RPD Review Questions

Answer to Question #191

There are many problems with this type of treatment for a large percentage of geriatrics patients. First of all, many older patients simply do not have the manual dexterity to control the precise insertion and removal of this type of prosthesis. Secondly, the splinting of teeth means the only means of assuring adequate interproximal plaque control by use of floss threaders under the soldered contacts---also a very difficult task for people with marginal coordination and dexterity. In general, one could say that plaque control is more difficult for the geriatric population than for younger patients. Recurrent decay around crown margins is common among geriatric patients. Whenever possible, margins should be as accessible as possible---that is not the case with this type of restoration.

The rule of "KISS" (keep it simple stupid) may not have the best connotation but is true most of the time and certainly in relation to removable prostheses for geriatric patients. Make insertion and removal of the prosthesis as easy as possible. Avoid precision attachments and the like. Allow for repair of the underlying restorations and design the RPD so that teeth can be added to the prosthesis if natural teeth are lost. Don't do anything that will compromise oral hygiene.