Dental management of the elderly patient

The population of the UK was approximately 52 million in 1992, of which 16% were over 65 years of age. By 2001, the population of the UK had risen to just under 59 million.1 It is predicted by some authorities that the over 65-year-old age group will increase by approximately 30% over the next 25 years and that the number of patients in the over 85 years age group will rise even more dramatically.

The Adult Dental Health surveys completed over the last forty-or-so years have consistently shown that the rate of edentulism in England and Wales has decreased from 37% in 1968 to 6% in 2009. In addition, there is further evidence from these surveys that elderly patients are retaining their natural teeth into their older age.2

There is, however, a difficulty in regarding the ‘elderly’ as one homogeneous patient cohort. Despite the fact that some authorities divide the over 65 years age group into classifications, such as the ‘young old’, the ‘old’ and the ‘old old’, dependent on their numerical age, a more appropriate viewing of the older patient cohort might take into account the ‘biological’ age of the patient, not just their numerical age. In other words, most experienced dental clinicians will recall having treated very young-looking, relatively healthy, numerically (in years) ‘old’ patients, as well as also treating relatively frail-looking, chronically-ill, numerically ‘young’ patients. The notion that the numerical and biological ages of ‘elderly’ patients are not always coincident is very evident in modern dental practice.