By Nick Triggle
Health reporter, BBC News
Demands on services are expected to increase
NHS dentistry is facing a major challenge coping with the consequences of the ageing population, a leading expert says.
British Dental Association scientific adviser Professor Damien Walmsley said better oral care meant people were increasingly keeping their own teeth.
He said that was good for patients, but would mean more work for dentists.
In particular, he cited a rise in demands for replacement fillings and care for tooth erosion.
Research by the BDA has shown that fewer than a third of over-65s currently have their own teeth, but within 20 years that is likely to increase to about 50% of them.
The numbers will also be swelled by the ageing population, with the over-65s age group expected to grow by a third and the over-85s doubling in the next two decades.
Prof Walmsley said there was growing concern about the issue.
Dentures do need monitoring and regular maintenance, but that is far outweighed by the demands in caring for the teeth of elderly patients.
Prof Walmsley said: "It has the potential to add to the workload.
"Fillings, crowns and root canal treatment have only been designed to last 20 years and may need to be replaced or maintained.
"Decay will cause problems as older people tend to get a different kind of decay, often around the gums which needs to be treated differently.
"There may also be teeth erosion. We can use compounds to build up teeth as well as fluoride varnishes to strengthen and protect them."
But he admitted resources would clearly be an issue.
He also said there would need to be more research into how to best tackle these problems - the ageing and erosion process can weaken teeth so much that treatment can be tricky.
"The needs are changing and I know the Department of Health is already looking into this."
There are also logistical issues to be overcome.
Last year, charities expressed concern about the lack of dental services being provided to care homes and through mobile clinics. Many elderly people struggle to visit dental surgeries and therefore rely on vans which tour communities.
The warning comes amid continuing problems over access to dental services generally. A new system was introduced in 2006, but is now in the process of being revamped after failing to make much of an impact.
Health minister Ann Keen agreed the issue would need to be addressed.
"The NHS will need to commission services to meet the needs of all people, including those who, because of age, infirmity or complex needs, may have difficulty in accessing traditional dental services."