Clinical Decision Making in the Dental Treatment of the Elderly1

Dental care of elderly persons is similar to that of younger persons but is modified by a variety of age-related and age-associated changes, as well as diseases and drugs. Clinical decision-making for the dental care of elderly persons is therefore more complex. The dental disease patterns in the elderly population seem to be changing and they seem to be expressed differently, which will require actual diagnosis and more complicated treatment planning. This paper evaluates the principles of problem solving and decision making in general, and applies them to dental diagnosis and treatment planning. A model of the different types of decision making in dentistry is presented, and its component parts discussed, with emphasis on the care of the elderly patient. The conclusions of this paper are that dental care for the elderly patient is becoming extremely complex, especially as more elderly patients will be dentate and more will be demanding care. Research is needed in the area of how dentists make decisions, and in methods of teaching decision-making skills. Longitudinal studies are required to evaluate the outcomes of treatment.