Alexandre Mersel

The aging of the elderly population is a dramatic demographic fact. One of the most important challenges of the dental profession in the coming years will be in providing oral care to geriatric patients. The new trend is that the elderly will have more retained teeth and that their expectation will be greater. On the other hand the increase of their life–span will increasingly affect their medical status, therefore the profession has to develop an adapted prevention management and treatment strategy. The main field of action will be: Prevention of the Dental caries A special preventive protocol and a conservative approach is necessary in order to achieve a maximum of teeth when aging “20 teeth for the eighties”. Oral cancer Oral cancer has a high morbidity and mortality rate. The 5-year survival rate is 75% for local lesions but only 17% for those with distant metastasis. Oral cancer constitutes 13-16 % of all cancers, therefore early detection, and preventive attitudes and actions are compulsory. The profession must start with an education program both for the practitioner and the patients. Salivary hypo function With aging a great decrease of the saliva flow is noted. Aside from the normal gland hypo function more than 700 medications are known to cause dry mouth. Bad taste, bad breath and more root caries are the direct consequences. Prevention and control of the salivary pH is indicated. Periodontal Prevention With the loss of periodontal attachments, bad habits (smoking), poor conservative restoration and poor prosthodontic rehabilitation, the elderly are often subject to chronic periodontal diseases. This situation will finally lead to the loss of their teeth, in a way that step by step they will be edentulous. Edentulism is now recognized by the WHO as a real disability. Special attention should be taken in order to provide a large preventive treatment including, of course, the education and motivation of these patients.