From Volume 38, Issue 7, September 2011 | Pages 460-470
For older patients, clinicians should consider maintaining teeth and using functionally-orientated treatment strategies as an alternative to removable prostheses. When the remaining dentition has a poor prognosis, key teeth should be preserved as overdenture abutments and a gradual transition to edentulousness planned. Where complete dentures are provided, these can be retained using dental implants to overcome many of the problems associated with conventional replacement dentures.
The demographics of the adult population, as described in adult health surveys, are changing dramatically. Worldwide, we are predicting longer life expectancies with the most dramatic improvements observed amongst the oldest age groups. In addition, we are seeing adults retaining natural teeth into old age with fewer becoming edentate. Those who lose all their natural teeth tend to do so later in life, when many find the limitations of removable prostheses difficult.
Whilst improvements in the retention of natural teeth represents significant oral and general health benefits for patients, it poses challenges for the dental profession.1 Increasingly, accessible sources of information have meant that older patients are better informed and less willing to accept treatment planning based around removal of teeth and complete replacement dentures. New paradigms of care are emerging, and there has been a move towards ‘minimally invasive dentistry’ and ‘functionally-orientated treatment planning’ for the elderly patient.2 These treatment strategies are aimed at maintaining a functional, natural dentition for life without recourse to removable prosthodontics.
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