ABSTRACT
Background:
The aim of this study was to assess oral health status and prosthetic needs of elderly populations in Almaty, Kazakhstan, and identify gaps in geriatric dental care.
Materials and Methods:
In cross-sectional and retrospective analyses a total of 708 adults aged 45 + were examined using the World Health Organisation-recommended methods. Participants were grouped by age, diagnosis, and treatment. Prosthetic status and needs were evaluated, including crowns, bridges, partial/complete dentures, and edentulism. Data were analyzed using SPSS version 22.0 (USA). Pearson’s correlation coefficient and Kruskal–Wallis analysis of variance were applied to assess associations between variables, with statistical significance set at P < 0.05. This study employed a mixed design that combined cross-sectional and retrospective analyses. It involved both sociological surveys and clinical dental examinations to assess prosthetic needs and oral health status.
Results:
Edentulism was common (41.9% complete, 38.8% partial). Over half (52.1%) used prostheses, mainly removable dentures, yet 42.6% were dissatisfied. Barriers included financial hardship (68.3%), limited access, and disability, with women, older adults, and low-income groups most affected. Preventive care gaps were evident: 28.4% required urgent care, and 64.3% lacked emergency records.
Conclusion:
Affordable, accessible, and high-quality dental services are urgently needed for Kazakhstan’s elderly. Findings support the development of targeted policies and future research to enhance geriatric oral health and promote healthy aging.
Keywords: Dental prosthesis, edentulism, geriatric dentistry, Kazakhstan, oral health, tooth loss
INTRODUCTION
The global population is undergoing a profound demographic shift, characterized by a rapid increase in the proportion of elderly individuals. According to United Nations projections, by 2050, the number of people aged 60 years and older will surpass 2 billion, representing over 20% of the global population.[1] This aging trend is not only a global phenomenon but also is acutely observed in Kazakhstan, where population aging and depopulation are becoming prominent demographic challenges. These changes bring significant social, economic, and healthcare implications, particularly for addressing the multifaceted needs of the elderly population. Among these, oral health care stands out as an often overlooked yet crucial determinant of quality of life, systemic health, and social well-being.[2]
Oral health is intricately linked to general health, and the loss of dental functionality has profound consequences for older adults.[3] Poor oral health can lead to difficulties in mastication, speech, and aesthetics, adversely affecting nutrition, self-esteem, and overall quality of life.[3,4] In elderly populations, the prevalence of dental pathologies such as edentulism, periodontal diseases, and dental caries is significantly higher due to cumulative wear, systemic health conditions, and inadequate preventive care over a lifetime.[5,6]
In Kazakhstan, these challenges are further compounded by socioeconomic disparities and insufficient state-supported dental care for older adults. While orthopedic dentistry, particularly the provision of fixed and removable prostheses, offers effective solutions for restoring oral functionality, the affordability and accessibility of such services remain critical issues.[7] The cost of dental prosthetics frequently exceeds the financial means of many elderly individuals, particularly those reliant on pensions.[8]
The role of geriatric dentistry in addressing the oral health needs of older adults is increasingly recognised in many countries.[9,10] However, in Kazakhstan and across the Commonwealth of Independent States, this field remains underdeveloped. A lack of specialized training for dental professionals, limited epidemiological data on the oral health status of the elderly, and the absence of targeted healthcare policies have contributed to unmet dental needs among aging populations. Without systematic interventions, the oral health disparities faced by older adults are likely to widen, exacerbating their vulnerability and reducing their quality of life.[11,12]
This study focuses on analyzing the state of orthopedic dental care among elderly populations in Almaty, Kazakhstan. By examining the prevalence of dental pathologies, patterns of prosthetic use, and factors contributing to unmet dental needs, the research aims to provide valuable insights into the current gaps in geriatric dental care.
MATERIALS AND METHODS
This study was conducted at the “Centre for the Provision of Special and Social Services,” the VOV Polyclinic, and the Dental Clinic of the S.D. Asfendiyarov National Medical University, Almaty city, Kazakhstan. A sociological survey and dental status assessment were performed using questionnaires recommended by the World Health Organization (WHO, 2013). A total of 708 individuals were examined and categorized into age groups: 45–59 years (9.9%), 60–74 years (46.9%), 75–90 years (37.4%), and over 90 years (5.8%).
