Periodontal treatment and prophylaxis in the frail elderly.

Throughout the world the numbers of elderly are rapidly increasing. Survival to age 80 years and beyond is now commonplace in many industrialized nations. Of particular concern to the health professions is the previously unimagined growth in the population aged 80 years and over who are at increased risk of morbidity and disability. The rates of edentulism and tooth loss are rapidly declining with a consequent increase in the risk of developing periodontitis. Periodontal treatment and prophylaxis for the frail and the functionally dependent elderly involve a complete analysis of the physical and emotional status of the patient. The effects of chronic conditions, illnesses and medications on the ability of the older patient to accept treatment must be understood if periodontal care is to have a reasonable chance of success. In medically compromised patients and in patients who are unable to maintain oral hygiene, non-surgical periodontal therapy may be the best approach to treatment, although there are alternative routes to treatment as well as prevention. Periodontal diseases can be treated successfully in the aged and periodontal health can be sustained.