Can someone really be too old for a crown?


This question might be better phrased " Can someone be too old for significant dentistry?. The answer is not really. It is not age that actually matters, it is the state of their health that matters. Some patients are too frail or ill to safely treat in a dental office. In that event the K.I.S.S. rule (keep it simple stupid!) usually applies. No point making treatment plans involving anything more than the simplest dentistry.  Some may need special precautions and some should  be seen in a hospital setting. It is not just a matter of the age, but instead it should be a question of their health and their ability to handle dental appointments. If a patient has an ailment that makes them a poor candidate for dentistry then dentistry should be delayed until they can be stabilized enough to take care of their tooth problem. Some patients with advanced Alzheimers will probably not be able to complete procedures in a standard dental office setting, since they will not be able to fully cooperate.   These patients may need to be sedated by a dental anaesthesiologist.

But what about extremely elderly patients. Should they be treatment planned for crowns or other multi visit procedures? For that matter,what about a root canal post and a crown? Ok, the truth is there areno  standard answers. Today I took an impression for a very nice 92 year old patient with mild case of dementia. I decided to proceed because her tooth was restorable and both she and her daughter gave me the thumbs up to fabricate a permanent restoration after the temporary I made 6 months earlier had come off.

She had to have two other teeth removed from that side and the tooth in question was important for chewing, It made sense to fix it properly since keeping it would facilitate her chewing.  As it turned out she did very well and I wish all my patients were as cooperative.

On the other hand some of my patients ten years younger are more frail and often I elect not to crown broken down teeth. Instead I place interim fillings using Miracle Mix and keep them in a "holding pattern". Often I place these patients on three month recall and if the interim filling breaks I will replace it, since these patients either do much better with short appointments or their finances will not allow complicated dentistry.

Treatment for the elderly is not "standardized"  but should be determined based on the needs of each individual patient and if the patient is not able to make informed decisions often I consult a trusted family member before deciding on a treatment. Also with some elderly patients I contact their primary physician in order to complete their medical history and get guidance from their physician on their general health and any suggested precautions for treating them.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/08/can-someone-really-be-too-old-for-crown.html - http://lspindelnycdds.blogspot.com/

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