The dental implant is a screw-like component that is fixed into the jaw bone to replace the missing tooth.

A dental implant topped with the crown after healing instills a natural tooth appearance. In the past, dental implants were considered the treatment option for young adults.

Due to the perception of high failure rates, many elders (>65 years of age) were not sure if dental implants would function just like they do in younger ones.

However, research suggests that oral rehabilitation with dental implants in the elderly has a long-term success rate. These restorations improve the chewing ability and quality of life of the elderly.

In this article, we discuss how safe are dental implants for the elderly.

What are the indications for dental implants in the elderly?

Here are some of the conditions that dentists may consider for dental implant treatments in the elderly:

  • Individuals looking for the fixed type of teeth instead of removable dentures

    With dentures in the mouth, many individuals worry about their dentures falling while speaking or laughing in social get-togethers.

    To have a more natural look and a comfortable feel, patients look out for fixed teeth options instead of removable dentures.

    Since dental implants are permanent teeth replacements, they are preferred more over removable dentures by the elderly.

  • Preservation of existing removable dentures

    Removable dentures are used to replace partially missing teeth in the mouth.

    These partial dentures take the support of natural teeth (also known as an abutment) with the help of clasps (hook-like structures made of stainless steel) to retain in the mouth. If these supporting teeth are lost, a partial denture may not fit in the mouth.

    In such conditions, placement of implants at missing abutment site, help restore the support and retention of the partial denture. This approach is cost-effective and elderly patients find it easy to adapt to existing dentures than new ones.

  • Stabilization of lower dentures

    Dentures take the support of underlying gums and soft tissues to remain firmly in the mouth.

    Upper dentures are usually more stable compared to lower dentures due to adequate tissue support.

    Hence, patients often complain of loosening of the lower denture compared to the upper denture.

    These lower dentures can be stabilized with the help of 2 dental implants in the lower jaws.This helps improve chewing efficiency, reduce thinning of masticatory muscle (e.g., masseter), and enhance the quality of life in the elderly.

What are the benefits of dental implants for the elderly?

Here are some of the benefits of dental implants for the elderly:

  • Dental implants are more stable, and mimic natural teeth, allowing individuals to smile more confidently.
  • Dental implants can be attached securely to dentures, improving the chewing efficiency and allowing individuals to speak, eat, and drink more comfortably.
  • Dental implant-supported dentures remain fixed in the mouth. Elderly individuals don’t have to take them out at the night and don’t have to use denture adhesives to hold them in place.
  • The placement of dental implants provides continuous stimulation to the jaw bone just like the natural teeth. This helps preserve the existing bone mass and prevents its loss.
  • Dental implants strengthen the jaw bone and offer support to the face, improving the appearance of facial features.
  • Dental implants allow elderly individuals to chew and bite better. This helps improve their diet and nutrition, boosting their overall health.

How old is too old for dental implants?

There is no age bar to have dental implants. Dental implants are proven to be predictable, effective, and long-lasting treatment solutions in healthy elderly individuals.

According to a meta-analysis, the 3-, 5, and 10-year survival rate of implants in elderly people was reported to be 96.3%, 96.2%, and 91.2% respectively.

Thereby supporting the fact that aging itself cannot be considered a risk factor for the placement of dental implants.

Dental implant failure involves a combination of several other factors such as systemic health of the individuals, quality and quantity of bone present, and ability to maintain the implant-supported restorations. A dentist can help you decide if you are an ideal candidate for dental implants.

What are the risk factors for dental implant failure in the elderly?

The placement of dental implants by no means is different in the elderly from younger individuals. However, several factors should be considered before placing dental implants on the elderly. Here are some of the risk factors that should be considered:

1. Systemic conditions

Worsening of several systemic conditions may present as a risk factor for dental implant failure.

The presence of conditions such as cardiovascular diseases, uncontrolled diabetes, osteoporosis cancer, rheumatic diseases, clotting disorders, dry mouth, periodontal diseases (gum infections), nutritional deficiencies,

Parkinson’s disease, and chronic smoking may hamper the attachment of dental implants to the underlying bone.

These conditions or medications used to treat these conditions negatively impact implant surgery, wound healing, and the long-term success of dental implants. Therefore, it’s essential to evaluate patients’ medical conditions before implant treatment.

2.Quality and quantity of jaw bone present

Research suggests that beyond the age of 50 years there was a marked increase in the porosity of the lower jaw bone (alveolar bone).

The increase in the porosity led to a decrease in the bone mass that may impact the new bone formation around the dental implant.

Besides, bone regeneration procedures performed to restore the width and height of the alveolar bone before implant placement can be time-consuming, expensive, and stressful for elderly individuals.

3.Ability to clean and maintain the oral cavity with implant restorations

The long-term success of dental implants relies on the ability to maintain oral hygiene.

However, a decrease in manual dexterity or cognitive function may cause difficulty to clean the oral cavity.

This increases the bacterial activity around the implant, causing implant failure. An appropriate understanding of cognitive function in the elderly is a must before implant treatment.

What are the complications of implant surgery in the elderly?

Some of the common complications include the following:

a)Biological complications:

  • Peri-implant mucositis (inflammation of soft tissue around the implant)
  • Mucosal enlargement (Swollen soft tissue)
  • Bone loss around the implant
  • Pain
  • Loosening of implant or implant loss

b)Mechanical complications:

  • Loosening or fracture of screw within the crown
  • Fracture of implant-supported denture
  • Chipping of ceramic from the crown
  • Fracture of the crown

References:

  • Sato Y, Kitagawa N, Isobe A. Current Consensus of Dental Implants in the Elderly—What Are the Limitations? Current Oral Health Reports. 2020 Sep;7(3):321-6.
  • Schimmel M, Müller F, Suter V, Buser D. Implants for elderly patients. Periodontology 2000. 2017 Feb;73(1):228-40.
  • Grant, B. T., & Kraut, R. A. (2007). Dental implants in geriatric patients: a retrospective study of 47 cases. Implant dentistry, 16(4), 362–368.
  • Ikebe K, Wada M, Kagawa R, Maeda Y. Is old age a risk factor for dental implants? Japanese Dental Science Review. 2009 May 1;45(1):59-64.
  • Compton, S. M., Clark, D., Chan, S., Kuc, I., Wubie, B. A., & Levin, L. (2017). Dental Implants in the Elderly Population: A Long-Term Follow-up. The International journal of oral & maxillofacial implants, 32(1), 164–170.
  • SRINIVASAN, Murali, et al. Dental implants in the elderly population: a systematic review and meta-analysis. Clinical oral implants research, 2017, vol. 28, no. 8, p. 920-930

 

Dr. Shilpy Bhandari
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