Oral rehabilitation of elderly patients

Improved living conditions, public health, and birth control have led to an unprecedented rise in the elderly population, making old age a major social issue. Gerontology (normal aging processes) and geriatrics (age-related diseases) have expanded, and gerodontology has emerged in dentistry. Today’s seniors retain more teeth but show physiological changes: sensory decline (vision, hearing, taste, smell, touch), reduced renal reserve, tissue dehydration, hypochlorhydria, and slower psychomotor speed. Orally: enamel becomes more brittle and worn; dentin shows secondary formation and sclerosis (reduced sensitivity and permeability); pulps are fibrotic with calcifications; mucosa is atrophic; salivary glands have function vulnerable to medications (xerostomia, higher root caries risk); gingiva is more friable; alveolar bone exhibits atrophy/osteoporosis; and masticatory muscles atrophy. Common conditions (cardiovascular, pulmonary, neurologic, rheumatologic, diabetes, endocrine) and polypharmacy affect dental planning (selective antibiotic prophylaxis, caution with anticoagulants/NSAIDs, drug interactions).

Nutritionally, edentulism and xerostomia promote soft diets low in vitamins/minerals, increasing malnutrition risk. Oral care focuses on maintaining function without overtreatment, emphasizing prevention, hygiene, and fluoride; root caries are managed conservatively (plaque control, fluoride, chlorhexidine, cementoplasty; restoration when needed). Endodontics is feasible but canal access is harder; periodontal therapy favors non-surgical and supportive approaches. In prosthodontics, the aim is to preserve remaining teeth and deliver stable long-term rehabilitations, with tailored solutions (fixed bridges when possible, removable dentures with protective design, overdentures on roots/implants for stability). Regular recall (6–12 months) monitors hygiene, occlusion, prostheses, and caries–periodontal risks.