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Updated: May 29, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Staging and Grading in Gerodontology-An Introduction
W Murray Thomson1, Gerry McKenna2, Murali Srinivasan3,4
1Faculty of Dentistry, The University of Otago, Dunedin, New Zealand.
Introduction:
Gerodontology lacks a unified framework to describe case complexity and assess the multidimensional determinants shaping oral health.
Methods:
An international initiative developed an evidence-based case definition for staging and grading older adults' oral health.
Results:
Staging includes three domains: person, oral function (clinical and subjective), and oral disease (caries, periodontal disease, mucosal conditions) level staging. Grading incorporates risk factors at the oral, systemic, and social levels, including caries and periodontal risk, prosthetic maintenance, xerostomia, multimorbidity/polypharmacy, care dependency, nutritional status, socioeconomic position, and social support.
Conclusions:
This framework integrates biological, functional, systemic, and social factors within a single structure and reached strong international consensus. It offers a common language for clinical care, research, education, and policy. Further work should evaluate its feasibility, validity, and responsiveness. Companion papers in this issue provide the detailed staging and grading criteria.
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