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Objectives: Weight loss is a critical health issue in older adults. Oral function is essential for nutrient intake and can be restored using dental prosthetic treatments in patients with tooth loss. This study aimed to investigate the relationship between tooth loss and weight loss among the older adults and to evaluate the magnitude of its risk reduction by dental prosthetic treatment., Design: Three-year follow-up longitudinal study based on a self-reported questionnaire., Setting: Community-dwelling older adults in Japan., Participants: Adults aged 65 and older (n = 53,690)., Measurements: We used >10% weight loss during follow-up, the number of remaining teeth, and the use of dental prostheses as the outcome variable, exposure variable, and mediator, respectively. We fitted the logistic regression model including possible confounders and calculated the odds ratios (ORs) and 95% confidence intervals (95% CIs) of the controlled direct effect (CDE) at the level of use or nonuse of the dental prosthesis based on a causal mediation analysis framework. Additionally, we calculated the proportion eliminated by the dental prosthesis., Results: The mean age of participants was 72.6 years (1 SD = 5.5), and 47.4% were males. About 5.8% (n = 3132) of them experienced >10% weight loss during the follow-up. Weight loss was observed in 6.8% of the participants with 0-19 remaining teeth and in 4.3% of them with ≥20 remaining teeth. The CDE of 0-19 remaining teeth was greater when no one used dental prosthesis (OR = 1.41; 95% CI = 1.26-1.59) compared with that when all participants used dental prosthesis (OR = 1.26; 95% CI = 1.08-1.46). This indicated that dental prosthesis decreased the risk of weight loss by 37.3%., Conclusion: Our study revealed that tooth loss increased the risk of clinically critical levels of weight loss among community-dwelling older adults. However, this risk was reduced by dental prosthetic treatment., (© 2021 The American Geriatrics Society.)

The aim of this study was to investigate the effects of a counselling-based dietary intervention on nutritional status in partially dentate patients receiving removable partial dentures (RPDs). Thirty-eight patients [mean age (standard deviation): 73.2 (7.7) years] who were scheduled to receive RPDs at a dental hospital and were currently eating <350 g of vegetables per day were included in the study. A dentist provided basic dietary counselling aimed at increasing dietary fruit and vegetable intake and improving dietary habits. Patients received dietary counselling directly after treatment with new RPDs and at 1 week after a 1-month follow-up evaluation (T1). Food intake was assessed via a validated brief-type self-administered diet history questionnaire, and carotenoids and vitamin C in 6-hour fasting blood samples were measured before RPD administration, and at 1 (T1) and 3 months (T3) thereafter. Vegetable but not the fruit intake increased significantly at T1 and T3 compared to before treatment. Alpha carotene significantly increased at T3 while β significantly increased both at T1 and T3 compared to before treatment (P < .05). The number of occlusal units on natural teeth was significantly positively associated with increased vegetable and β-carotene intake (P < .05). Serum carotenoids and vitamin C levels measured with 6-hour fasting blood samples remained constant. These results suggest that basic dietary counselling may improve vegetable intake in partially dentate patients receiving RPD treatment, but did not lead to haematological changes. The presence of occlusion of remaining posterior teeth may be critical for improving vegetable intake., (© 2018 John Wiley & Sons Ltd.)