The orthopedic dental status of participants was assessed to evaluate the presence of single crowns, bridge prostheses, combined prostheses, partial or complete removable dentures, and instances of complete edentulism without prosthetic restoration. The need for orthopedic dental care was determined based on the condition of the dentition, the presence and quality of existing prostheses, and the presence of defects in the dental arches or complete tooth loss. The criteria for determining the need for prosthetic care were categorized into five levels:
No need for prosthetics: Dental arches were intact with no defects. Natural teeth and existing prostheses were in satisfactory condition, and there were no indications for additional prosthetic intervention
Need for fixed dentures: Dental defects were limited to Kennedy Class III (up to three missing teeth) or Class IV (up to four missing teeth). Natural teeth were in good condition, supporting the use of fixed prostheses
Need for partial removable dentures: Extensive dental defects, including Kennedy Classes I and II or more severe cases in Classes III and IV (more than three or four missing teeth, respectively), indicated the necessity for partial removable dentures
Need for combined prosthetics: A combination of dental defects in Kennedy Classes I, II, III, and IV required the use of both fixed prostheses (e.g., bridge prostheses for Classes III, I, and IV) and partial removable dentures (for Classes I and II)
Need for complete removable dentures or combined partial and complete dentures: Complete edentulism in one jaw combined with partial edentulism in the opposing jaw, or complete absence of teeth in both jaws, required complete removable dentures or a combination of complete and partial removable dentures.
Study design
The analysis was conducted among 708 interviewed and examined persons of the “Centre for the Provision of Special and Social Services,” the polyclinic (clinic for the veterans of World War II), and the dental clinic of the S.D. Asfendiyarov National Medical University (Almaty city). Questionnaire data, a dental examination was conducted using the WHO card. The design of the study in this work is mixed, including cross-sectional and retrospective analysis. Patients were divided into subgroups by age, diagnosis, and method of treatment.
Study design: This study employed a mixed design that combined cross-sectional and retrospective analyses. It involved both sociological surveys and clinical dental examinations to assess prosthetic needs and oral health status.
In a comparative analysis between the percentage distribution of the structure of diagnoses in the context of biological age, a statistically significant relationship was found (P ≤ 0.01) between class 1 and the age of 60–74 years (66.7%) with the calculated odds ratio (OR) of 2.60; class 4 and the age of 45–59 years (26.7%; OR – 3.61; P ≤ 0.01); adentia and the age of 75–90 years (50.8%; OR – 2.15; P ≤ 0.05); adentia and the age over 90 years (10.9%; OR – 3.02; P ≤ 0.01); crown defect and the age of 45–59 years (17.5%; OR – 2.04; P ≤ 0.05); prosthesis failure and age 75–90 years (60.0%; OR – 2.54; P ≤ 0.01) and prosthesis failure and age over 90 years (30.0%; OR – 7.44; P ≤ 0.001). In the remaining cases, there was a uniform percentage distribution both in terms of age and diagnoses, with calculated OR values within the range of –0.25 – 1.66 (P ≥ 0.05). The Kruskal–Wallis analysis of variance (by age: 66.77; P ≤ 0.0001; by diagnosis: 40.76; P ≤ 0.0001) helped to conclude that the older the patient (75–90 years and over 90 years), the more pathologies such as combined class (30.6%–34.1%), adentia (‘anodontia’) (37.0%–51.2%), crown defect (4.5%) and prosthesis failure (2.3%–7.3%) are found in the structure of diagnoses, and, conversely, the younger the age (45–59 years – 60–74 years), the pathology varies within classes 1–4 (class 1 – 17.1%–21.1%; class 2 – 10.0%–6.6%; class 3 – 12.9%–7.2% and 4th grade – 11.4%–3.9%, respectively).
Thus, when assessing the quantitative relationship between the structure of diagnoses and the biological age of patients, it was found that the critical value of χ2 at a significance level of P ≤ 0.0001 is 97.60, the Spearman correlation coefficient is 0.22 (P = 0.0001), and the calculated Cramer’s V criteria and the contingency coefficient showed an average relationship between the studied variables at the level of −0.21 and 0.35, respectively. Based on the data, it is clear that the older the age, the greater the likelihood of adentia.
Ethical issues
Code of Ethics No. 11 (119)/2023, approved by the Local Ethics Committee of the Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan (Registration number N 258). The signed patient consent forms have been obtained before the study. The procedures followed were by the ethical standards of the responsible institutional or regional human experimentation committee and the Helsinki Declaration of 1975, as revised in 2000.
