Today's routine preventive measures were not in place when most older individuals were younger. By the time a dentate patient is seventy years of age, s/he will likely have numerous restorations. A virtual history of dentistry may exist in some mouths, replete with diverse filling materials and a full array of fixed and removable prostheses. Failing restorations are the primary source of dental decay among older adults.
As teeth age, they change. Pulp spaces shrink and the pulps contain less and less sensitive, nerve tissue, resulting in minimal dentinal and pulpal sensitivity. This can lead to advanced oral pathology that is asymptomatic. The impact of this process is accelerated by caries and the placement of dental restorations. For these reasons, it is uncommon for an elderly patient to complain of a toothache. More commonly reported are soft tissue complaints (e.g., a tongue laceration from the sharp edge of a broken tooth or a denture ulceration).
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