Objectives: This clinical study evaluated the long-term outcome and survival rate of all-ceramic cantilever resin-bonded fixed dental prostheses (RBFDPs) made of zirconia-ceramic with a single-retainer design to replace missing incisors. In addition, whether the reason for missing incisors has an influence on the longevity of RBFDPs was analyzed., Materials and Methods: One hundred and eight zirconia ceramic cantilever RBFDPs were provided for 87 patients. Seventy-five RBFDPs replaced maxillary incisors and 33 mandibular incisors. The restorations were subsequently categorized into 3 groups according to the reasons for missing teeth (congenitally missing, trauma and other reasons). The patients were followed up annually, and the restorations were assessed for function and aesthetics. The mean observation time of the RBFDPs was 92.2±33months., Results: Six debondings and 1 loss of restoration were recorded. The lost restoration was removed at the patient's request after a small chip occurred on the mesial edge of the pontic. Three of the 6 observed debondings were caused by traumatic incidents. All debonded RBFDPs were rebonded successfully with no further complications. Zirconia ceramic RBFDPs yielded a 10-year survival rate of 98.2% and a success rate of 92.0%., Conclusions: Anterior zirconia ceramic cantilever RBFDPs provided excellent clinical longevity. The reasons for missing incisors did not influence the longevity of the cantilever RBFDPs., (Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: According to the literature, the occurrence of dysphagia is high in cases of stroke, and its severity can be enhanced by loss of teeth and the use of poorly fitting prostheses., Objective: To verify that the status of oral health influences the level of oral intake and the degree of swallowing dysfunction in elderly patients with stroke in chronic phase., Methods: Thirty elderly individuals affected by stroke in chronic phase participated. All subjects underwent assessment of their oral condition, with classification from the Functional Oral Intake Scale (FOIS) and nasoendoscopic swallowing assessment to classify the degree of dysphagia. The statistical analysis examined a heterogeneous group (HG, n=30) and two groups designated by the affected body part, right (RHG, n=8) and left (LHG, n=11), excluding totally dentate or edentulous individuals without rehabilitation with more than one episode of stroke., Results: There was a negative correlation between the need for replacement prostheses and the FOIS scale for the HG (P=0.02) and RHG (P=0.01). Differences in FOIS between types of prostheses of the upper dental arch in the LHG (P=0.01) and lower dental arch in the RHG (P=0.04). A negative correlation was found between the number of teeth present and the degree of dysfunction in swallowing liquid in the LHG (P=0.05). There were differences in the performance in swallowing solids between individuals without prosthesis and those with partial prosthesis in the inferior dental arch (P=0.04) for the HG., Conclusion: The need for replacement prostheses, type of prostheses, and the number of teeth of elderly patients poststroke in chronic phase showed an association with the level of oral intake and the degree of oropharyngeal dysphagia.

Objectives: Previous investigations have confirmed that every fifth dental patient suffers from clinically significant depressive symptoms. However, the putative impact of depressive symptoms on the prosthetic status has not been addressed in these studies. The objective of this study was to investigate the association between depressive symptoms and prosthetic status based on data from the Study of Health in Pomerania (SHIP-0)., Methods: Data from 2,135 participants aged 30 to 59 years were analyzed. A classification (six classes regarding the number and position of missing teeth per jaw) was used to identify the degree of prosthetic status (no/suboptimal/optimal tooth replacement). The presence of depressive symptoms was assessed with a modified version of von Zerssen's complaints scale. Screening for lifetime diagnoses of mental disorders was performed with the Composite International Diagnostic-Screener (CID-S). Multivariable logistic regressions including several confounders were calculated., Results: A significant protective dose-response effect of depressive symptoms on prosthetic status was found only in men for the lower jaw [0-1 depressive symptoms: odds ratio (OR) = 3.84, 95 % confidence interval (CI, 1.65-8.92), p < 0.01; 2-3: OR = 2.87 (CI, 1.22-6.74), p < 0.05; reference, ≥8; adjusted for age, school education, smoking status, household income, marital status, living without a partner, risky alcohol consumption, obesity, diabetes, and physical activity]. There was no such association in women or for the upper jaw. The analyses using the CID-S confirmed these results., Conclusions: In the lower jaw, men with depressive symptoms had a better prosthetic status than men without depressive symptoms suggesting a higher level of concern regarding their personal health., Clinical Relevance: If dentists might have an opportunity to identify men with depressive symptoms they can provide a wide range of treatment options that may enhance patients' self-esteem and contribute to the patient' well-being. Furthermore, depressive symptoms could indicate a discrepancy between self-perception of the dental health and the actual status which influence the dentists' treatment decision making.

