Dental restorative materials and special consideration for the elderly


  • Tarik Mohammed Ali Alakkad Department of Restorative Dentistry, Al Thager Hospital, Jeddah, Saudi Arabia
  • Moayad Adnan Diwan Makkah Healthcare Cluster, Ministry of Health, Mecca, Saudi Arabia
  • Mohammed Khalid Al Sanie Family Dental Medicine, Al Noor Specialist Hospital, Mecca, Saudi Arabia
  • Ola Jamal Balkhair King Abdulaziz Medical City, Jeddah, Saudi Arabia
  • Faisal Musaad Al Mobarak College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
  • Rasha Ahmed Badahdah King Abdulaziz Medical City, Jeddah, Saudi Arabia
  • Abdulaziz Fahad Bakhsh College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
  • Norah Rjaa Al Otaibi College of Dentistry, Princess Nourah Bint Abdul Rahman University, Riyadh, Saudi Arabia
  • Saud Fahad Al Abdulwahed General Dentist, North of Riyadh Dental Center, Riyadh, Saudi Arabia
  • Haifa Mohammed Al Sharif King Abdulaziz Medical City, Jeddah, Saudi Arabia
  • Riyadh Obied Al Anazi Riyadh Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia



Dental caries, Restorative materials, Elderly, Root caries, Oral health


With the global population aging, the oral health of elderly individuals faces unique challenges, particularly concerning dental caries. Root caries, in particular, have become a growing concern due to the significant number of retained teeth in older adults. This review delves into the frequency of root caries among older individuals and examines the limitations of existing dental restorative materials, including amalgam, glass ionomer cement, and light-cured composite resin, in meeting the unique requirements of the elderly. It underscores the urgent necessity for improving the antibacterial, bonding, remineralization, strength, and durability characteristics of these materials. Additionally, the study discusses factors related to aging, treatment planning, and special considerations in geriatric dental care. The review also delves into the challenges associated with providing dental care to elderly individuals, including depression, postural hypotension, prescribed drugs, delayed healing, adaptive potential, mucosal quality, and poor plaque control. Moreover, it addresses the role of xerostomia, bruxism, and certain medical conditions in exacerbating dental issues in the elderly. It also introduces novel anticariogenic restorative materials, such as antimicrobial materials, remineralization materials, and self-healing/low-shrinkage materials, highlighting their potential to improve oral health in older individuals.


Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global Burden of Untreated Caries:A Systematic Review and Metaregression. J Dental Res. 2015;94(5):650-8.

Eke PI, Wei L, Borgnakke WS, Gina T-E, Xingyou Z, Hua L et al. Periodontitis prevalence in adults ≥ 65 years of age, in the USA. Periodontology 2000. 2016;72(1):76-95.

Fure S. Ten-year cross-sectional and incidence study of coronal and root caries and some related factors in elderly Swedish individuals. Gerodontology. 2004;21(3):130-40.

Jiang Q, Liu J, Chen L, Gan N, Yang D. The Oral Microbiome in the Elderly With Dental Caries and Health. Frontiers Cellular Infect Microbiol. 2019;8.

Murray C. Advanced restorative dentistry-a problem for the elderly? An ethical dilemma. Australian Dental J. 2015;60(S1):106-13.

Lester V, Ashley F, Gibbons D. Reported dental attendance and perceived barriers to care in frail and functionally dependent older adults. Brit Dental J. 1998;184(6):285-9.

Gilmour AG, Morgan CL. Restorative Management of the Elderly Patient. Primary Dental Care. 2003;10(2):45-8.

Simons D, Brailsford S, Kidd E, Beighton D. Relationship between oral hygiene practices and oral status in dentate elderly people living in residential homes. Community Dentistr Oral Epidemiol. 2001;29(6):464-70.

Nunn J, Morris J, Pine C, Pitts N, Bradnock G, Steele J. The condition of teeth in the UK in 1998 and implications for the future. Bri Dental J. 2000;189(12):639-44.

Lynch E, Beighton D. A comparison of primary root caries lesions classified according to colour. Caries Res. 1994;28(4):233-9.

Nyvad B, Fejerskov O. Active root surface caries converted into inactive caries as a response to oral hygiene. Eur J Oral Sci. 1986;94(3):281-4.

Leistevuo J, Järvinen H, Osterblad M, Leistevuo T, Huovinen P, Tenovuo J. Resistance to mercury and antimicrobial agents in Streptococcus mutans isolates from human subjects in relation to exposure to dental amalgam fillings. Antimicrobial Agents Chemotherapy. 2000;44(2):456-7.

Setcos J, Staninec M, Wilson N. Bonding of amalgam restorations: existing knowledge and future prospects. Operative Dentistr. 2000;25(2):121-9.

