Among older adults the rate of edentulism is declining and they retain substantial numbers of teeth, but molar teeth remain
more vulnerable to premature loss. Therefore, it is likely that in the future many more older adults will have missing posterior teeth. Dental care should be aimed at the preservation of a natural functioning dentition for life, within the available resources. In general, preference should be given to dentitions comprising complete dental arches or 14 occluding pairs of teeth. However, in many subjects-such as elderly-this goal might be neither attainable nor necessary. In these cases, dental care should be aimed at preserving the strategic parts of the dental arch, which are the front and premolar regions(the so-called ultimate occlusal preservation target). The shortened dental arch(SDA) concept suggests that the minimum number of occluding pairs of teeth required to provide satisfactory levels of oral function may vary according to age and other factors. The anterior and premolar teeth are the ’strategic’ part of the dental arch and are essential for satisfactory oral function and oral comfort. The SDA concept involves the direction of treatment efforts and resources at the preservation of the anterior and premolar teeth. This paper describes the role of the SDA concept in the management of reduced dentitions, including criteria for its application, possible indications and contraindications, and presents a review of research supporting SDA. In light of recent research, it is suggested that SDA will be of increasing importance as a treatment philosophy for the future elderly.
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