Statistical analysis
When processing the data, methods of modern statistics were used (grouping data by gender, age, constructing tables and graphs, calculating relative values, and methods for assessing the reliability of the difference in the obtained data). Statistical and mathematical processing of data was carried out using the IBM SPSS Statistics version 22.0 (IBM, USA) on a personal computer Aspire E 15 Intel Core i5 2.8 GHz. To interpret, the obtained data Pearson correlation coefficient was employed.
RESULTS
Demographic overview
The analysis of oral health status and dental pathologies among patients in Almaty City, Kazakhstan, provides valuable insights into the challenges and needs of the population, particularly among older adults. The gender distribution in the study population is nearly balanced, with 50.85% male and 49.15% female participants. However, the data show that oral health issues are predominantly concentrated in older age groups, with 46.89% of the patients aged 60–74 years and 37.43% aged 75–90 years. Only a small proportion of the population falls within the 45–59 age range (9.89%) or is above 90 years old (5.79%), highlighting the increasing prevalence of dental issues with age. The age distribution is depicted in Figure 1.
Figure 1.
Age distribution of study participants.
The analysis of gender distribution showed that 49.15% of the participants were men (n = 360), while women accounted for 50.85% (n = 348) [Figure 2].
Figure 2.
Characteristics of patients involved in the study.
Results of Pearson correlation analysis
The Pearson correlation analysis provides valuable insights into the relationships between key demographic factors (age and gender) and various oral health parameters among patients in Almaty City. Strongest correlations were observed with the need for lower jaw prosthetics (0.21), orthopedic condition of the upper jaw (0.19), and number of extracted teeth (0.19), indicating that older individuals are more likely to require prosthetic interventions and experience tooth loss.
No strong correlations with any factors, but the highest positive correlation was with clinical evaluation (0.06), suggesting minor gender-based differences in dental health assessments.
Age showed the strongest correlations with the need for lower jaw prosthetics (0.21), the orthopaedic condition of the upper jaw (0.19), and the number of extracted teeth (0.19). These findings align with existing research that associates aging with increased dental complications, tooth loss, and the need for prosthetic interventions. As individuals age, cumulative exposure to oral diseases, mechanical wear, and systemic conditions (such as osteoporosis and diabetes) contributes to compromised dental integrity, necessitating prosthetic rehabilitation.
On the other hand, gender did not exhibit strong correlations with any of the analysed dental health indicators. The highest positive correlation (0.06) was observed between gender and clinical evaluation, implying only minor gender-related differences in dental health assessments.
Scatter plot analysis
Age versus number of extracted teeth
The scatter plot analysis of age versus the number of extracted teeth revealed a clear trend: as individuals age, the number of extracted teeth tends to increase. This relationship aligns with well-established findings in dental research, highlighting the cumulative effects of oral health deterioration over time. Another important contributing factor is the reduction in salivary function often observed in older adults, which can be attributed to both natural ageing processes and the side effects of medications commonly prescribed to manage chronic illnesses. Saliva plays a crucial role in maintaining oral health by neutralizing acids and aiding in the remineralization of teeth, and its reduction significantly increases the risk of dental caries and subsequent tooth extractions. In addition, limited access to preventive dental care among older individuals, especially those from lower socioeconomic backgrounds, can result in delayed interventions and a higher reliance on extractions rather than restorative treatments.
Periodontal index versus number of remaining teeth
The relationship between the periodontal index and the number of remaining teeth reveals a moderate negative correlation, indicating that individuals with higher periodontal index values tend to have fewer remaining teeth. This finding aligns with existing research demonstrating that worsening periodontal health is a significant predictor of tooth loss.
Several factors contribute to the observed relationship between a higher periodontal index and reduced dentition. One of the primary drivers is the chronic inflammation associated with periodontitis, which not only weakens periodontal attachment but also triggers systemic inflammatory responses that can further compromise oral health.
The negative impact of periodontal disease on dentition underscores the importance of early diagnosis and intervention. Preventive measures such as regular dental cleanings, improved oral hygiene practices, and patient education on periodontal health can help mitigate disease progression and preserve the remaining teeth.
