Prosthodontics for the elderly patient

Oversigtsartikel Dato: 24.02.2017

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The decision to replace missing teeth in the elderly is complicated because no scientific standards exist as to what constitutes acceptable oral function. In the elderly the same condition may receive different treatments depending on individual evaluations. Reduced dentitions without anterior gaps may provide satisfactory function. Simplified treatments may be acceptable on specific indications. Age or disease related impediments to optimal treatment may exist. Prostheses should be maintained to retain oral function. Small fixed dental prostheses (bridges) should never be written off as a treatment as this option has many advantages over partial removable dentures, and may not cost more.

Age and health are important factors in any treatment. The main purpose of the article has been to discuss the need for replacing missing teeth in the frail elderly. Neither reliable definitions of acceptable oral function nor the need for tooth replacement exist. Nevertheless, the dentist must relate to these concepts. «The Shortened Dental Arch Concept» shows that acceptable oral function in the elderly can still be obtained, even in severely reduced dentitions.
Informed consent is only fulfilled when the elderly person is fully informed of all acceptable treatments. Optimal treatment can be impeded by a reduced ability to endure long-lasting, multiple appointments, motor diseases or financial limitations.
Some simplified prosthetic treatments with reduced longevity can be justified; others are contraindicated because of tissue harm. Prosthodontics may also sometimes be justified for the elderly even if oral diseases are imperfectly controlled. Deciding whether to repair or renew prostheses is difficult, and must be assessed individually.
Small fixed dental prostheses (bridges) are easy to produce, usually provide better oral function, may not cost more than partial removable dental prostheses, are preferred by the elderly and should never be excluded as an option. A need for replacing missing teeth in the elderly will persist, but should only be implemented after careful individual evaluations.