Periodontal therapy for the ageing mouth.

Epidemiological studies have shown that the prevalence and severity of periodontal disease and tooth loss increase with age. Other studies indicate that gingival recession becomes more prevalent as age progresses. In addition, it has been demonstrated experimentally that elderly individuals develop more rapid and severe gingivitis than young individuals following the abstention of oral hygiene. However, to date no one has established which changes associated with ageing are responsible for these clinical observations. A population of elderly patients (60 years or older) has been evaluated at Northwestern University as to the role of gingival recession and inadequate zones of attached gingiva in the development of dental plaque and gingivitis. The controls for this study consisted of a young population (under 25 years old) with similar gingival defects. In addition, we have found that elderly individuals need more frequent oral prophylaxis for the maintenance of gingival health and to prevent further loss of alveolar bone. This need for more frequent oral prophylaxis is due in large part to the increased incidence of exposed root surface which allows for more rapid plaque accumulation and calculus formation than do enamel surfaces. This and other preliminary evidence suggests that elderly patients with periodontal disease should receive more aggressive therapy than is commonly practised today.