Introduction

• The likelihood of reaching age 65 year with all or most teeth intact is much greater than in previous generations. However, about 1/3 of adults more than age 65 are missing part or all of their teeth (edentulism).
• Although dentition (or teeth) may be well preserved in the absence of caries and periodontal disease (disease affecting the parts of the mouth that surround and support the teeth), poor dentition is common and a major contributor to impaired chewing and reduced caloric intake.

Sign & Symptoms

• As people age, the gums recede slightly. Consequently, the lower parts of the teeth are exposed to food particles and bacteria.
• The hard white outer layer of a tooth (tooth enamel) also tends to wear away.

Disease

• These changes make the teeth more susceptible to decay and cavities (caries), which make tooth loss more likely.
• For older people, other common problems include periodontal disease. In periodontal disease, the gums may be inflamed and infected (as gingivitis).
• The ligaments and bones that support the teeth may be inflamed and infected (as periodontitis).
• Partial and complete tooth loss is an age-related condition that is caused primarily by dental caries and periodontal disease.

Complications

• Tooth loss impairs chewing, swallowing and speaking which can lead to nutritional deficiencies, aspiration complications, social isolation and depression.
• Dentures are associated with many oral health problems, including irritation, ulceration, gingival overgrowth, candidal infection and pain.

Treatment

• Most of these problems can be prevented or treated effectively.
• Partial tooth loss is treated with fixed (eg, bridges, implants) or removable (eg, partial dentures) appliances. Complete tooth loss is treated with complete dentures.