When should root remnants and unrestorable broken teeth be extracted in frail older adults?

Abstract

Background: Many frail older adults have an unhealthy dentition; unrestorable broken teeth and root remnants with open root canals, commonly accompanied by periapical and periodontal inflammation, are often seen. Improving oral health in the growing group of frail older adults with remaining teeth is a considerable challenge for dental care professionals. Dentists are often uncertain how to deal with root remnants and unrestorable broken teeth in frail older adults.

Methods: The authors aim was to provide recommendations to dentists to help in their clinical decision making about the extraction or retention of roots remnants and broken teeth in frail older adults.

Conclusions: Decisions about the extraction or retention of root remnants should made on the basis of preventing pain and oral discomfort, preventing severe inflammation, and preventing additional decline in oral health. Both root-related and patient-related factors are considered.

Practical implications: Decision-making trees can help dentists decide whether to extract root remnants and unrestorable broken teeth in frail older adults.

Keywords: Frail elderly; clinical decision making; dental infection; poor oral health; root remnants.