Geroprosthodontics: The Nijmegen and Manchester Dental Schools approach

If quality of care for elderly patients is to be achieved, thorough and realistic geroprosthodontic treatment planning is essential. This requires mature consideration, incorporating comprehensive patient assessment and selection of the most appropriate treatment option for each patient. The latter should be based on criteria which meet the demands of a healthy dentition and which enable a patient to achieve satisfactory oral function. The Nijmegen and Manchester Dental Schools have evolved simple patient-related treatment guidelines. These start with a problem-oriented approach which leads to a provisional treatment. The provisional treatment is intended to result in a healthy dentition that is monitored over an appropriate period. Evaluation of the provisional treatment leads to three options: extension of the monitoring time, preservation of the natural occlusion or loss of the natural occlusion. Definitive prosthodontic treatment plans are based on the second or third option. In the maintenance of good oral health after prosthodontic treatments, plaque and diet control are essential elements. Recall or maintenance programmes must be carried out if successful treatment is to be achieved and maintained.