Moreover, the findings highlight the need for integrating periodontal assessments into routine dental checkups to identify at-risk individuals before extensive tooth loss occurs. Public health initiatives should emphasize the role of modifiable risk factors, such as smoking cessation programs and improved glycaemic control in diabetic patients, to reduce the burden of periodontal disease-related tooth loss.
The orthopedic status of patients
The orthopedic status of patients underscores the significant burden of edentulism and unmet prosthetic needs. For the upper jaw, 69.49% of patients have no dentures, indicating either natural dentition or untreated tooth loss. The most common prosthetic solution for this group is bridge dentures, utilized by 16.81% of patients, whereas 5.23% rely on multiple bridge dentures. Partial dentures and combinations of bridge and partial dentures are less frequent, at 2.12% and 1.84%, respectively. Complete dentures are used by only 4.52% of patients, reflecting a relatively low adoption of full prosthetic rehabilitation. The situation for the lower jaw is slightly better, with 76.69% of patients having no dentures, followed by 18.93% using bridge dentures. Partial removable dentures and completely removable dentures are less commonly utilized at 2.26% and 1.69%, respectively, and combinations of bridge and partial dentures are rare, at just 0.42%.
A closer look at prosthetic needs reveals a substantial demand for interventions. For the upper jaw, 42.23% of patients require prosthetics to replace all teeth, a striking indication of widespread edentulism. In addition, 35.17% need prosthetics to replace more than one tooth, whereas 2.26% require replacements for a single missing tooth. Only 20.06% of patients report no need for prosthetics in the upper jaw, suggesting satisfactory oral health or prior treatment. In the lower jaw, the data reflect slightly better conditions, with 26.69% reporting no prosthetic needs. However, 43.36% require prosthetics to replace multiple teeth, and 27.12% need complete prosthetic rehabilitation, indicating persistent issues with tooth loss and its functional consequences.
The need for emergency dental care further highlights gaps in preventive and routine care. Only 7.34% of patients reported no need for emergency interventions, whereas 28.39% required urgent dental treatment. Alarmingly, the status of emergency care was unrecorded for 64.27% of cases, revealing a significant gap in data management and reporting.
The data reveal a strong correlation between age and oral health status among patients in Almaty City. The Pearson correlation coefficient, a measure of linear correlation, shows a strong negative correlation (-0.94) between age and oral health index [Figure 3]. This indicates that as age increases, the oral health index tends to decrease, suggesting a decline in oral health with age. Conversely, there is a strong positive correlation (0.94) between age and the number of dental pathologies, implying that the number of dental problems increases with age.
Figure 3.
Correlation analysis of age versus number of dental disorders.
Scatter plot analysis demonstrates these findings. The scatter plot of age versus oral health index shows a clear downward trend, with older patients generally having lower oral health index scores [Figure 4].
Figure 4.
Correlation analysis of age versus oral health index.
The analysis of prosthetic needs
The analysis of the need for jaw prosthetics among the elderly population in Almaty City, Kazakhstan, reveals significant disparities in oral health and prosthetic requirements between the upper and lower jaws. The findings highlight the extent of tooth loss in this demographic and underscore the urgent need for targeted interventions to address these challenges. For the upper jaw, 42.23% of individuals require prosthetics to replace all teeth, indicating a high prevalence of complete edentulism [Figure 5]. In addition, 35.17% need prosthetics to replace more than one tooth, whereas only 2.26% require a prosthetic solution for a single missing tooth. A small fraction (0.28%) reported a combined need for replacing a single tooth and additional teeth. Despite these needs, only 20.06% of the elderly population had no requirement for upper jaw prosthetics, suggesting relatively better oral health or previous access to prosthetic care in this subset.
Figure 5.
Need for jaw prosthetics.
In contrast, the lower jaw shows a slightly different distribution of prosthetic needs. While 43.36% of individuals require prosthetics to replace more than one tooth, a smaller proportion (27.12%) reported complete edentulism, necessitating prosthetics for all teeth. The need for replacing a single tooth was marginally higher in the lower jaw (2.40%) compared to the upper jaw, and combined needs were reported by 0.42% of individuals. Notably, 26.69% of the population did not need prosthetics in the lower jaw, reflecting better preservation of natural dentition or successful prior treatment.
The data underscore the higher prevalence of complete edentulism in the upper jaw compared to the lower jaw, which could be attributed to differences in bone density, anatomical variations, or chewing forces. The greater need for partial prosthetics in the lower jaw highlights the importance of addressing localized tooth loss, which, if untreated, can progress to more severe conditions.
