Dental advice, diagnosis and treatment for the elderly needs to be tailored to their specific medical and living circumstances, says Professor Finbarr Allen, who is Dean of the National University of Singapore’s Faculty of Dentistry and Chair of the University Dental Cluster at National University Hospital.

He explained: “An elderly person who is motivated to keep their teeth, medically fit, and who lives independently and is not reliant on people to come and look after him, has relatively low dental risks. He can seek any advice he needs from a general practitioner and should have a check-up once or twice a year. This patient should be able to maintain a healthy, functioning dentition for life.

“An elderly person who is medically frail, and who lives in a nursing home, where dental care may be overlooked because there are other more pressing concerns, on the other hand – this person will need a lot of regular inspections and help with cleaning teeth from his dentist.”

Prof Allen noted that dentists also need to find out more about their elderly patients’ attitude towards dental care. “Medical issues such as smoking, diabetes and dry mouth affect a person’s dental prognosis, but so does his attitude. Is he interested and willing to do what is required to maintain his teeth? The answer should shape the treatment approach,” he said.

Prof Allen outlined three main treatment options for elderly patients whose teeth have begun to deteriorate. He said: “We should try to avoid complete tooth loss because using a full set of dentures is a learned skill, and many older people have trouble adapting to it.”

Dentists should take a minimally invasive approach for patients with a compromised dentition, such as adding adhesive resin material, to build up broken teeth to the point where they are functional, or place dentures over the roots of the teeth. “However, we have to make sure that the patient is motivated to maintain the remainder of his teeth and work hard at oral hygiene,” said Prof Allen.

He added that if complete tooth loss is unavoidable, dentists can help patients to adapt to dentures by fitting them with partial ones first: “By moving on to full dentures gradually, and removing teeth in a planned way, you give the patient the best possible chance to adapt.”

Source: IDEM 2018