Patients With Transmandibular Implants Are at Risk for Severe Complications When Becoming Frail

When should root remnants and unrestorable broken teeth be extracted in frail older adults?

“…3,4 In 2016, approximately 40% of older adults ( 75 years) in the Netherlands had teeth remaining, and this number is expected to increase in the next decades. 5 While they are aging, many older adults become frail. Frailty is defined as a state in which older adults are vulnerable to sudden changes in health status because of a decline in physiological function and reserve.…”

“…6 When older adults become frail, care-dependent, and homebound, attention to oral health care often declines. 5 Important reasons for this decline in personal oral health care are cognitive impairment and physical disability (that is, gross and fine motor problems). 7,8 In addition, both home-dwelling and institutionalized older adults visit a dentist less frequently due to lack of perception of need for oral health care, worsened systemic and functional health, nervousness and fear about visiting the dentist, finances, declined mobility, and poor accessibility of the dental office for older adults with walking aids or wheelchairs.…”

“…Homebound older adults or older adults residing in a nursing home are particularly at risk of having poor oral health. 3,5 Caries, root remnants, and broken teeth with open root canals and inflammation of the gingiva are often seen in these frail older adults. 3 This is not without consequences for general health and well-being.…”

“…In care-dependent older adults, for whom radiographic assessment is often not possible, clinical prevalence of roots or broken teeth is much higher; it has been reported to be 62%. 5 Root remnants and unrestorable broken teeth are clinically present more often in older adults with dementia than in older adults without dementia, which might be a result of higher caries prevalence, fewer dental examinations, care-resistant behavior, and decreased verbal communication skills regarding dental problems and pain. 22…”

When should root remnants and unrestorable broken teeth be extracted in frail older adults?

“…3,4 In 2016, approximately 40% of older adults ( 75 years) in the Netherlands had teeth remaining, and this number is expected to increase in the next decades. 5 While they are aging, many older adults become frail. Frailty is defined as a state in which older adults are vulnerable to sudden changes in health status because of a decline in physiological function and reserve.…”

“…6 When older adults become frail, care-dependent, and homebound, attention to oral health care often declines. 5 Important reasons for this decline in personal oral health care are cognitive impairment and physical disability (that is, gross and fine motor problems). 7,8 In addition, both home-dwelling and institutionalized older adults visit a dentist less frequently due to lack of perception of need for oral health care, worsened systemic and functional health, nervousness and fear about visiting the dentist, finances, declined mobility, and poor accessibility of the dental office for older adults with walking aids or wheelchairs.…”

“…Homebound older adults or older adults residing in a nursing home are particularly at risk of having poor oral health. 3,5 Caries, root remnants, and broken teeth with open root canals and inflammation of the gingiva are often seen in these frail older adults. 3 This is not without consequences for general health and well-being.…”

“…In care-dependent older adults, for whom radiographic assessment is often not possible, clinical prevalence of roots or broken teeth is much higher; it has been reported to be 62%. 5 Root remnants and unrestorable broken teeth are clinically present more often in older adults with dementia than in older adults without dementia, which might be a result of higher caries prevalence, fewer dental examinations, care-resistant behavior, and decreased verbal communication skills regarding dental problems and pain. 22…”

The medically compromised patient: Are dental implants a feasible option?

“…), homeostasis control is at a level allowing for implant placement (for patients on anticoagulants and hemophiliacs) and oral self-care is at the appropriate level. Occasionally, particularly in neuropsychiatric patients, help is needed from relatives to safeguard a proper level of oral care (Hoeksema, Raghoebar, Vissink, & Visser, 2015;Hoeksema et al, 2016). Notwithstanding the potential health risk of dental implants in frail patients, quality of life, activities of daily living, and general health are higher among community-living elderly with implant-supported overdentures than in edentulous elderly (Hoeksema et al, 2017).…”

When should root remnants and unrestorable broken teeth be extracted in frail older adults?