Analysis of prevalence of dental disorders
The data reveal a substantial prevalence of dental conditions, including various patterns of edentulism categorized under the Kennedy classification system, complete tooth loss, crown defects, and issues with prosthetic devices [Table 1]. These findings reflect the urgent need for targeted interventions to improve the oral health and quality of life of the population.
Table 1.
“Distribution of dental conditions amongst study groups (Kennedy Classification) – values expressed as percentage of total patients”
| Diagnosis | Percentage |
|---|---|
| 1 class Kennedy | 14.83 |
| 2 class Kennedy | 5.93 |
| 3 class Kennedy | 8.33 |
| 4 class Kennedy | 4.24 |
| Combined | 32.34 |
| Edental defect | 27.26 |
| Crown defect | 5.65 |
| Prosthesis failure | 1.41 |
All data expressed as percentages
Tooth loss patterns based on the Kennedy classification highlight the widespread need for prosthetic rehabilitation. Class I, characterized by bilateral edentulous areas posterior to the remaining natural teeth, is the most common, affecting 14.83% of patients. This underscores the necessity for bilateral prosthetic replacements, such as partial dentures or implant-supported bridges. Class II, with unilateral edentulous areas posterior to remaining teeth, affects 5.93% of patients, reflecting localized tooth loss that often requires tailored prosthetic solutions. Class III, representing a unilateral edentulous area with teeth both anterior and posterior to it, accounts for 8.33%, indicating a moderate need for fixed or removable prostheses. Class IV, involving a single edentulous area crossing the midline, is observed in 4.24% of cases, emphasizing the importance of anterior prosthetic rehabilitation to restore both function and aesthetics. Moreover, 32.34% of cases fall under combined classifications, indicating complex patterns of tooth loss that necessitate advanced diagnostic and treatment planning.
Edentulism, or complete tooth loss, emerges as a critical issue, affecting 27.26% of patients. The impact of complete edentulism extends beyond oral health, affecting chewing efficiency, speech, and facial aesthetics, ultimately diminishing the quality of life. Crown defects are present in 5.65% of patients, representing structural damage to individual teeth caused by decay, trauma, or wear. Prosthesis failure, although reported in a smaller percentage of cases (1.41%), is a significant concern. Failures in prosthetic devices can arise from poor material quality, improper fabrication, or patient noncompliance, leading to compromised functionality and increased financial and emotional strain on patients. Table 2 summarizes the study findings while offering actionable recommendations to address the identified challenges.
Table 2.
A summary of the study findings and actionable recommendations
| Parameter | Result | Recommendations |
|---|---|---|
| Demographics | 50.85% male, 49.15% female. Most patients were aged 60–74 years (46.89%) and 75–90 years (37.43%) | Develop targeted geriatric dental care programs focused on older adults, particularly those aged 60+ years |
| Prosthetic use | 52.1% of participants used prosthetic devices, predominantly removable dentures | Promote the use of durable and comfortable prosthetics, and subsidise access for economically disadvantaged groups |
| Prosthetic needs - upper jaw | 69.49% had no dentures; 42.23% required complete prosthetics for all teeth, and 35.17% needed partial replacement | Expand access to complete prosthetics and establish programs to address widespread edentulism in the upper jaw |
| Prosthetic needs - lower jaw | 76.69% had no dentures; 43.36% required replacement of multiple teeth, and 27.12% needed complete prosthetics | Provide affordable solutions for lower jaw prosthetic rehabilitation, prioritizing patients with extensive tooth loss |
| Prevalence of Edentulism | 41.9% were completely toothless in at least one jaw, while 38.8% experienced partial edentulism | Implement preventive oral health strategies and improve access to affordable dentures and implant-supported solutions |
| Dissatisfaction with prosthetics | 42.6% of prosthetic users reported dissatisfaction | Enhance the quality of prosthetics through the use of advanced materials and techniques to improve patient satisfaction |
| Barriers to care | Financial constraints (68.3%), geographic inaccessibility, and physical disabilities were key obstacles | Introduce mobile dental clinics, telemedicine consultations, and financial assistance programs for underserved areas |
| Use of state-supported programs | Only 21.5% utilized state-supported dental programs despite higher satisfaction among users | Increase public awareness about state-supported programs and streamline access to these services for elderly patients |
| Distribution of Kennedy classes | Class I: 14.83%, Class II: 5.93%, Class III: 8.33%, Class IV: 4.24%, Combined: 32.34% | Train dental professionals to manage complex Kennedy classifications and improve diagnostic tools for tailored treatments |
| Crown defects | Present in 5.65% of patients | Provide access to affordable restorative options such as crowns or on-lays to address structural tooth damage |
| Prosthesis failure | Reported in 1.41% of cases | Invest in high-quality materials and fabrication techniques to reduce the incidence of prosthetic failure |
| Emergency dental care | 28.39% required emergency dental care, while 64.27% lacked emergency care records | Improve emergency dental care availability and ensure comprehensive data collection to address unmet care needs |
All data expressed as percentages
Multivariate statistical analysis results
The ordinary least squares regression analysis examined the relationship between the number of extracted teeth and key factors, including age, gender, smoking, alcohol consumption, education level, and periodontal index.
