Funke N, Fankhauser N, McKenna G J, Srinivasan M. Impact of shortened dental arch therapy on nutritional status and treatment costs in older adults: A systematic review. J Dent 2023; DOI: 10.1016/j.jdent.2023.104483.

A shortened dental arch is cost-effective.

Tooth loss tends to lead to a poor diet, particularly amongst older people. Poor diet is associated with a number of systemic conditions, such as cardiovascular disease, bowel disease, osteoporosis, sarcopenia and cognitive decline. Research shows that restoring function with a shortened dental arch (SDA) can provide sufficient oral function and comfort without the need for an RPD.

Only four papers from two studies fulfilled the selection criteria for the systematic review. With this limited evidence, the authors found that provision of an SDA was more cost-effective than RPDs which also have ongoing risks of caries and consequent higher long-term maintenance costs. A large proportion of RPDs are not worn, indicating a waste of public funds on this treatment modality. Nutritional status did not change in either the SDA or RPD groups, and in order to improve this in older adults, 'a multi-disciplinary approach may be necessary, involving oral health practitioners, dieticians and nutritionists.'