The main reasons for loss of autotransplanted teeth are different from those involved in natural teeth loss. The aim of this study was to investigate which procedures were employed to treat spaces vacated when autotransplanted teeth were lost. Participating dentists were requested to provide information on transplantations they had undertaken. A total of 614 teeth in 552 patients (37 dentists) ranging in age from 17 to 79 years (mean age: 44.1 years) were examined. A total of 102 transplanted teeth were lost during the observation period. Procedures for treatment of spaces vacated were not influenced by main reason for transplanted tooth loss. The procedure used to treat depended on the original prosthodontic treatment of the transplanted teeth. For single crowns, the spaces were left empty (33.9%) or replaced by bridge work (30.5%), implants (20.3%), or dentures (10.2%). For single crowns in the upper and lower second molar regions, the spaces were usually left empty (upper 100%, lower 71.4%), while for those in the upper and lower first molar regions, the spaces were often replaced by bridge work (upper 41.7%, lower 50.0%). For bridge abutments, spaces were replaced by dentures (42.9%), implants (33.3%), or left empty (14.3%), and in the lower second molar region, they were mostly replaced by implants (5 cases, 41.7%). For most denture abutment cases, the spaces were replaced by dentures (88.9%). During the survival period of the transplanted teeth, the masticatory burden on the other teeth is reduced and the adjacent teeth are supported by the transplanted tooth. Even if transplanted teeth are eventually lost, traditional procedures can be performed to fill the vacated space.

The replacement of a mandibular incisor is a dental treatment warranting special consideration. Some of the challenges associated with the anterior mandible are limited space, challenging surrounding anatomy, and tough esthetic requirements. Proper diagnosis and treatment planning may require a multidisciplinary approach to successfully meet the demands of replacing a missing tooth in this sextant. Several treatment options currently exist for mandibular incisor replacement. These options include (1) resin-bonded fixed dental prostheses (RBFDPs), (2) orthodontic treatment, (3) full-veneer fixed dental prostheses (FDPs), (4) dental implants for single-tooth replacement, (5) possible extraction of one or more incisors and restoration with implant-supported FDPs, (6) possible extraction of one or more teeth and restoration with FDPs from #22 to 27, (7) possible extraction of one or more teeth and restoration with removable dental prostheses (RDPs). This manuscript outlines the various treatment options for the replacement of mandibular incisors and discusses benefits and drawbacks of each., (© 2011 by the American College of Prosthodontists.)

Aim: The purpose of this study was to assess the attitude of patients towards anterior teeth extraction and prosthetic replacement of same at the Dental center of the University of Port Harcourt Teaching Hospital (UPTH)., Methods: A retrospective review of the data of patients who presented for anterior teeth extraction and prosthetic replacement or anterior teeth extraction only over a two-year period was done using the records of the oral surgery and prosthetic clinics of UPTH Dental centre. Demographic and clinical information were retrieved and analyzed using the SPSS version 15.0 (SPSS Inc., Chicago, IL, USA)., Results: Ninety-two patients comprising 58 males(63%) and 34 females (37%), giving a male to female ratio of 1.7:1, were involved. The age range was 6 to 86 years with a median age of 34.5 years. Forty- three patients (46.7%) had both extraction and replacement within the study period while 49 patients (53.3%) had extraction without replacement. Trauma was the major cause of anterior tooth loss, especially among males and young individuals. Plastic removable partial denture was the main type of replacement offered. Fifty percent of the females (17/34) had replacement compared to 44.8% of the males (26/58). Among those who had both extraction and replacement, majority (74.4%, 32/43) requested for replacement within a month post extraction. Also, 86.2%t of the patients below 40 years either had immediate dentures or replacement within a month compared to 50% of those above 40 years., Conclusion: Most of the patients, surprisingly, tolerated anterior edentulousness. However, it appears that anterior edentulousness was more abhorent to female patients and younger individuals.