The multivariate statistical analysis provided valuable insights into the factors influencing tooth extraction rates. Age demonstrated a significant positive association with the number of extracted teeth (β = 0.1105, P < 0.001), confirming that older individuals are at a higher risk of tooth loss.
Interestingly, gender was not found to be a significant predictor of extracted teeth (P = 0.853), suggesting that tooth loss rates do not differ meaningfully between males and females. This finding indicates that biological sex alone may not be a determining factor for tooth retention or extraction, with other behavioral and socioeconomic factors likely playing a more influential role.
A surprising finding was the significant negative association between smoking and the number of extracted teeth (β = −0.8386, P < 0.001), suggesting that smokers reported fewer extractions. Alcohol consumption was found to have a strong positive association with the number of extracted teeth (β = 0.6874, P < 0.001), indicating that individuals who consume alcohol are significantly more likely to experience tooth loss. Education level was identified as a strong protective factor, with a significant negative association observed (β = −1.8317, P < 0.001). Individuals with higher education levels had significantly fewer extracted teeth, reinforcing the critical role of health literacy in preventive dental care. Surprisingly, the periodontal index did not emerge as a significant predictor of extracted teeth (P = 0.424).
DISCUSSION
This study highlights major oral health challenges and unmet prosthetic needs among elderly individuals in Almaty, Kazakhstan. The high prevalence of edentulism and partial tooth loss reflects both cumulative oral health neglect and systemic barriers to timely care. These conditions compromise chewing, speech, nutrition, and self-esteem, emphasising the broader health and social consequences of oral health decline in older adults. The prevalence of complete edentulism, observed in 41.9% of participants in at least one jaw, is particularly concerning. This condition, often viewed as an inevitable consequence of aging, reflects both cumulative oral health neglect and systemic barriers to timely dental care.[13,14] The impact of edentulism extends beyond the immediate oral cavity, affecting essential functions such as chewing and speaking, and leading to broader health issues, including nutritional deficiencies, gastrointestinal problems, and psychological distress.[15,16]
Age was a strong determinant of oral health deterioration, with older participants showing more advanced periodontal disease and higher prosthetic requirements. The strong correlation between advanced age and severe dental conditions, including complete edentulism and prosthetic failure, underscores the need for age-specific care strategies.[17,18]
While the periodontal index alone was not a reliable predictor of tooth loss, the combined effects of systemic conditions, oral hygiene practices, and limited access to dental services likely influenced outcomes. Education emerged as a protective factor, whereas alcohol consumption was linked to higher extraction rates. Gender differences were minimal, and the unexpected association between smoking and fewer extractions requires further study.
Socio-economic barriers remain central. Financial constraints, geographic inaccessibility, and physical limitations restricted access to dental services, with many participants unable to afford prosthetic care. Although satisfaction with state-supported programs was relatively high, their use was very limited, indicating low awareness and accessibility. Expanding outreach and simplifying enrolment could significantly improve utilisation.
Patient dissatisfaction with removable dentures was common, often related to poor fit and durability. While removable options remain widespread due to affordability, investment in advanced prosthetic technologies, such as implant-supported or computer-aided design/computer-aided manufacturing-fabricated devices, could improve comfort and function.[19,20] Training dental professionals in modern prosthetic fabrication techniques is equally critical to improving patient outcomes.
