Fall 2004, Vol. 17, No 2
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Implant Therapy For the Older Edentulous Patient
Myers G
The population of older adults has increased dramatically in recent decades and will continue to grow in the future. These people will anticipate a greater life expectancy accompanied by a higher quality of life. Their expectations, like those of all patients, include a functional dentition that is esthetically attractive. Many of these older patients are fully edentulous and are often given dentures as the only restorative option.
About one-fourth of denture wearers report disatisfaction with removable prostheses. Studies have shown that older patients have more difficulty in adapting to a removable denture. In addition, the added life expenctancy will lead to further increased risk of dissatisfaction because long term denture use promotes increased bone loss.
Due to these problems with removable dentures, there is a need for an alternative dental treatment for older edentulous patients. Previous studies indicate that patients who have had dentures replaced with a fixed implant retained prosthesis reported an improvement in the quality of their lives. Other studies indicate improved chewing ability as a result of implant therapy.
Universally, the older population has not experienced the same access to dental implants as a treatment option. The lack of implants used in older patient populations can be attributed to two possible causes: misconceptions arising from negative stereotypes regarding older adults, and misconceptions regarding the feasibility of implants in older adults.
Studies have shown that dentists often make different treatment decisions for older adults, based on stereotype views of the elderly, such as life expectancy, dexterity, motivation, and economic standing. These stereotypes tend to be negative and can lead to reduced options and quality of care for the elder patient.
Studies attest that age has no bearing on the success of osseointegrated dental implants. Reports also indicate the long-term reliability of osseointegrated dental implants even in situations with less than optimal oral hygiene. These reports do not support the exclusion of patients due to lack of manual dexterity or motivation. The author states that "...regardless of economic status, it is the patient's ethical right to make decisions regarding the economic feasibility of implants and it is the dentist's responsibility to offer them as a treatment option." Dentists need to be better informed of the realities of the aging process as it relates to the success of implant placement, and to the need and desires of older patients. The dental community would then be more likely to offer a wide range of available therapies to edentulous older patients, including implant supported reconstructions.
First place. Fourteenth Annual Arthur
Elfenbaum Essay Award Contest, 1995:
Sponsored by the
American Society of Geriatric Dentistry The Dietary
Adequacy of Edentulous Older Patients Greksa et al
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