Medications and oral health : points to consider in older people

This chapter describes the increase of chronic illness, multimorbidity, care dependency, and related polypharmacy as a consequence of ageing. Moreover, a focus has been put on drug-related oral health problems since clear associations have been found between the medication intake and the oral status of older people. Prescribing physicians must be aware of the potential oral complications caused by medications in order to be able to develop an appropriate and tailored treatment plan that also considers oral health-related complications. Approaches to identify potential drug-related problems and to optimize medication use comprise medication reconciliation followed by medication review and criteria to assess quality of prescribing, preferably incorporated in computer-based prescribing systems and as a part of comprehensive geriatric assessment (CGA) and management. Taking into consideration the differences in life expectancy, and in order to provide an integrated plan for treatment, rehabilitation, support and long-term care, CGA and assessment of multimorbidity are assumed to distinguish between three groups of older patients, i.e. fit, vulnerable, and frail