“…3,4 In 2016, approximately 40% of older adults ( 75 years) in the Netherlands had teeth remaining, and this number is expected to increase in the next decades. 5 While they are aging, many older adults become frail. Frailty is defined as a state in which older adults are vulnerable to sudden changes in health status because of a decline in physiological function and reserve.…”

“…6 When older adults become frail, care-dependent, and homebound, attention to oral health care often declines. 5 Important reasons for this decline in personal oral health care are cognitive impairment and physical disability (that is, gross and fine motor problems). 7,8 In addition, both home-dwelling and institutionalized older adults visit a dentist less frequently due to lack of perception of need for oral health care, worsened systemic and functional health, nervousness and fear about visiting the dentist, finances, declined mobility, and poor accessibility of the dental office for older adults with walking aids or wheelchairs.…”

“…Homebound older adults or older adults residing in a nursing home are particularly at risk of having poor oral health. 3,5 Caries, root remnants, and broken teeth with open root canals and inflammation of the gingiva are often seen in these frail older adults. 3 This is not without consequences for general health and well-being.…”

“…In care-dependent older adults, for whom radiographic assessment is often not possible, clinical prevalence of roots or broken teeth is much higher; it has been reported to be 62%. 5 Root remnants and unrestorable broken teeth are clinically present more often in older adults with dementia than in older adults without dementia, which might be a result of higher caries prevalence, fewer dental examinations, care-resistant behavior, and decreased verbal communication skills regarding dental problems and pain. 22…”

The medically compromised patient: Are dental implants a feasible option?

“…), homeostasis control is at a level allowing for implant placement (for patients on anticoagulants and hemophiliacs) and oral self-care is at the appropriate level. Occasionally, particularly in neuropsychiatric patients, help is needed from relatives to safeguard a proper level of oral care (Hoeksema, Raghoebar, Vissink, & Visser, 2015;Hoeksema et al, 2016). Notwithstanding the potential health risk of dental implants in frail patients, quality of life, activities of daily living, and general health are higher among community-living elderly with implant-supported overdentures than in edentulous elderly (Hoeksema et al, 2017).…”

When should root remnants and unrestorable broken teeth be extracted in frail older adults?

“…3,4 In 2016, approximately 40% of older adults ( 75 years) in the Netherlands had teeth remaining, and this number is expected to increase in the next decades. 5 While they are aging, many older adults become frail. Frailty is defined as a state in which older adults are vulnerable to sudden changes in health status because of a decline in physiological function and reserve.…”

“…6 When older adults become frail, care-dependent, and homebound, attention to oral health care often declines. 5 Important reasons for this decline in personal oral health care are cognitive impairment and physical disability (that is, gross and fine motor problems). 7,8 In addition, both home-dwelling and institutionalized older adults visit a dentist less frequently due to lack of perception of need for oral health care, worsened systemic and functional health, nervousness and fear about visiting the dentist, finances, declined mobility, and poor accessibility of the dental office for older adults with walking aids or wheelchairs.…”

“…Homebound older adults or older adults residing in a nursing home are particularly at risk of having poor oral health. 3,5 Caries, root remnants, and broken teeth with open root canals and inflammation of the gingiva are often seen in these frail older adults. 3 This is not without consequences for general health and well-being.…”

“…In care-dependent older adults, for whom radiographic assessment is often not possible, clinical prevalence of roots or broken teeth is much higher; it has been reported to be 62%. 5 Root remnants and unrestorable broken teeth are clinically present more often in older adults with dementia than in older adults without dementia, which might be a result of higher caries prevalence, fewer dental examinations, care-resistant behavior, and decreased verbal communication skills regarding dental problems and pain. 22…”

The medically compromised patient: Are dental implants a feasible option?

“…), homeostasis control is at a level allowing for implant placement (for patients on anticoagulants and hemophiliacs) and oral self-care is at the appropriate level. Occasionally, particularly in neuropsychiatric patients, help is needed from relatives to safeguard a proper level of oral care (Hoeksema, Raghoebar, Vissink, & Visser, 2015;Hoeksema et al, 2016). Notwithstanding the potential health risk of dental implants in frail patients, quality of life, activities of daily living, and general health are higher among community-living elderly with implant-supported overdentures than in edentulous elderly (Hoeksema et al, 2017).…”