Staging in Gerodontology: A Framework

INTRODUCTION: Comprehensively, systematically and reproducibly assessing and describing the (oral) health status and care needs of older adults is challenging. We aimed to provide a framework for evaluating and reporting older adults' oral health, capturing general and oral function and disease, as well as oral, systemic and socio-economic/social risk factors determining oral care complexity and capability, care needs and levels, and clinical management, including prevention, active and supportive therapy, as well as informing education, research, surveillance and health services. The present paper describes the first aspect, staging of oral health in this population. METHODS: Eight reviews were conducted to identify risk factors for deterioration of oral health in older adults; existing systematic reviews were further considered during the framework development. A 2.5-day workshop with 31 international researchers and stakeholders was held and a structured consensus process implemented to come to an agreed, internationally applicable framework. A 75% level of agreement was achieved after two rounds of voting. RESULTS: A case definition based on staging and grading, reflecting the current general and oral health and function, care complexity, and the risk of deterioration of oral health due to local, systemic, and socio-economic and social factors, was developed. Staging includes person-level (based on clinical frailty), function-level (based on clinical and subjective evaluations reflecting oral function, such as tooth loss and oral impacts), and disease-level (including caries, periodontal disease, and oral mucosa assessments) domains. CONCLUSION: Oral health staging in older adults can allow clinicians, carers, and policymakers to systematically and comprehensively define and classify patient cases in order to derive appropriate and adequate care. Staging should be used in combination with grading, and both may allow capturing the overall health status and care needs of older patients for health surveillance, research, and education purposes. Next steps will include validation, dissemination, and implementation of the framework.

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Journal
Gerodontology
Published
2026-05-29
DOI
https://doi.org/10.1111/ger.70058
Primary Topic
Dental Health and Care Utilization
Type
article
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article

Staging in Gerodontology: A Framework

Frauke Müller, Sabrina Maniewicz, Najla Chebib, Sayaka Tada et al.
Gerodontology
Dental Health and Care Utilization
article

Staging in Gerodontology: A Framework

Frauke Müller, Sabrina Maniewicz, Najla Chebib, Sayaka Tada, Annika Neri, Sophie Dartevelle, Cristiane da Mata, Koichiro Matsuo, Terry Walton, Danielle Layton, Helena Dujic, Foteini Spyraki, Kittipit Srisanoi, Anastassia Kossioni, Sungkrit Pojmonpiti, Barbara Janssens, W. Murray Thomson, Saif S. Syed, Jean‐Philippe Haesler, Pedro Molinero Mourelle, Jennifer Gallagher, Manabu Kanazawa, Gerry McKenna, Georgios Tsakos, Murali Srinivasan, Takahiro Ono, Azize Bell, Falk Schwendicke
article en

Abstract

INTRODUCTION: Comprehensively, systematically and reproducibly assessing and describing the (oral) health status and care needs of older adults is challenging. We aimed to provide a framework for evaluating and reporting older adults' oral health, capturing general and oral function and disease, as well as oral, systemic and socio-economic/social risk factors determining oral care complexity and capability, care needs and levels, and clinical management, including prevention, active and supportive therapy, as well as informing education, research, surveillance and health services. The present paper describes the first aspect, staging of oral health in this population. METHODS: Eight reviews were conducted to identify risk factors for deterioration of oral health in older adults; existing systematic reviews were further considered during the framework development. A 2.5-day workshop with 31 international researchers and stakeholders was held and a structured consensus process implemented to come to an agreed, internationally applicable framework. A 75% level of agreement was achieved after two rounds of voting. RESULTS: A case definition based on staging and grading, reflecting the current general and oral health and function, care complexity, and the risk of deterioration of oral health due to local, systemic, and socio-economic and social factors, was developed. Staging includes person-level (based on clinical frailty), function-level (based on clinical and subjective evaluations reflecting oral function, such as tooth loss and oral impacts), and disease-level (including caries, periodontal disease, and oral mucosa assessments) domains. CONCLUSION: Oral health staging in older adults can allow clinicians, carers, and policymakers to systematically and comprehensively define and classify patient cases in order to derive appropriate and adequate care. Staging should be used in combination with grading, and both may allow capturing the overall health status and care needs of older patients for health surveillance, research, and education purposes. Next steps will include validation, dissemination, and implementation of the framework.

Gerodontology
University of Geneva (CH), University of Bern (CH), Universidad Complutense de Madrid (ES), Tokyo Medical and Dental University (JP), Queen's University Belfast (GB), The University of Sydney (AU), Chulalongkorn University (TH), The University of Queensland (AU), National University of Singapore (SG), Queen Mary University of London (GB), Khon Kaen University (TH), King's College London (GB), Johannes Gutenberg University Mainz (DE), National and Kapodistrian University of Athens (GR), University of Zurich (CH), FDI World Dental Federation (CH), Instituto Cajal (ES), Ghent University Hospital (BE), Cork University Hospital (IE), LMU Klinikum (DE), UNSW Sydney (AU), Ghent University (BE), St Vincent’s Private Hospital Sydney (AU), Chulabhorn Hospital (TH), Poliklinik für Zahnärztliche Prothetik und Werkstoffkunde (DE), Swiss Dental Association (CH), Poliklinik für Zahnärztliche Prothetik (DE), Institute of Science Tokyo (JP), University College London (GB), University of Otago (NZ), Ludwig-Maximilians-Universität München (DE), Osaka Dental University (JP)
Openalex Percentile: Top 6%
Dental Health and Care Utilization
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