Chun KJ, Lee JY. Comparative study of mechanical properties of dental restorative materials and dental hard tissues in compressive loads. J Dental Biomechanics. 2014;5.

Caplan DJ, Li Y, Wang W, Kang S, Marchini L, Cowen HJ et al. Dental Restoration Longevity among Geriatric and Special Needs Patients. JDR Clin Translational Res. 2019;4(1):41-8.

Thanyavuthi A, Boonchai W, Kasemsarn P. Amalgam Contact Allergy in Oral Lichenoid Lesions. Dermatitis Contact, Atopic, Occupational, Drug. 2016;27(4):215-21.

Nakata TT, Bae KS, Baumgartner JC. Perforation repair comparing mineral trioxide aggregate and amalgam using an anaerobic bacterial leakage model. J Endodontics. 1998;24(3):184-6.

Sidhu SK, Nicholson JW. A Review of Glass-Ionomer Cements for Clinical Dentistry. J Functional Biomaterials. 2016;7(3):16.

Ullah R, Zafar MS. Oral and dental delivery of fluoride: a review. Fluoride. 2015;48(3):195.

Wiegand A, Buchalla W, Attin T. Review on fluoride-releasing restorative materials--fluoride release and uptake characteristics, antibacterial activity and influence on caries formation. Dental Materials. 2007;23(3):343-62.

Bhavana V, Chaitanya K, Gandi P, Patil J, Dola B, Reddy R. Evaluation of antibacterial and antifungal activity of new calcium-based cement (Biodentine) compared to MTA and glass ionomer cement. J Conservative Dentistr. 2015;18(1):44-6.

Naik RG, Dodamani AS, Khairnar MR, Jadhav HC, Deshmukh MA. Comparative assessment of antibacterial activity of different glass ionomer cements on cariogenic bacteria. Restorative Dentistr Endodontics. 2016;41(4):278-82.

Cabral MFC, Martinho RLdM, Guedes-Neto MV, Rebelo MAB, Pontes DG, Cohen-Carneiro F. Do conventional glass ionomer cements release more fluoride than resin-modified glass ionomer cements? Restorative Dentistr Endodontics. 2015;40(3):209-15.

Berzins DW, Abey S, Costache MC, Wilkie CA, Roberts HW. Resin-modified Glass-ionomer Setting Reaction Competition. J Dental Res. 2010;89(1):82-6.

Carlén A, Nikdel K, Wennerberg A, Holmberg K, Olsson J. Surface characteristics and in vitro biofilm formation on glass ionomer and composite resin. Biomaterials. 2001;22(5):481-7.

Van Dijken JWV, Pallesen U. Fracture frequency and longevity of fractured resin composite, polyacid-modified resin composite, and resin-modified glass ionomer cement class IV restorations: an up to 14 years of follow-up. Clin Oral Investigations. 2010;14(2):217-22.

Xie D, Brantley WA, Culbertson BM, Wang G. Mechanical properties and microstructures of glass-ionomer cements. Dental Mat. 2000;16(2):129-38.

Vallittu PK. An overview of development and status of fiber-reinforced composites as dental and medical biomaterials. Acta Biomaterialia Odontologica Scandinavica. 2018;4(1):44-55.

Cao W, Zhang Y, Wang X, Yinyan C, Qiang L, Xiaodong X et al. Development of a novel resin-based dental material with dual biocidal modes and sustained release of Ag+ ions based on photocurable core-shell AgBr/cationic polymer nanocomposites. J Materials Sci. 2017;28(7):103.

Cheng L, Weir MD, Xu HHK, Joseph MA, Alison MK, Nancy JL et al. Antibacterial amorphous calcium phosphate nanocomposites with a quaternary ammonium dimethacrylate and silver nanoparticles. Dental Materials. 2012;28(5):561-72.

Chen S, Gururaj S, Xia W, Engqvist H. Synthesis of Ag doped calcium phosphate particles and their antibacterial effect as additives in dental glass ionomer cements. J Materials Sci. 2016;27(11):172.

Breschi L, Mazzoni A, Nato F, Marcela C, Erika V, Leo T et al. Chlorhexidine stabilizes the adhesive interface: A 2-year in vitro study. Dental Materials. 2010;26(4):320-25.

Huang Y, Song B, Zhou X, Chen H, Wang H, Cheng L. Dental Restorative Materials for Elderly Populations. Polymers. 2021;13(5).




How to Cite

Mohammed Ali Alakkad, T., Diwan, M. A., Sanie, M. K. A., Balkhair, O. J., Al Mobarak, F. M., Badahdah, R. A., Bakhsh, A. F., Otaibi, N. R. A., Abdulwahed, S. F. A., Sharif, H. M. A., & Anazi, R. O. A. (2023). Dental restorative materials and special consideration for the elderly. International Journal Of Community Medicine And Public Health, 11(1), 381–386.



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