Aspects of Polypharmacy in Dental Treatment of Seniors

Due to demographic changes, the task of dental treatment for older patients is increasing. The aim of this study was to record polypharmacotherapy in elderly patients undergoing dental-prosthetic treatment. In addition, it was hypothesized that patients with removable dentures have a higher polypharmacy rate than patients with fixed dentures.

In a prospective and observational study, 103 patients aged 70 years and over were included. Age, gender, and the type of denture were recorded. Daily medication was charted using a questionnaire and patients' medication plan. The medication was recorded according to the anatomical-therapeutic-chemical classification system of the World Health Organization. In addition, a patient-related medication analysis was carried out.

Of the 103 study participants, 59 were female and 44 were male. The average age was 80.7 years. Twenty-six patients were fitted with fixed restorations (PFR) and 77 patients with removable dentures (PRD). Polypharmacy (more than 5 medications taken) was equally common in both patient groups (62% in PFR and 61% in PRD; P = 0.964). The number of medicaments (4.8 ± 2.8 in PFR and 6 ± 4.3 in PRD; P = 0.318) and the number of medication groups (1.6 ± 0.9 in PFR and 2 ± 1 in PRD; P = 0.053) did not differ significantly. Considering the medication groups PRD group took anti-diabetic drugs significantly more frequent (4% in PFR and 25% in PRD; P = 0.021). Of the medications taken, 24% belonged to the group of anticoagulants/platelet inhibitors, 12% to the group of psychotropic/neurological drugs, 11% to antidiabetics, 1% to bisphosphonates/monoclonal antibodies, 1% to cytostatics, and 51% other medications. The patient-related analysis showed that 47% of the study participants took anticoagulants/platelet inhibitors, 25% psychotropic/neurological drugs, 19% anti-diabetics, 3% cytostatics/angiogenesis inhibitors, and 2% bisphosphonates/monoclonal antibodies. In addition, 93% of the patients took other medications, while only 6% of the study participants received no drug therapy.

On average, the majority of patients requiring prosthetic treatment were on polypharmacy. However, there was no difference between PFR and PRD patients regarding the number of medication groups and the number of medicaments. The dental treatment of elderly patients requires beside expertise in gerostomatology profound knowledge of pharmacotherapy in old age.