For old age, as well as for other periods of a person's life — childhood, youth, maturity, age features are characteristic, their own age norm. If in youth the phenomena of progressive development prevail with an increase in the possibilities of adaptation to the environment, then in the period of withering and reverse development (involution), regressive phenomena that worsen the adaptive capabilities of a person prevail.

All the vital paws of a person from the moment of birth to old age are complex, contradictory processes. Not all cells, tissues, organs and their functions age simultaneously and to the same extent. With all that, the process of physiological aging is naturally harmonious. Although there is not always a coincidence between calendar (age) and actual (physical and mental) aging (both premature and delayed aging may occur), nevertheless, late age mainly determines senile changes.

The science that studies various problems of aging is called gerontology (gcron — old man). It has three aspects:

biological — in this aspect of gerontology, the fundamental aspects of aging are considered;

clinical — this direction includes the study of diseases of "senile age", such as cardiovascular, vascular diseases of the brain, malignant tumors, arthritis, rheumatism, autoimmune diseases, and the development of methods for their treatment. It is called geriatrics;

socio-psychological — this direction deals with the social and psychological problems of old and retired young people.

It is known that in the prevention of premature aging of a person, the full function of the chewing apparatus is important. From this point of view, prosthetics should also be considered as a factor in combating the phenomena of aging. It is important to study and evaluate the adaptive capabilities and reserve forces of the body, its compensatory mechanisms. There is no doubt that the age-related decrease in the adaptive capabilities of the body, morphological and functional changes in tissue structures are factors that determine the features of age-related changes in the system of neurohumoral regulation, as well as the structural fund of organs.

Complete or significant tooth loss is most common at the age of 60 years and older. The elderly age determines the main feature and complexity of orthopedic treatment of this group of patients due to a decrease in the adaptive capabilities of their body. Orthopedic treatment of elderly and elderly people requires taking into account the mental and somatic status of the patient as a whole, as well as the condition of the organs of the maxillofacial region due to the appearance of age-related changes and disorders in them.

With the complete loss of teeth, the body and branches of the jaws become thinner, and the angle of the lower jaw is more blunt, the tip of the nose descends, nasolabial folds are pronounced, the corners of the mouth and even the outer edge of the eyelid drop. The lower third of the face decreases in size. There is a flabbiness of the muscles, and the face becomes senile. Due to the regularities of bone atrophy, the so-called senile progenia is formed to a greater extent from the vestibular surface on the upper and lingual on the lower jaws, which is characterized by a change in the ratios of the jaws in the transversal direction.

Orthopedic treatment of patients with complete loss of teeth

With complete loss of teeth, the function of the chewing muscles changes. As a result of reducing the load, the muscles decrease in volume, become flabby, atrophy. There is a significant decrease in bioelectric activity, while the phase of bioelectric rest in time prevails over the period of activity.

Senile people are characterized by the extinction of metabolic processes, a decrease in the functions of the endocrine glands, a slowdown in reparative processes, the prevalence of dystrophic and atrophic processes, which are most clearly manifested in the bone tissue of the human skeleton, skin. Age-related changes also affect all organs and tissues of the maxillofacial system: joints, muscles, jaw bones, remaining teeth, periodontal and oral mucosa. It is known that with age, the epithelial layer of the oral mucosa undergoes atrophy, elastic fibers disappear in the submucosal layer, the mucous membrane becomes sensitive, easily vulnerable, and the wound healing process is disrupted. The vascularization of soft tissues and bone base worsens, there is a general dehydration of tissues. Metabolic disorders in the body, in particular calcium balance, and increased leaching of calcium from the body leads to discharge of the cortical and spongy components of the jaw bones, therefore, in elderly patients, even with normal prosthetic load, manifestations of atrophic processes in the bone tissue are aggravated and lead to irreparable losses. In old age, degenerative changes in the salivary glands are possible, which leads to a decrease in salivation and an increase in mucin content in saliva. Saliva becomes thick and viscous. It should be noted that

this category of patients has a low level of hygienic condition of removable dentures. Partly because of the difficulties associated with the fact that patients, given their age, cannot serve themselves, partly because of the high cost of hygiene products for cleaning dentures.

Changes also occur in the TMJ. The articular fossa flattens, the head shifts posteriorly and upwards.

The loss of teeth as a result of complications of caries and periodontal diseases determines the high need for prosthetics. Removable prosthetics is difficult due to age-related and pathological changes in the alveolar process. In some cases, patients who are accustomed to grinding food with a compacted mucous membrane covering the alveolar process do not want to be prostheticized.

The specifics of using removable dentures in this category of people is the prolonged and uncontrolled use of them for 10-15 years or more.

There are a number of reasons why elderly and senile people refuse dental care:

fear of pain during medical procedures;

a visit to the dentist is postponed until the moment of urgent need;

indifference to yourself, your health;

distrust of treatment;

poor health, difficulty in movement;

the remoteness of the dental clinic from the place of residence and the inconveniences associated with traveling by public transport;

poor health and short duration (according to patients) of the remaining life span.