Geriatric dentistry and systemic frailty: diagnostic, surgical, and rehabilitative implications

Population ageing has profoundly changed the clinical management of dental patients, making systemic frailty, multimorbidity and functional dependence key determinants of treatment planning. The aim of this review was to summarize the current evidence on the diagnosis and management of geriatric dental patients, focusing on periodontal disease, implant rehabilitation, oral oncology and the care of non-self-sufficient older adults. A narrative review of the literature was conducted through a comprehensive search of the PubMed/MEDLINE, Scopus and Web of Science databases. International guidelines, systematic reviews, meta-analyses and high-quality clinical studies were preferentially included. The review was developed according to the principles of methodological quality and transparency proposed by the Scale for the Assessment of Narrative Review Articles (SANRA). Representative clinical cases were included to illustrate the practical application of the concepts discussed. Current evidence indicates that chronological age alone should not determine therapeutic decisions. Comprehensive assessment of systemic frailty, functional status, comorbidities and long-term oral health maintenance plays a central role in treatment planning. Personalized, minimally invasive and multidisciplinary approaches appear to improve functional outcomes and oral health-related quality of life, although evidence remains limited for frail and institutionalized older adults. The management of geriatric dental patients should be based on an individualized approach integrating frailty assessment into clinical decision-making. Further prospective studies are needed to develop evidence-based protocols specifically tailored to frail older adults. Integrating frailty assessment into routine dental practice may facilitate personalized treatment planning, optimize oral rehabilitation and improve long-term oral health-related quality of life in older patients.