Prosthetic Dental Treatment for Seniors

Considerations for Prosthetic Dental Treatment of Geriatric Patients

Advocating for seniors and their oral health requires a comprehensive understanding of their unique needs and challenges. The National Institute of Health estimates that the global population of individuals aged 65 and over is expected to grow to 1.6 billion people, or 17 percent, by 2050. In the United States alone, the population is projected to nearly double from 48 million to 88 million within the same timeframe.¹ This demographic shift necessitates that dental providers adapt treatment plans to meet the needs of the dependent elderly population.

Thanks to advancements in medical and dental treatments and technologies, people are living longer than ever before. However, longer life expectancy does not necessarily equate to improved quality of life. Caring for this population requires careful consideration of individual diseases, potential multimorbidities, polypharmacy, and associated limitations.² Medical-dental integration is crucial when providing care to geriatric patients.

Although people are living longer, their oral health is not always prioritized, leading to significant challenges. Risk factors such as tobacco and alcohol use, poor diet choices, excessive sugar intake, and a lack of preventive care throughout life often manifest in later years. Avoiding edentulism should remain the gold standard of care, as tooth retention contributes significantly to quality of life.

The Challenge of Tooth Loss in Seniors

Tooth loss is becoming increasingly prevalent among seniors, requiring extensive prosthetic rehabilitation at higher ages than ever before. Extractions are an invasive surgery that requires overall health and healing ability to be considered before proceeding with treatment. Lost teeth can be replaced with dental implants, fixed prostheses, or removable dentures. Cost and the success rate typically lead one to determine tooth replacement. While dental implants do not develop cavities, they must be cleaned and maintained to ensure periodontal health and long-term success. Before placing implants in geriatric patients, providers should thoroughly review the reasons behind their tooth loss, as underlying conditions may impact outcomes.²

Mastication and Cognitive Health

The research underscores the importance of masticatory (chewing) function on overall health. Studies indicate that masticatory function affects cognitive processing speed, physical reaction time, and cerebral blood oxygen-dependent signals. Restoring this function has been shown to improve arousal and modulate cognitive functions.³ Conversely, a decrease in mastication correlates with reduced cerebral blood volume, diminished brain activity, cognitive decline, and a potential increase in dementia risk—all of which negatively impact one’s quality of life.⁴

Restoring Mastication with Dentures

Replacing lost teeth with removable dentures requires careful consideration of their benefits and limitations.

Pros of Denture Prosthetic Replacement:

Improved Chewing and Digestion: Restoring the ability to chew enhances digestion and overall nutrition.
Jawbone Preservation: Properly fitting dentures stimulate the jawbone, helping reduce the rate of bone resorption.
Improved Speech: Dentures restore pronunciation and speech clarity.
Structural and Facial Support: Dentures maintain facial contours, preventing the sunken appearance associated with tooth loss.
Emotional Well-being: Restoring a smile can boost self-confidence and improve overall self-worth.

Cons of Denture Prosthetic Replacement:

Reduced Functionality: Dentures will never fully replicate the function of natural teeth.
Rehabilitation Period: Adjusting to dentures requires time, patience, and effort.
Ongoing Jawbone Loss: Bone resorption continues over a lifetime, even with dentures.
Dietary Adjustments: Some foods may remain challenging to eat, necessitating dietary changes.
Maintenance Requirements: Dentures require daily cleaning and soaking to prevent bacterial growth.
Limited Lifespan: Dentures typically last about five years before needing replacement.
Risk of Gum Disease: Partial dentures can increase the risk of gum disease in adjacent teeth.

Conclusion

Caring for the geriatric population’s oral health demands a holistic approach that prioritizes function, comfort, and overall health. As dental providers, we must advocate for treatments that preserve oral health, maintain quality of life, and integrate seamlessly with medical care. Through proactive planning and tailored prosthetic solutions, we can ensure that seniors retain their dignity, health, and quality of life as they age.

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