The body’s ability to function changes with advancing age, and this is also true in the field of dentistry. Geriatric dentistry focuses on the oral care of the elderly and addresses the particularities and specific needs of this patient group. Patients’ wishes and expectations for dental treatment vary according to age and the problems associated with ageing.

The body’s ability to function changes with advancing age.

Patients’ wishes for dental treatments follow certain aspects depending on the age of the patients and the problems that old age brings.

Young people want impeccable aesthetics while the elderly want to eat optimally.

There are certain indications and contraindications depending on the state of health.

While the full range of interventions can be performed on a healthy body, when the patient has another local or general pathology, the indications are restricted according to the body’s ability to tolerate the intervention and allow the tissues to heal.

Internal organs undergoing changes:

• Cardiovascular system – going to the dentist is always accompanied by a dose of stress, regardless of the severity of the case. The heart no longer adapts as well to stressful conditions.

In the elderly patient, the arteries can thicken due to cholesterol deposits and as a result, blood flows at a faster rate, causing an increase in pressure in the lumen.

This increases the risk of ischemic heart disease.

• Bone system – bones, which are hard structures that support muscles and form the entire human skeleton, can suffer resorption processes over the years.

• Osteoporosis is characterized by a decrease in bone mass, the weakening of the hard substance and the appearance of porosities.

All of this reduces bone strength, making the elderly patient prone to fractures.

Any small trauma to the facial bones can result in a fracture, which is more difficult to heal in old age.

Even some difficult extractions can lead to fracture of pieces of bone in the facial mass.

Reduced bone thickness and quality prevents the patient from being a good candidate for dental implants.

Also, when total dentures are applied, the retention provided by the stretched and raised bone surfaces is lacking, thus often resulting in the disinsertion of prosthetic work.

• Salivary glands – with advancing age, patients’ salivary glands atrophy, resulting in decreased saliva secretion. Reduced salivary flow predisposes to multiple carious processes, ulcerative lesions in the oral mucosa and difficulties in chewing, phonation and swallowing.

Salivary stagnation due to calcium deposits in the salivary glands can lead to inflammation and infection.

Another effect of xerostomia (reduction in saliva quantity) is papillary atrophy, which can alter the patient’s sense of taste and reduce perception of food.

The patient becomes less and less motivated to eat because they cannot enjoy the taste of the food and this, superimposed on the loss of dental units, leads to malnutrition.

The ageing process is a physiological one, as the body finds resources to adapt to new conditions.

In terms of dental treatments, older people place less emphasis on aesthetics and more on being able to grind food.

Implant treatment is also harder for older people to tolerate because of surgery.

In contrast, dental bridges can bring both aesthetic and functional satisfaction.

Importance of dental treatments for elderly patients

Geriatric dentistry plays an essential role in maintaining the oral and general health of elderly patients.

One of their major concerns is their ability to eat optimally.

Even when patients have other local or general conditions, dental treatments can play a significant role in improving quality of life and general health.

Indications and contraindications in dental treatment for elderly patients

Indications and contraindications in dental treatment for elderly patients depend on their general health.

In a healthy body, a full range of dental interventions can be performed.

However, when the patient has other conditions, dental interventions must be adapted to ensure tolerability and tissue healing.

Effects of ageing on body systems and implications for geriatric dentistry

1. Cardiovascular system: Going to the dentist is always accompanied by a dose of stress, regardless of the severity of the case. In elderly patients, arteries can thicken due to cholesterol deposits, increasing the risk of ischemic heart disease. This should be taken into account when planning dental interventions.

2. Bone system: Osteoporosis is a common condition among older people, characterized by a decrease in bone mass and weakening of bone tissue. These changes can affect bone strength and predispose elderly patients to facial fractures and difficulty in tissue healing. Dental implants may therefore be contraindicated in these cases.

3. Salivary glands: As we age, patients’ salivary glands atrophy, leading to decreased saliva secretion. This can lead to tooth decay, ulcerative lesions in the oral mucosa and difficulties in chewing, phonation and swallowing. Xerostomia (dry mouth) can also affect patients’ sense of taste, reducing the pleasure associated with eating. These issues can contribute to a decrease in elderly patients’ motivation to eat properly and can lead to malnutrition.

4. Dental treatments and preferences of elderly patients: In general, elderly people place less importance on aesthetics and focus more on functionality and the ability to grind food. As surgery may be more difficult for older patients to tolerate, dental implant treatments may be less preferred. Instead, dental bridges can offer satisfactory aesthetic and functional solutions.

Conclusion

Geriatric dentistry plays a crucial role in maintaining the oral and general health of elderly patients. As the body ages, there are physiological changes that can influence the dental treatments and treatment options available. Understanding the specific needs and peculiarities of elderly patients is essential to provide appropriate and personalized care. By tailoring dental interventions to patients’ individual health status and needs, it can help to improve their quality of life and maintain optimal oral health as they age.