruxism (teeth grinding). This happens when there is continuous contact behind the opposing teeth. This results in a high pressure experienced by the teeth. Another causative factor is clenching, which is the phenomenon in which the teeth gets squeezed together. The phenomenon of parafunctioning can increase the wear & tear of the teeth. This mainly occurs during the sleeping hours, where the patient is unconscious.

There are many conservative measures that can minimize this disorder:

• The patient can be advised to avoid excessive gum chewing.
• If the patient has the habit of consciously chewing the gum, then he/she might be advised to reduce this habit significantly.
• Parafunctioning may be the result of many factors. Some of these factors include tension, bite discrepancies, neurological trait etc.
• Consultation with a dental professional shall help in suggesting measures that are related to individual constitution.
• Other causative factors like abrasion & erosion needs to be minimized.

Dry mouth is a normally seen condition in older people. Negative changes in the saliva constitution can lead to this condition. The condition of hyposalivation (low saliva amount) can lead to such a condition.

This condition can also be caused due to the side effects of various medications. The phenomenon of mouth-breathing can lead to this condition in many cases. Other conditions like radiotherapy, dehydration, damage to the nerves etc can also lead to this condition. In some cases, this condition can also occur without any major etiological factors.

For diagnosing this condition, consultation with a doctor is very much necessary. A comprehensive review of the medical history of the patient is required. The patient may also be required to take blood tests, imaging tests of the salivary glands etc may also be necessary.

If the doctor finds that certain 'taken-in' medications can contribute to this condition, then he/she may either decrease the dosage of such medications or may even replace this medication with another medicine that does not have such side effects. In certain situations, the dental professional may even resort to fill the teeth with a particular sort of substance such a fluoride to wear during night hours.

The formation of mucosal lesions & oral ulceration has a definite effect on the quality of life in older adults. Some of these common lesions are premalignant lesions & oral lesions, candidiasis, vesiculoerosive diseases, herpes virus de-activation etc. Appropriate diagnosis & care have to be performed so that these conditions are treated in the right time. If these lesions (malignant or benign) are diagnosed in the early stages, it shall help in the management of various diseases. The quality of the patient life can also be increased considerably if the diagnostic procedures are carried out in an appropriate manner. While prescribing the curative drugs, the dental professional must seriously consider the side-effects of the medications. This is because the side effects of the medications vary with individual body constitution.

Oral ulceration: Oral ulceration is the medical condition wherein an ulcer occurs in the oral cavity. Most normally, the ulcer is present in the mucosal membrane of the oral cavity. Medically, mouth ulcers are also known as apthous ulcers. These ulcers can make daily activities like talking and eating uncomfortable. Mouth ulcers can be classified into 2:

• Simple Mouth ulcers: These ulcers can appear 3-4 times in a year. When they are affected, they may last for a week. People in the age group of 10-20 years are mostly affected.
• Complex mouth ulcers: They are less common than the previous category. They mostly affect those persons who are previously affected with this condition.

The exact etiological factors behind this condition are unknown. It is said that stress is one of the factors that causes the formation of ulcers in mouth. Certain food items such as acidic vegetables & fruits can result in such a condition. Sharp dental appliances can also aggravate or trigger this condition. These include improperly placed dentures, braces etc.

Underlying health conditions such as impaired immune system, malnutrition, gastrointestinal disease etc can cause this condition. A common misconception is that cold sore is the other name for mouth ulcers. However this is false.

The common symptoms of this condition are fever, swollen lymph nodes, physical sluggishness etc. The appropriate treatment method is selected on the basis of the diagnosis results. Some of the usual treatment methods include application of a suitable mouth rinse, an appropriate solution of regular application, corticosteroid ointments etc.