Three cheers for senior citizens! 8 September 2010
Author: Hadi Antoun
Journal and references: L’INFORMATION DENTAIRE n°30 - 8 septembre 2010
In France, life expectancy has nearly doubled in the twentieth century. The share of senior citizens over the age of 65 years in the population as a whole was on average around 17% in European countries in 2000. It will be close to 30% by 2040! In 1998, the world had 390 million senior citizens; this amount is expected to double for 2025. According to figures from the World Health Organization, in some countries in South America or in Asia, the proportion of people over 60 years old will increase by 300% over this period and will reach 2 billion in 2050, all countries combined, 80% of whom will be in industrialized countries.
This poses a considerable challenge in terms of public health particularly regarding the development of certain diseases, such as cardiovascular diseases, hypertension, diabetes and cancer. Dental prevention is almost non-existent for the elderly. The development of caries and periodontal diseases is constantly increasing in this age group. Access to healthcare for the elderly is not always possible for various reasons even in our developed countries: the geographical distance in some areas where there are few practitioners, the economic conditions or a negative attitude against oral health.In France, 16% of individuals aged between 65 and 74 years were edentulous in 1990-1992 (Bourgeois, Berger, Hescot et al. 1995). In a relatively extensive literature review, only four countries (Finland, Sweden, UK and USA) had reliable data for a projection of the prevalence of tooth loss in the near future (Mojon et al. 2004). Nevertheless, it shows that the total tooth loss rate should decline, probably through prevention and conservative care among the younger citizens. However, since the number of missing teeth is proportional to the patient's age and since the population is ageing, will the absolute amount of edentulous patients fall? The question is left open.As for edentulous patients treated with implant-borne restorations, it should become mainstream. When completed successfully, it still remains the most reliable technique for regaining the function, the comfort, the taste and the aesthetics of teeth. What attitude should we adopt when our ageing patients are left with severe bone resorption or diseases which contraindicate heavy surgery? While simplifying procedures, reducing the number of implants and searching for bone anchoring in the basal bone, such as the zygomatic process for the maxilla or the symphysis menti for the mandible, should help rehabilitate the vast majority of our seniors citizens. Of course, the economic problem remains in addition to the technical challenges. But, I can not claim to resolve it within these few lines. However, a contribution has been made with these technical advances and these new therapeutic approaches. Our politicians will have to do the rest...
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