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The UK population is ageing with over a quarter of people predicted to be over 65 by 2040. People are retaining their teeth into old age, often having experienced complex restorative dental work over the years. The increasing complexity of dental treatment that older people require will create challenges for those who provide care for this population, including dental treatment under sedation or general anaesthesia. This article discusses the medical, dental and social considerations that need to be taken into account when planning dental care for older patients under sedation or general anaesthesia.
CPD/Clinical Relevance: Dentists who provide sedation must be able to appropriately assess and manage their older patients safely if considering this method of pain and anxiety control for dental treatment.
Article
The population of the United Kingdom is ageing, with over a quarter of people predicted to be over 65 by 2040. This will create challenges for our health system, including dentistry, where people are retaining their teeth for longer. Since 1978, the proportion of edentulousness has reduced from 28% of the population to 6%, with increasing numbers of patients retaining a complex dentition into old age, which could include crowns, bridgework or dental implants.1
Demand for dental sedation and general anaesthesia is currently high, with the NHS commissioning just over 136,000 courses of treatment in primary dental care involving the use of conscious sedation across England.2 In UK hospitals, general anaesthetia for dental treatment has been ranked the eighth most common reason for a general anaesthetic (111,600 caseload in 2013), with 1.5% being provided in patients aged over 65 years and which is sure to increase.3 Quantifying activity in the private sector is more challenging as a recent report from Northern Ireland suggests that just over half of sedation services provided there were in the private sector.3 The demand for sedation and general anaesthesia may increase as patients who may require complex dentistry, such as dental implants, may choose these modalities of treatment.
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