Minimal or advanced restorative dentistry? Concepts for oral rehabilitation measures in elderly patients

Abstract Body: Prosthetic treatment of many older adults does not differ from any other adult patient. However, oral health of older individual can change fast when the ability to maintain personal hygiene decreases. Impairment in motoric skills, vision and the onset of memory disorders should be considered in prosthetic treatment planning. Treatment plan must have realistic goal and diagnosis ought to contain careful analysis of chewing ability and occlusal conditions.
Many older adults retain their own teeth. Unfortunately this does not mean that natural dentition guarantees good chewing function. Shortened dental arch (SDA) is usually sufficient for proper chewing. SDA is often good goal for oral rehabilitation in older adults. Maintenance of SDA can be achieved with fixed prosthetic restorations combined with the use of oral implants. One advantage of SDA concept is also the fact that anterior area is easier to clean even in the case if maintenance of proper oral hygiene requires assistance from a caregiver.
SDA concept is not realistic treatment goal for all older adults. In case of poor prognosis extractions and fabrication of removable partial dentures (RPD) can guarantee sufficient chewing function. However, the decision to make RPD ought to be taken early enough so that patient still can learn how to manipulate it. This is also the case when oral conditions have changed to the level when complete dentures are the only option. If the hopeless teeth are removed early enough, one can still be good candidate for implant retained overdenture treatment.
This presentation focuses on prosthetic treatment planning of older adults. The aim is to present cases when extensive treatment is possible and how this may help prognosis in the long run. Minimal treatment goals for those whose condition does not allow normal prosthetic treatments will also be discussed.