This case report describes the treatment of a 37-year-old woman with multiple restored and missing teeth, a Class III subdivision malocclusion, and complete dental crossbite. Treatment options included orthognathic surgery and an orthodontic-prosthetic approach. The patient opted for nonsurgical treatment with space opening for prosthetic replacement of the first maxillary molars., (Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Objectives: The level of knowledge, awareness, and attitude about teeth-replacement options among a group of medical and paramedical subjects and to compare them with the general population., Materials and Methods: A self-administered questionnaires using simple Arabic language were distributed to two groups of subjects. Questions focused on the willingness to replace the missing teeth, the preferable methods of choice for replacement, and the reasons for these choices. The first group (G-I) was from the medical and paramedical staff who work in a military hospital at Jordan Royal medical services, the dental staff was excluded from the study. The other group (G-II) was from the general population who attended the dental department in the same hospital with comparable level of education. All the participants were partially edentulous excluding the third molars. Clinical examination was done by qualified prosthodontist to evaluate the possible prosthetic treatment options for replacement. A total of 612 questionnaires were distributed, of which 533 questionnaires were returned (response rate 87.09%). The results were analyzed and comparison was made between the two groups., Results: Responses to questions about awareness and attitude about prosthetic management of missing teeth revealed that G-I have more awareness than G-II to the probable causes for tooth/teeth replacement and limitation of the preferable method for replacement (P<0.05). More than 80% of the participants believed that replacement of anterior teeth is more important than the posterior teeth. Implants and fixed partial denture (FPD), respectively, were more preferable than removable prosthesis, although clinically was not indicated in cases (P<0.05). There was no clinical benefit from replacement of missing teeth in 33.4% while only 6% believe this., Conclusions: This study showed that the awareness and attitude between the medical and paramedical staff to prosthetic needs is better than between general populations. The demands for dental replacement by patients were significantly different when compared with the actual needs.

This qualitative research analyses the repercussions of total dental loss on people's quality of life. The Oral Health Impact Profile short-form (OHIP14) was applied to 50 volunteers, and after analyzing the results, 13 out of those 50, were selected to be individually interviewed in an opened questions script. The criteria to select these 13 people were: perception of the impact of mouth condition on quality of life measured by the score reached on OHIP. We tried to comprise the sample with a good variety, according to the profile of the initial sample. After analyzing people's statements, it was possible to verify that dental loss had strong negative consequences on people's life, like shame, difficulty to eat, impact on social relationship and feeling of not being complete. The possibility of having their teeth replaced generates some anxiety. Although being aware that wearing total prosthesis represents some sacrifices, people considered it worthwhile because the possibility of regaining the social pattern and the self-image is renewed.

Purpose: To evaluate parents' attitude toward esthetic defects of maxillary primary incisors and the association between various demographic parameters and the treatment parents chose for their children., Methods: The study consisted of two parts: 1) a clinical examination of the child's primary incisors, and 2) a questionnaire for the accompanying parent. 362 parents who accompanied 294 children aged 1-6 years, participated in the study. They were divided in 2 groups: parents' accompanying children with esthetic defects (study group) and parents' of children without esthetic defects (control group)., Results: Significantly more parents in the study group (73%) recognized an esthetic problem in their child's incisors, compared to (17%) in the control group. Eighty seven percent (219 in the Study Group [85.20%] and 97 in the Control Group [92.4%]) advocated dental treatment to save a primary tooth even if the chances for success were only 50%. 35.9% rejected the idea of a prosthetic replacement for a lost primary incisor. The same percentage of parents (35.9%) answered that they "want it 'very much'" while the rest (28.2%) chose intermediate scores '2-3' on a scale of '0' (= not at all) to '5' (= yes! very much)., Conclusion: Parents are interested in a conservative treatment for preserving esthetically damaged incisors, but will be less enthusiastic to replace extracted or missing teeth with an esthetic device.

Single-tooth replacement may be effected through various methods, including the use of a resin-bonded fixed partial denture, a conventional fixed partial denture, and a single implant-supported crown. Although the introduction of newer therapeutic modalities, surgical and restorative techniques, and restorative materials has significantly expanded available treatment options, a greater demand is now placed on the diagnostic and treatment planning acumen of the clinician. The questions confronting each clinician are when to apply each treatment modality and how to use these therapeutic approaches to their maximum benefit for the patient. This article focuses on the factors that should be considered when making such clinical decisions and offers a framework within which to formulate appropriate treatment algorithms.

