- Email: [email protected]
Othodontics in an Aging Society
DEPARTMENT OF REVIEWS AND ABSTRACTS
Edited
by
Alex Jacobson, DMD, MS, MDS, PhD Birmingham, A/a. All inquiries regarding il~ormation on reviews and abstracts shoMd be directed to the respective authors. Articles or books for review in this department shotdd be addressed to Dr. Alex Jacobson, University of Alabama School of Dentistry, Universio, StationlBirmhzgham, Alabama 35294.
Orthodontics in an Aging Society David S. Carlson, (editor) Ann Arbor, Michigan: Centerfor Human Growth and Development, The University of Michigan, 1989. 199 pages
Since approximately 12% of the population is currently over the age of 65 years, it is not surprising that the theme for the 15th Annual Symposium on Craniofacial Growth (held Feb. 19-20, 1988) should be "Orthodontics in an Aging Society." The book comprises 12 essays by the contributors to that symposium. The first of the three goals of the symposium was to provide background information on our aging society and the aging process itself. The second goal was to review current information about changes in the craniofacial complex that take place in adult life; the third goal was to provide strategies for the management of older orthodontic patients. The first essay by historian W.A. Achenbaum provides perspective and highlights factors worthy of note about human life in an aging society. If we are to understand the aging society, he recommends cumulative multidisciplinary research efforts and effective communication that cuts along traditional disciplinary boundaries. Because of the change in disease patterns in dentistry, the"new elderly" tend to be more active, healthy, and, most of all, dentate. Just as many "family" practices aregeared mainly toward children's dentistry, the demographic inversion of our time will require such practices to give much more attention to older persons. The myths and realities of biologic aging are described by Richard C. Adelman. In a subsequent chapter, Stanley M. Garn further elaborates on various physiologic changes in men and women. Jeffrey B. Halter views aging as a gradual loss of physiologic competence, which reaches its maximum level in early adulthood and begins to decline thereafter. In gcriatrics, he claims, we are dealing with disease processes that may accel-
erate the loss of physiologic competence and may be viewed as premature disease, sometimes leading to death. For many years it was generally accepted that the craniofacial skeleton does not change to any appreciable, practical, or measurable extent during adulthood. However, in a well-referenced study, Rolf G. Behrents ably demonstrates that skeletal changes do occur during this period. He further discusses the clinical impact that these changes have on the dentition in orthodontically corrected cases. In the short essay that follows, Donald H. Enlow differentiates between growth and development. Degeneration of the dentition generally refers to loss of teeth, loss of periodontal support, and decrease in general bone density. The orthodontic management of such cases is well described and illustrated by Birte Melsen. Among the interesting orthodontic options offered is that of a segmented arch technique for the treatment of adults with periodontal problems. Empiric data suggest that masticatory muscle disorders and internal derangement problems in the aged are not as prevalent as in the young and middle-aged, according to C. S. Stohler. Pain, the motor system, psychophysiologic factors, and parafunction in the aged are factors that must be understood in older patients. William R. Proffit provides a succinct overview of orthodontics in an aging society. Secondary sex characteristics and their relationship to the pubertal maximum of growth in boys form the basis of an essay by Urban Hfigg et al. The concluding essay by J. J. Stutzmann and A. G. Petrovic is a description of alveolar bone responsiveness to orthodontic treatment in adults. The monograpah (No. 22) of the Craniofacial Growth Monograph Series is likely to be of interest to orthodontists who are involved in treating adults or who wish to be more acquainted with the pathophysiology of the aging masticatory system. Alex Jacobson
271
Edited
by
Alex Jacobson, DMD, MS, MDS, PhD Birmingham, A/a. All inquiries regarding il~ormation on reviews and abstracts shoMd be directed to the respective authors. Articles or books for review in this department shotdd be addressed to Dr. Alex Jacobson, University of Alabama School of Dentistry, Universio, StationlBirmhzgham, Alabama 35294.
Orthodontics in an Aging Society David S. Carlson, (editor) Ann Arbor, Michigan: Centerfor Human Growth and Development, The University of Michigan, 1989. 199 pages
Since approximately 12% of the population is currently over the age of 65 years, it is not surprising that the theme for the 15th Annual Symposium on Craniofacial Growth (held Feb. 19-20, 1988) should be "Orthodontics in an Aging Society." The book comprises 12 essays by the contributors to that symposium. The first of the three goals of the symposium was to provide background information on our aging society and the aging process itself. The second goal was to review current information about changes in the craniofacial complex that take place in adult life; the third goal was to provide strategies for the management of older orthodontic patients. The first essay by historian W.A. Achenbaum provides perspective and highlights factors worthy of note about human life in an aging society. If we are to understand the aging society, he recommends cumulative multidisciplinary research efforts and effective communication that cuts along traditional disciplinary boundaries. Because of the change in disease patterns in dentistry, the"new elderly" tend to be more active, healthy, and, most of all, dentate. Just as many "family" practices aregeared mainly toward children's dentistry, the demographic inversion of our time will require such practices to give much more attention to older persons. The myths and realities of biologic aging are described by Richard C. Adelman. In a subsequent chapter, Stanley M. Garn further elaborates on various physiologic changes in men and women. Jeffrey B. Halter views aging as a gradual loss of physiologic competence, which reaches its maximum level in early adulthood and begins to decline thereafter. In gcriatrics, he claims, we are dealing with disease processes that may accel-
erate the loss of physiologic competence and may be viewed as premature disease, sometimes leading to death. For many years it was generally accepted that the craniofacial skeleton does not change to any appreciable, practical, or measurable extent during adulthood. However, in a well-referenced study, Rolf G. Behrents ably demonstrates that skeletal changes do occur during this period. He further discusses the clinical impact that these changes have on the dentition in orthodontically corrected cases. In the short essay that follows, Donald H. Enlow differentiates between growth and development. Degeneration of the dentition generally refers to loss of teeth, loss of periodontal support, and decrease in general bone density. The orthodontic management of such cases is well described and illustrated by Birte Melsen. Among the interesting orthodontic options offered is that of a segmented arch technique for the treatment of adults with periodontal problems. Empiric data suggest that masticatory muscle disorders and internal derangement problems in the aged are not as prevalent as in the young and middle-aged, according to C. S. Stohler. Pain, the motor system, psychophysiologic factors, and parafunction in the aged are factors that must be understood in older patients. William R. Proffit provides a succinct overview of orthodontics in an aging society. Secondary sex characteristics and their relationship to the pubertal maximum of growth in boys form the basis of an essay by Urban Hfigg et al. The concluding essay by J. J. Stutzmann and A. G. Petrovic is a description of alveolar bone responsiveness to orthodontic treatment in adults. The monograpah (No. 22) of the Craniofacial Growth Monograph Series is likely to be of interest to orthodontists who are involved in treating adults or who wish to be more acquainted with the pathophysiology of the aging masticatory system. Alex Jacobson
271