Age-induced changes in the oral mucosa and their therapeutic consequences

The oral mucosa is subject to specific changes with increasing age but these do not by themselves impair the function and well-being of the patient. The dentist should, however, devote particular attention to the reactions of the oral mucosa when it has undergone age-induced changes, to the effects, extending over years and even decades, of foreign bodies such as prostheses and of other agents--in particular, smoking. Changes are brought about mainly by arteriosclerotic processes, the progressive obliteration of the capillaries and the reduction of cell metabolism. Nerves and end organs in the oral mucosa may also be affected by age. The effects include a progressive loss of sensitivity to thermal, chemical and mechanical stimuli, while gustatory ability declines in old age. The reactions of the oral mucosa to a prosthesis also change with increasing age. In young people, mechanical irritation tends to give rise mainly to painful inflammation and swelling, while chronic atrophic processes predominate in old age. Although the age-induced changes in the oral mucosa show a wide range of individual variation, there are nevertheless some specific trends which bring out the difference between chronological age and biological status. The dentist must be aware of possible age-induced morphological and functional processes, so that he can adopt a preventive strategy and draw the right conclusions for therapy, even in very old patients. Given constant care of both the mouth and prostheses, regular examinations and prompt therapeutic measures, there is no reason why the oral tissues of denture wearers, like those of other patients, should not be healthy and fully functional even into very old age.