Caries, Tooth Loss, and Conventional Tooth Replacement for Older Patients

Abstract

During the recent decades, industrialized countries have shown an important decline in edentulism and a corresponding increase in the mean number of teeth present among elderly people (Atchieson & Andersen, 2000; Morse, Holm-Pedersen, & Holm-Pedersen, 2002). However, studies still show rather large populations of older with few or no teeth (Kiyak, 2000; Avlund, Holm-Pedersen, & Schroll, 2001). This implies that prevention of oral health problems should be aimed at the growing number of older adults at risk of oral diseases and that caries therapy and prosthetic therapies should be considered and implemented in order to maintain and restore oral function and aesthetics. Because any restorative caries or prosthetic therapies have a short-term or long-term biologic price, such therapies should only be implemented when there is clear evidence that function or aesthetics is invalidated. When considering the indications for prosthetic therapy and the choice of treatment modality, professional considerations as well as the patient’s demand and socio-economic situation are key factors. However, treatment planning for the medically compromised or dependent geriatric patient is even more complex, as it also includes an assessment of the patient’s general physical and cognitive state and the patient’s perceived need for prosthetic treatment as well as the realistic need (Vigild, 1989). The latter is based on a professional assessment of the normative need, the perceived need, and the expressed demand for treatment, taking into account the general mental and physical state of each individual. Finally, dental and prosthodontic treatment planning is dependent on the allocation of resources, and hence is a political decision. Socio-economic factors are particularly important in the prosthetic treatment of older patients because restricted financial means often limits the possibilities to very simple treatments, such as treatment with conventional complete dentures (Mojon, Thomason, & Walls, 2004; Palmqvist, Soderfeldt, & Vigild, 2001).