Studies on self-perception have demonstrated that tooth loss is associated with esthetic, functional, psychological and social impacts for individuals. However, not all subjects seek treatment immediately after tooth loss, even when desire for replacement is strongly expressed. The aim of this study was to evaluate the perception of patients submitted to tooth extraction about factors associated with tooth loss and prosthodontic treatment, at the time and after extraction. A convenience sample of 211 consecutive patients were clinically evaluated and answered to a questionnaire about perceived impacts and prosthodontic treatment needs. Data were collected at the time of extraction and after a 3-month time interval. Perceived impacts were high (21 to 76% at the time and 35 to 87% after extraction). From 72.5% patients who expressed intention of immediate replacement of edentulous spaces, only 8.1% had actually been treated. Financial limitation was considered the most important factor that restricted access to treatment. Bivariate statistical analysis showed association between immediate dental replacement and anterior tooth loss (p=0.00) and extension of edentulous space (p=0.01). Position of lost teeth was associated to perceived functional limitation (p=0.03). Worsened appearance was associated to tooth loss in the maxillary arch (p=0.02), and desire of prosthodontic treatment was associated to the extension of edentulous space (p=0.05). Perceived impacts were more frequent in women than men. It was concluded that although patients usually expressed prosthodontic treatment needs, clinical and financial issues are determinant factors for tooth replacement.

Purpose: The surgical treatment of oral cancer results in functional and aesthetical impairments. Patients' quality of life is considerably impaired by oral symptoms resulting from therapy of oral cancer. In many cases the inevitable resection of the tumor, as well as the adjuvant radiochemotherapy will cause the destruction of physiologically and anatomically important structures. One focus of research was the specific rehabilitation of dental loss by functional dentures. Another was the course of 19 impairments (comprehension of speech for unknown others, comprehension of speech for familiar others, eating/swallowing, mobility of the tongue, opening range of the mouth, mobility of lower jaw, mobility of neck, mobility of arms and shoulders, sense of taste, sense of smell, appearance, strength, appetite, respiration, pain, swelling, xerostomia, halitosis)., Methods: Commissioned by the German, Austrian and Swiss cooperative group on tumors of the maxillofacial region (DOSAK), data were collected in 3.894 questionnaires at 43 hospitals in Germany, Austria and Switzerland. The catalogue comprised 147 items in 9 chapters. At the end of the enquiry, 1.761 anonymous questionnaires were returned by 38 hospitals. 1.652 of these could be evaluated regarding the question., Results: The sum score of the 19 impairments was highly increased immediately after the operation and recovered over the next 6 months, without, however, reaching the pre-surgery level. Of 1.652 patients, only 35% did not lose any teeth during therapy. 23% lost up to 5, 17% up to 10 teeth. A quarter of the patients lost more than 10 teeth. The more teeth were lost, the greater the decline of quality of life (p < or = 0.001), although this could be allayed by the functionality of the dentures (p < or = 0.001). There is a reciprocal dependence between the functionality of dental prosthetics and impairment by eating/swallowing (p < or = 0.001)., Conclusions: Patients' quality of life after radical surgery of a carcinoma of the oral cavity depends not only on the functionality of dentures and the specificity of rehabilitation, but also from the initial findings, the extent and location of the resection, the chosen therapy, the general circumstances of the patient's life as well as their strategies of coping. These factors, however, unlike those of functionality of dental prosthesis and rehabilitation, are not modifiable.

Purpose: The concepts of need and demand are central in studies on dental care. In the literature, a normative definition is often used, but it pays little attention to the individual's personal comfort and quality of life. Need and demand for prosthodontic services are difficult to measure, as prosthodontic treatment is highly individual and not closely related to edentulousness. Need, however defined, does not always lead to demand for treatment, depending on a variety of factors., Materials and Methods: The present article is part of a larger study in which the intention is to evaluate need and demand for prosthodontic treatment among the participants in a 1989 and 1999 longitudinal study of a population sample. As the first step, this article reports a conceptual analysis of the need concept from the literature., Results: Need is stated as socially established in the interaction between patient and clinician. It makes demand dependent on available treatment options from the care provider and society. In the prosthetic treatment decision-making process, the emancipatory perspective with the patient-clinician dialogue is of utmost importance to achieve an optimal treatment result., Conclusion: The professional attitude toward need must be that there is no true objective or subjective need. Need is established only in a communicative dialogue with mutual respect between the professional and the patient.

