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The proportion of elderly persons in the American population is increasing significantly, and the number of individuals losing all or some of their teeth is decreasing. Consequently, the number of teeth in the elderly at risk for developing periodontis is growing. The prevalence and severity of periodontitis apparently increase with increasing age. These facts have led to the widely held supposition, that periodontitis in elderly people is an ever‐increasing burden that society and the dental profession must face. A careful assessment of the data, especially the most recent, shows that this may in fact not be the case. Elderly people have a type of periodontitis that, at any given site, usually progresses infrequently and slowly. The enhanced prevalence and severity among older people may not result from an enhanced susceptibility, but rather, most likely reflect the accumulation of lesions over time. The most recent epidemiological studies indicate that the prevalence of gingivitis, the precursor to periodontitis, is decreasing significantly, especially in the younger segments of the population, and that this may translate into a markedly decreased prevalence of periodontics as these same individuals enter the older age groups. The types of therapy most needed in dealing with periodontitis in older people are not complex and the capacity to perform them does not require specialized periodontal training; it can, in fact, for the most part, be performed by auxillaries such as dental hygienists. Thus, the treatment burden on the dental profession will probably not be as great as in currently anticipated. The numerous gaps in our knowledge about periodontitis in the elderly include a poor understanding of its true prevalence and severity as well as its likelihood of occurrence and rate of progression. We have almost no knowledge about the flora at normal and periodontally diseased sites. Except for the immune system, we have but little knowledge about how the host defense mechanisms change during the aging process. Resolution of these questions would aid greatly in planning prevention and treatment programs and in improving therapeutic decision‐making in individual cases.
Gerodontology – Wiley
Published: Apr 1, 1984
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