Extract

Background and study aims The dental health of older patients has changed considerably over the last 30 years around the world. The traditional picture of older patients with no remaining natural teeth and complete replacement dentures is becoming increasingly outdated. Instead, older patients are retaining some of their natural teeth into old age. However many of these patients still require treatment to replace some of their missing natural teeth for functional and aesthetic reasons. Currently the vast majority of these patients receive Removable Partial Dentures (RPDs) to fill spaces and replace some missing teeth. In a number of countries, including the Republic of Ireland and the United Kingdom, RPD is the only treatment offered to older patients to replace teeth as part of state funded healthcare. However, many patients struggle to wear RPDs, particularly those replacing lower teeth, and only wear them infrequently. In addition RPDs are very difficult to keep clean so high levels of tooth decay and gum disease are often found in these patients. Other treatment options do exist including a concept called the Shortened Dental Arch (SDA). These concept aims to only replace teeth towards the front of the mouth using fixed bridges to provide patients with a set of teeth which are aesthetic, functional and easy for them to maintain. Despite the SDA concept originating in the early 1980s, very few studies have ever compared it to traditional RPDs in older patients. This study aims to compare the quality of life, nutritional status and cost effectiveness of these two treatments. Who can participate? Patients over 65 years of age, have more than 6 natural teeth remaining and are generally fit and well What does the study involve? Patients will be randomly allocated to one of two treatment groups: RPD group and SDA group. Both groups will have a routine dental examination followed by filling of cavities and tooth cleaning. Those in the RPD group will be provided with RPDs to replace all of their missing natural teeth. Those in the SDA group will have fixed bridges fitted to their teeth to replace their front teeth only. All patients will complete a quality of life questionnaire, nutritional status measurement and give a blood sample at the beginning of the study which will be repeated 6 months, 12 months and 24 months after the intervention. The cost of providing the treatment for both groups will be calculated on an ongoing basis throughout the study. What are the possible benefits and risks of participating? Patients will receive all treatment within the study free of charge. All blood samples will be taken by a trained specialist who will warn the patients about potential bruising, bleeding, swelling and pain after giving blood. Where is the study run from? Cork University Dental Hospital and St Finbarr's Geriatric Day Hospital in Cork City (Ireland) When is study starting and how long is it expected to run for? January 2010 to December 2015 Who is funding the study? Health Research Board (Ireland) Who is the main contact? Dr Gerald McKenna [email protected]

Inclusion criteria

• Loss of teeth

Links

• isrctn
• ictrp