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Minimal-Burden Prosthodontics: Simple Care and Comprehensive Risk Assessment in Older Adults

AI Summary
  • Perform comprehensive risk assessment before rehabilitation to establish feasible maintenance, proportional care, and contingency plans for future frailty, cognitive decline, or loss of support.
  • Explicitly identify and minimise biological, functional, temporal, psychological, and maintenance burdens, and justify any prosthesis by demonstrable, meaningful patient benefit.
  • Deliver the simplest suitable care fulfilling the patient's wish to eat comfortably and enjoy daily life, with arranged access and follow up for homebound patients.
Summarise with AI (MRCPsych/FRANZCP)

Gerodontology. 2026 Oct 20. doi: 10.1111/ger.70132. Online ahead of print.

ABSTRACT

BACKGROUND: Older adults represent a growing population in whom oral health impairment may affect comfort, nutrition, dignity, social participation, and quality of life. Conventional prosthodontic approaches, often guided by comprehensive rehabilitation, technical refinement, and long-term restorative ideals, require assessment of present and foreseeable functional, cognitive, and maintenance needs.

OBJECTIVE: This commentary discusses minimal-burden prosthodontics as an application of established gerodontology principles to independent and semi-dependent community-dwelling older adults.

DISCUSSION: The concept does not imply that prosthodontic care can be burden-free. All prostheses carry biological, functional, temporal, psychological, and maintenance-related costs, and no prosthesis is permanent. These burdens should be explicitly identified, minimized, and justified by meaningful benefit. Building on rational dental care, geriatric dental assessment, the Seattle Care Pathway, minimal intervention dentistry, and patient-priorities-aligned care, comprehensive risk assessment should precede rehabilitation and establish a feasible maintenance plan. Proportional care serves as the ethical principle, prosthodontic sufficiency as the clinical objective, and contingency planning as a practical requirement if later frailty, cognitive decline, or loss of support makes treatment unmaintainable. Homebound patients require explicit arrangements for access and follow-up.

CONCLUSION: When the patient’s main wish is to eat comfortably and enjoy daily life, the goal should be the simplest suitable care that achieves that wish.

PMID:42902529 | DOI:10.1111/ger.70132

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