Preventive care remains underdeveloped. Strengthening preventive programs, regular screenings, periodontal maintenance, and patient education could reduce progression to severe tooth loss. In fact, timely preventive measures can significantly delay its progression and reduce the risk of severe pathologies.[21,22]
Study limitations
Despite the valuable insights gained, this study has several limitations. First, self-reported behaviours (such as smoking, alcohol consumption, and oral hygiene practices) may be subject to recall bias or social desirability bias. Additionally, the cross-sectional design prevents causal inference, meaning that while associations can be identified, the directionality of these relationships remains uncertain. Finally, the study focused on urban populations in Almaty, which may limit the generalizability of findings to rural areas where access to dental care is even more restricted. Future research should incorporate longitudinal data to track oral health deterioration over time and evaluate the effectiveness of targeted interventions.
CONCLUSION
This study reveals significant oral health challenges among Kazakhstan’s elderly, including high rates of tooth loss, unmet prosthetic needs, and barriers to affordable care. Addressing these issues requires comprehensive policies that emphasise prevention, expand access to prosthetic services, and integrate oral health into broader public health initiatives. A multidisciplinary approach is essential, combining dental professionals, healthcare providers, and policymakers to expand outreach, subsidise treatment for low-income groups, and use technology to improve access in remote areas.
Future research should assess the long-term impact of such interventions and explore innovative solutions, including minimally invasive methods and implant-supported prosthetics. Prioritizing oral health within healthy ageing strategies will enhance the quality of life for older adults and reduce the burden of untreated conditions on the healthcare system.
Conflicts of interest
The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or non-financial in this article.
Acknowledgments
The authors are grateful to S.D. Asfendiyarov Kazakh National Medical University for the administrative and technical support provided.
Funding Statement
Nil.
REFERENCES
- 1.Amuthavalli Thiyagarajan J, Mikton C, Harwood RH, Gichu M, Gaigbe-Togbe V, Jhamba T, et al. The UN decade of healthy ageing: Strengthening measurement for monitoring health and wellbeing of older people. Age Ageing. 2022;51:afac147. doi: 10.1093/ageing/afac147. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Lipsky MS, Singh T, Zakeri G, Hung M. Oral health and older adults: A narrative review. Dent J (Basel) 2024;12:30. doi: 10.3390/dj12020030. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Fôlha CN, Cascaes AM, Correa MB, Cademartori MG, Matijasevich A, Santos IS, et al. Lifetime use of dental services and dental caries in adolescents in 2004 pelotas birth cohort. Community Dent Oral Epidemiol. 2025;53:198–204. doi: 10.1111/cdoe.13023. [DOI] [PubMed] [Google Scholar]
- 4.Promruck N, Ruengorn C, Thavorn K, Bandhaya P, Nochaiwong S. Association between oral health conditions and the risk of major noncommunicable diseases: A protocol for systematic review and meta-analysis. SAGE Open Med. 2024;12:1–6. doi: 10.1177/20503121241290385. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Stanbouly D, Stanbouly D, Zeng Q, Jou Y, Chuang S. Edentulism (missing teeth) and brain central nervous system (CNS) deafferentation: A narrative review. Front Oral Maxillofac Med. 2024;6:8–8. [Google Scholar]
- 6.Yaparathna N, Hettiarachchi RM, Tadakamadla SK, Love R, Robb ND, Abuzar M. Impact of removable partial dentures on masticatory performance in partial edentulism: A systematic review. Int J Prosthodont. 2024;37((3)):327–338. doi: 10.11607/ijp.8278. [DOI] [PubMed] [Google Scholar]
- 7.Ruzuddinov N, Ruzuddinov S, Kozhakhmetovna SM, Ruzuddinov T, Amerbekkyzy KN. Evaluation of dental health of the adult population of Kazakhstan and solutions for improving removable prosthetics. J Popul Ther Clin Pharmacol. 2022;29:e73–9. doi: 10.47750/jptcp.2022.941. [DOI] [PubMed] [Google Scholar]
