Minimal intervention dentistry for partially dentate older adults

Abstract

Background Chronic dental and oral diseases, such as dental caries and periodontal disease, continue to be a significant health problem among older adults. Given the rapidly changing profile of the ageing population, and their complex health needs, there is a need to develop new evidence‐based approaches to oral health care. Recently, care philosophies have been developed that take a minimally invasive, functionally oriented, approach to oral health care with a focus on providing a reduced, but healthy, natural dentition which can be maintained with support of better oral hygiene. Method A review of the literature concerning use of minimal intervention dentistry (MID) to manage caries and toothloss in partially dentate older adults was undertaken. Results A variety of chemotherapeutic agents are available to prevent development of root caries and/or arrest root caries lesions, with professionally applied solutions (ie 22 500 NaF, 38% SDF or 40% CHX) every 3 to 6 months demonstrating best outcomes. Application of 38% SDF annually in high‐risk, institutionalised older adults is effective in arresting root caries. Atraumatic restorative treatment can be used successfully to manage active carious lesions and limit the removal of natural tooth tissue. Finally, functionally oriented treatment planning to manage partial toothloss is successful in terms of quality of life impact and cost‐effectiveness. Conclusion Available evidence is somewhat limited and more long‐term studies are need. However, currently available evidence suggests that minimal intervention dentistry can be predictable and cost‐effective in older adults.

Delivering Mobile Dentistry to the Geriatric Population—The Future of Dentistry

“…Every retained root does not require extraction, asymptomatic deficient endos can be monitored, and removable prostheses should be offered as an option to implant retained prostheses. Deliver dentistry that will improve the patient, not leave him/her with potential post-op complications [10].…”

Evaluation of PhD Students’ and Endodontists’ Treatment Approaches during the COVID-19 Pandemic: A Questionnaire-Based Survey

“…Among these treatments, ART is an MIDT method that is supported by scientific evidence, limits the removal of natural tooth structure, has a positive effect on the patient's quality of life, and is cost effective. 26,27 In the profound caries lesions extending into the pulpal third or quarter of the dentine radiographically, selective removal to soft dentine or stepwise removal with the advantage of not requiring a second visit may also be an appropriate treatment option. 26,28 In cases that require root canal treatment, treatment should be completed as soon as possible and in a single session without sacrificing quality, thus reducing exposure of the patient and the dental team to the virus during treatment and preventing the spread of the disease due to repeated sessions.…”

Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review

“…13 Thus, implementing this less invasive approach results in low levels of pain, discomfort, and anxiety; good predictability; low costs; and good patient acceptance. 18,19 However, studies have been inconclusive on whether ART should be considered as an adequate alternative to replace CT, which is considered the gold-standard therapy for dental caries for the elderly. Accordingly, the present review aimed to systematically investigate the survival rate of restorations placed using ART in elderly patients.…”