Minimal Intervention Dentistry for Older Adults

Author(s): Shaista Rashid

Aging of baby boomers and longer life spans had lead to an increasing population of older adults. In the United States population of older adults is projected to double over the next four decades. The older adults are retaining their teeth longer and have more dental prosthesis. Older adults have compromised dental health due to medication-induced xerostomia, age-related gingival recession with exposed root surface, which is more susceptible to caries. Compromised medical health, physical or cognitive disabilities, and high caries risk maintain the existing prosthesis becomes a challenge. Teeth that are retained with the prosthesis are more prone to caries around their margins (recurrent caries). Prevention and treatment of recurrent caries around the margin of dental prosthesis become are challenge. Removing the prosthesis and replacing it with a new one is the only viable therapeutic option. The restorative option is expensive, time-consuming, and requires multiple appointments and involves technical difficulties. Restorative options could be a problem for older adults due to lack of finances, lack of transportation frailty, or lack of access to care. These issues require to treat multiple teeth at the same time, are less expensive, and do not a lot of time in treatment. Prevention becomes an area of paramount important. Prevention and treatment of recurrent caries through chemotherapeutic management can have an advantage of cost-effectiveness, speed and being minimally invasive. The most effective method for prevention to date is considered to be fluoride. In the United States fluoride has been incorporated in many ways like water fluoridation, fluoride mouth wash, dentifrices, and professionally applied fluoride varnishes. The American Dental Association (ADA) recommended the use of fluoride for patients of all ages who are at risk of developing dental caries. With the high success of fluoride, another treatment method using Silver Diamine Fluoride (SDF) is gaining popularity in the United States. We will discuss different preventive therapies for older adults to maintain their dental prosthesis longer.