Objectives: To quantify incidence of tooth loss, prosthodontic dental restoration, and chewing difficulty onset and the effect of tooth loss and prosthodontic restoration on chewing difficulty onset., Design: A prospective cohort study of oral health and related behaviors with in-person interviews and clinical examinations conducted at baseline and 24 months. Telephone interviews were conducted every 6 months between these sessions., Setting: A community-based sample of four counties in north Florida., Participants: Eight hundred seventy-three persons who had at least one tooth and were aged 45 and older at baseline., Measurements: Persons were queried regarding onset of chewing difficulty, an important component of oral health-related quality of life (OHRQoL). The chewing index of Leake, with minor revision, was the primary outcome of interest. Tooth loss was measured using direct clinical examination. Dental care use was reported during each interview., Results: Approximately 22% of participants reported tooth loss during follow-up. Fixed prosthodontics (crowns and bridges) was the most common form of new prosthodontic treatment. People who reported tooth loss were 2.7 times more likely to report chewing difficulty onset than people without tooth loss (P<.001). Having fewer occluding pairs of teeth at baseline was significantly associated with an increased probability of chewing difficulty onset. People who received removable prosthodontic treatment were much less likely to report chewing difficulty onset than people who did not (P<.01)., Conclusion: Incident tooth loss and removable prosthodontic restoration strongly predicted chewing difficulty, an important component of OHRQoL.

Dental prostheses are frequently used to avoid psychologic, speech, or swallowing problems in preschool children with considerable tooth loss. Two cases of preschool children are presented, involving multiple loss of primary teeth. The purpose of this study was to promote the correct development of the maxilla and mandible by using removable dental prostheses and to guide the eruption of the permanent molars. Removable acrylic prostheses were provided for two children, with a special metallic s-shaped handle (ansa), which guided the eruption of the first permanent molars. These prostheses were modified as the children grew. By replacing missing teeth, several oral functions were re-established, development of the maxilla and mandible was promoted, and each child could develop socially from a psychologic point of view. The use of removable dental prostheses in preschool-aged children presenting with considerable tooth loss can be a viable and successful treatment option.

Objective: To report on adult patients' perceived need for replacement of teeth at the time of extraction and to study predictors of their perceived need for treatment., Design: Cross-sectional postal questionnaire survey., Participants: A systematic random sample of 1,500 Norwegian general dental practitioners. The response rate was 67% after two reminders and 75% of their patients responded. After exclusions, the final sample consisted of 438 patients (16-92 years old), who had had 599 permanent teeth extracted by 248 dentists over a period of two weeks., Results: The median number of remaining teeth was 23 (range: 0-31). The patients' wish for a replacement of the extracted tooth was coded as necessary (47%) and unnecessary (53%). Factor analysis (varimax rotation) was used to create two unidimensional variables, measuring the attitude to the importance of dental appearance and dental function. Logistic regression analysis showed that, compared to molars, the odds ratio for wishing a replacement for an incisor or canine was 13.7 (95% CI 5.6, 33.3) and for a premolar 4.1 (95% CI 2.4, 7.1). The likelihood of patients wanting a replacement when >1 tooth was extracted, or they did not believe that they would keep their teeth for life, was 2.5 (95% CI 1.2, 4.4) and 1.7 (95% CI 1.1, 2.8), respectively. Demographic characteristics and attitude to appearance and function had no significant effect on the patients' wish. CONCLUSIONS The most important predictors of patients' wish for a replacement were tooth type, number of teeth extracted and not believing in keeping their teeth for life.

A random probability sample of 2667 United Kingdom (UK) addresses was selected in a multistage sampling process. Participants were interviewed about their oral health status--number of teeth possessed and denture status. In addition information was collected about their socio-demographic characteristics (age, gender, social class and income level) and dental service factors--type of service used and difficulty accessing national health service (NHS) care. The response rate was 70%. Six percent (107) claimed they had less than 20 teeth but did not use a denture. Variations in this practice were apparent in relation to a number of socio-demographic factors: age (P < 0.05), gender (P < 0.01) and social class (P < 0.001) but not service related factors. In regression analysis, social class, gender and age emerged as important predictors of this practice. For example, those from lower social classes were approximately half as likely to use dentures despite experiencing considerable tooth loss (OR=0.53, 95% CI 0.34, 0.83), having controlling for other factors. More than one in 20, in Britain claim they have experienced considerable tooth loss but are without resource to a denture. Socio-demographic factors rather than service related factors are associated with this practice, particularly social class.

