PT - JOURNAL ARTICLE AU - Alhajji, Dalal AU - Amaral Mendes, Rui TI - Global health challenges in treating an elderly institutionalised patient: an oral medicine perspective AID - 10.1136/bcr-2017-221539 DP - 2017 Nov 04 TA - BMJ Case Reports PG - bcr-2017-221539 VI - 2017 4099 - http://casereports.bmj.com/content/2017/bcr-2017-221539.short 4100 - http://casereports.bmj.com/content/2017/bcr-2017-221539.full AB - A 64-year-old institutionalised woman presented to our clinic for the management of black hairy tongue. Despite the predictable outcome in treating this disease, this case presents multiple challenges such as the patients’ cognitive impairment, her family dynamics, social factors and the health system as a whole, that makes it difficult to treat.