Different Oral Mucosal Lesions in Elderly People

Introduction:

The oral cavity is often called the gateway of the human body. The food one eat enters the body through the oral cavity. However, the oral cavity helps to exchange gasses, speaking, talking, and smiling. The oral mucous membrane plays an important role in maintaining the integrity of the oral cavity. Also, the condition of oral tissues maintains the functioning of the oral cavity. Almost 55 percent of the adult population in the world suffers from oral health complications.

What Are the Risk Factors for Oral Lesions in Adults?

1. Systemic Diseases: Systemic diseases are responsible for changes in the oral cavity. In elderly individuals, conditions like diabetes are very common, which causes decreased salivary flow. Also, it is often related to poor wound healing and alternate immune response. This may cause decreased tissue healing and increased susceptibility to infections. It is related to several yeast infections and altered tissue responses. Also, autoimmune disorders and immunocompromised patients experience these types of complications. Gastric disorders are responsible for the malabsorption of different nutrients, vitamins, and minerals. These are related to the loss of tongue papillae.

2. Systemic Effects: Overall, systemic effects of patients can be associated with changes in the oral tissue. Anemia, stress, and malnutrition are related to loss of the tongue papillae and changes in the salivary flow.

3. Salivary Flow: Salivary flow is important for maintaining oral health. Saliva provides cleansing action. Decreased salivary flow may cause complications like dry mouth or burning mouth syndrome. Patients often complain of dryness in the mouth, difficulty talking and chewing, and a burning sensation in the mouth. Decreased salivary flow is often seen in elderly individuals and persons suffering from stress. It can also be caused by the application of several medications. Autoimmune disorders like Sjogren syndrome are responsible for decreased salivary flow.

4. Medications: Medications often have ill effects on the salivary flow. Drugs like antidepressants, antihypertensive drugs like beta blockers, antihistamines, and opioids are responsible for such symptoms. Radiation therapy, chemotherapy, and immunomodulatory drugs are associated with decreased salivary flow and destruction of oral mucosa. Such drugs are often associated with chronic infectious lesions and chronic ulcers in the oral cavity.

What Are the Oral Mucosal Lesions Seen in the Elderly?

Several oral mucosal lesions are seen in elderly people. These lesions are,

1. Fissured Tongue: The fissured tongue is a malformation of the tongue characterized by the presence of deep grooves and fissures. A smooth surface over the tongue sometimes characterizes it. This is caused by the loss of tongue papillae. It often causes a burning sensation in the tongue while eating.

2. Angular Cheilitis: This is a skin lesion seen in the corner of the mouth. It is characterized by the presence of a grayish-white area with a cracked surface. Sometimes, it is ulcerated. Patients often complain of a burning sensation in the affected area with difficulty in opening their mouth. In most cases, it is related to the loss of vertical dimension of the mouth. This is caused by the loss of teeth structure, faulty prosthesis, and temporomandibular disorder. All these factors lead to the accumulation of saliva at the corner of the mouth and infection in the affected area. It is also related to contact dermatitis caused by toothpaste, mouthwash, and food. A deficiency of vitamin B is one of the major causes of angular cheilitis. Less salivary secretion can also be associated with this.

3. Denture Stomatitis: Denture stomatitis is commonly seen in older individuals who are using dentures or removable prostheses for a longer duration. However, it is mainly caused by ill-fitting dentures and abnormal resorption of the bone supporting the prostheses. It is often associated with plaque and food particles accumulating in the denture base. Gradually, this leads to mechanical trauma, ulcer, and yeast infections in the affected area. Candida albicans is the most common yeast responsible for this. This causes itching, ulceration, and a burning sensation in the affected area. In some cases, chronic trauma and infection lead to the growth of the mucosa in the affected area. This is called epulis fissuratum. This is nothing but mucosal hypertrophy due to low-grade inflammation and trauma.

4. Traumatic Fibroma: Traumatic fibroma is a benign tumor seen in the oral cavity. This is caused by chronic trauma due to malpositioning of the teeth, sharp cusps, and broken teeth. This is commonly seen in the lateral border of the tongue, the anterior portion of the tongue, the buccal mucosa, and the retromolar region. Usually, these lesions appear as tissue overgrowth with a pedunculated base and raised surface. In most cases, this does not cause bleeding, pain, or discomfort. However, repeated trauma may cause ulceration and bleeding.

5. Premalignant Lesions and Conditions: Premalignant lesions and conditions are not strictly related to age or elderly individuals. In most cases, it is associated with the use of tobacco or alcoholic products in any form. As the chronic use of these products is related to such pathologies, these lesions are seen mainly in old age. Premalignant lesions like leukoplakia or erythroplakia often appear as grayish-white patches with cracked mud appearance. Such lesions are not pedunculated and may be ulcerated. Premalignant conditions like oral submucous fibrosis are associated with tobacco or betel nut chewing. It is responsible for grayish-white oral mucosa with fibrotic bands. It causes a burning sensation in the mouth and decreased mouth opening.

6. Oral Thrush: Oral thrush is a fungal infection in the oral cavity. In most cases, it is seen in the hard palate, dorsal surface of the tongue, and corner of the mouth. It is mainly caused by Candida albicans species. It is mostly seen in patients suffering from diabetes or immunocompromised individuals. Patients taking hormonal replacement therapy or suffering from malnutrition may also suffer from this.

How to Control Oral Lesions in the Elderly?

The following steps can be taken to prevent the formation of oral lesions. These are;

1. Maintaining oral hygiene is the most important thing. Persons suffering from systemic disorders should brush and clean their teeth properly. If the person is suffering from reduced salivary secretion, an artificial saliva solution can be helpful.

2. Elderly individuals should focus on systemic health. They should eat and drink healthy things to prevent any sort of malnutrition. Conditions like anemia should be treated.

3. Ill-fitting dentures and malpositioned teeth should be treated. Oral rehabilitation is an important part of maintaining oral health in adults.

Conclusion:

Oral health is an important aspect of the elderly population. It is as important as systemic health. Improper oral health is caused by systemic issues and drug side effects. As a result, the assessment of oral health is an important tool to understand the systemic condition of the body. Moreover, maintaining proper oral hygiene is necessary to prevent any oral lesions.