Reduced chewing ability in community-dwelling older people is linked to the presence of removable dentures and having fewer than 20 natural teeth present. Compensation is provided by chewing longer and swallowing larger food particles. Replacement of posterior tooth loss by fixed or removable prostheses increases the activity of the masticatory muscles, and reduces chewing time and the number of chewing strokes until swallowing. In residents of nursing homes and long-term care facilities undernutrition is prevalent because of general medical problems, reduced appetite, and poor quality of life. Poor oral health and xerostomia are often present and may have a negative effect on masticatory function and nutrition, precipitating avoidance of difficult-to-chew foods. There is no evidence that the provision of prosthetic therapies can markedly improve dietary intakes; however, it might improve oral comfort and quality of life and avoid enteral alimentation.

Purpose: This pilot study evaluated potential relationships between dental status and various sociodemographic variables in the age group segment of the United States population at greatest risk for the disruption of dental function due to treatment of an oral cavity cancer., Methods: The Dental Health Supplement of the 1989 National Health Interview Survey was used to evaluate the self-reported status of natural dentition and prior dental rehabilitation among the population of persons 45 years or older., Results: Sociodemographic variables, which showed a significant association with status of natural dentition, were level of income and occupation at lower income levels (p < 0.05). Increased levels of prior dental rehabilitation were significantly associated with lower age, female gender, increased level of income, and occupation (p < 0.05). Occupations that required social interaction had the highest levels of both status of natural dentition and prior dental rehabilitation (p < 0.05)., Conclusions: Overall dental status after treatment of oral cancer may be related to the occupational status of many persons. Sociodemographic factors that influence the dental rehabilitation needs of individual patients after treatment of an oral cancer should be considered in policy decisions affecting accessibility of dental rehabilitative care. A follow-up, survey study that would further define the identified relationships between a person's demographic status and dental rehabilitation needs is recommended.

Using the literature on the subject, an assessment was made of the state of the oral health in rural population: dental state, periodontal diseases, state and needs for prosthetic rehabilitation. The articles presents possible causes of this state of things.

The elderly have both the greatest level of need for prosthodontic services of any age group, and the greatest degree of complicating dental, medical, and behavioral factors. Issues arise in daily practice of whether or not to replace a missing tooth or teeth for a patient of advanced age and a wide variety of challenges-dental/oral and others-face the dentist who is considering replacing some or all of an older person's teeth. This article focuses on clinical approaches and techniques that have proven particularly important and useful for providing prosthodontic care to the older adult.

The early loss of permanent teeth following trauma or congenital aplasia may be corrected by orthodontic or prosthetic means, sometimes combined with implant therapy. The orthodontic solution results usually in different anatomic, functional, and esthetic problems. Prosthetic and implant procedures, on the other hand, are very demanding and require long-term maintenance. Considering these limitations, a comprehensive diagnostic and treatment plan is mandatory to achieve the most satisfactory clinical result. Modern restorative modalities, such as recontouring, bleaching, and resin composite bonding, may improve the final clinical result after orthodontic space closure. In more difficult situations, veneers and crowns may also be indicated.

The fewer the remaining teeth, the more difficult is prosthetic rehabilitation in the old patient. In the case of patients with disordered motoricity or mental disturbances, as well as those who refuse implants, or in whom implants are not possible for health reasons, the stepwise adaption of existing prostheses should be given preference over the provision of completely new dentures.

The prime objective of dental care is maintaining a natural functional dentition for life. It is expected that a growing group of adults will keep their dentition into old age. Although routine prosthodontic care will still be important in the future the treatment strategy for older adults and elderly people with a reduced dentition does require a different approach. The traditional approach in prosthetic therapy was guided primarily by morphological criteria aimed at preservation of complete dental arches, which resulted in emphasis on quantity in dental care. Nowadays requirements such as aesthetics and functional comfort are considered more important and more easily achieved. In the presented principles for treatment planning the importance of a thorough preliminary treatment is stressed. Furthermore, needs for tooth replacement are discussed and guidelines are given for a preventive prosthodontic treatment approach in severely broken-down dentitions and edentulous patients.