- 8.Charyeva OO, Altynbekov KD, Nysanova BZ. Kennedy classification and treatment options: A study of partially edentulous patients being treated in a specialized prosthetic clinic. J Prosthodont. 2012;21:177–80. doi: 10.1111/j.1532-849X.2011.00809.x. [DOI] [PubMed] [Google Scholar]
- 9.Dibello V, Lobbezoo F, Solfrizzi V, Custodero C, Lozupone M, Pilotto A, et al. Oral health indicators and bone mineral density disorders in older age: A systematic review. Ageing Res Rev. 2024;100:102412. doi: 10.1016/j.arr.2024.102412. [DOI] [PubMed] [Google Scholar]
- 10.Brandt AC, Abbas A, Dong CS. Exploring the acceptance of geriatric dentistry programming for undergraduate dental students through stakeholder interviews. J Dent Educ. 2024;88:573–86. doi: 10.1002/jdd.13461. [DOI] [PubMed] [Google Scholar]
- 11.Mosaddad SA, Talebi S, Keyhan SO, Fallahi HR, Darvishi M, Aghili SS, et al. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil. 2024;51:1250–302. doi: 10.1111/joor.13683. [DOI] [PubMed] [Google Scholar]
- 12.Rasmussen EL, Musaeus P. Subject matter changes in the dental curriculum: A scoping review of the last two decades. J Dent Educ. 2024;88:1101–14. doi: 10.1002/jdd.13530. [DOI] [PubMed] [Google Scholar]
- 13.Heydari MH, Sharifi F, Sobhaninejad S, Sharifi A, Alizadeh L, Darmiani S, et al. The association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus among the elderly population. J Diabetes Metab Disord. 2024;23:1371–80. doi: 10.1007/s40200-024-01434-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Kaurani P, Kakodkar P, Bhowmick A, Samra RK, Bansal V. Association of tooth loss and nutritional status in adults: An overview of systematic reviews. BMC Oral Health. 2024;24:838. doi: 10.1186/s12903-024-04602-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Guan W, Li J, Liang Q, Huang Y, Li S, Xu X, et al. Disease burden and health inequality of older adults with edentulism and the projected trend until 2040: Based on the global burden of disease study 2021. Clin Oral Investig. 2024;29:22. doi: 10.1007/s00784-024-06111-5. [DOI] [PubMed] [Google Scholar]
- 16.Tariq S, Shoaib A, Chaudhary FA, Habib SR, Javed MQ. Impact of complete dentures treatment on oral health-related quality of life (OHRQoL) in edentulous patients: A descriptive case series study. Pak J Med Sci. 2024;40:2130–5. doi: 10.12669/pjms.40.9.9402. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Akhtarkhavari M, Rajagopal P, Clovis Da Costa G, Aras M, Chitre V, Naik SG. Prosthodontic rehabilitation of a completely edentulous patient by salvaging ailing implants using a bar retained over denture: A case report. Cureus. 2024;16:e63157. doi: 10.7759/cureus.63157. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Sánchez-Torres A, Moragón-Rodríguez M, Agirre-Vitores A, Cercadillo-Ibarguren I, Figueiredo R, Valmaseda-Castellón E. Early complications and quality of life in patients with immediately loaded implant-supported maxillary partial rehabilitations: A prospective cohort study. Med Oral Patol Oral Cir Bucal. 2024;29:e172–9. doi: 10.4317/medoral.26158. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Deeban Y. Effectiveness of CAD-CAM milled versus DMLS titanium frameworks for hybrid denture prosthesis: A narrative review. J Funct Biomater. 2024;15:376. doi: 10.3390/jfb15120376. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Mansoor MA, Sayed ME, Abdul HN, Zaidan MS, Hakami TM, Dighriri MA, et al. Comparative accuracy of intraoral and extraoral digital workflows for short span implant supported fixed partial denture fabrication: An in vitro study. Med Sci Monit. 2024;30:e943706. doi: 10.12659/MSM.943706. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Kimoto S, Kawai Y, Suzuki A, Koide Y, Kondo H, Nomura T, et al. Effect of denture adhesives on masticatory performance: Multicenter randomized controlled trial. J Prosthodont Res. 2024;68:132–8. doi: 10.2186/jpr.JPR_D_22_00105. [DOI] [PubMed] [Google Scholar]
- 22.Dierens M, Collaert B, Deschepper E, Browaeys H, Klinge B, De Bruyn H. Patient-centered outcome of immediately loaded implants in the rehabilitation of fully edentulous jaws. Clin Oral Implants Res. 2009;20:1070–7. doi: 10.1111/j.1600-0501.2009.01741.x. [DOI] [PubMed] [Google Scholar]