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Integrating Staging and Grading in Gerodontology: From Frameworks to Clinical Practice
Satya Ranjan Misra1, Rupsa Das1
1Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India.
None:
The recently proposed consensus frameworks for staging and grading in gerodontology represent an important advance toward multidimensional assessment of oral health in older adults. While staging characterises current oral health status by integrating disease burden, oral function, frailty, and care dependency, grading complements this approach by estimating future vulnerability based on oral, systemic, behavioural, and social determinants. Together, these frameworks provide a more comprehensive foundation for personalised, risk-informed geriatric oral healthcare. This correspondence discusses their complementary roles, highlights alignment with contemporary healthy ageing initiatives including the World Health Organisation's Integrated Care for Older People (ICOPE) framework and considers opportunities for integration into comprehensive geriatric assessment. We further discuss key implementation challenges related to clinical feasibility, interdisciplinary collaboration, and adaptation across diverse healthcare systems, particularly in low- and middle-income countries. Finally, we propose pragmatic implementation strategies, including tiered assessment pathways, to facilitate routine clinical adoption. Successful validation and implementation of these complementary frameworks have the potential to strengthen person-centred care, improve interdisciplinary communication, and advance equitable oral healthcare for ageing populations worldwide.
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