2026 Volume 18 Issue 2 Pages 84-92
In home-visit dental care settings, the decision of whether to undertake prosthodontic intervention cannot be resolved solely on the basis of intraoral conditions; rather, it constitutes a complex decision-making process in which the living environment, care services and support systems, and the patient's own values intersect. This paper proposes the use of the International Classification of Functioning, Disability and Health (ICF) as a framework for comprehensively organizing the issues to be examined, grounded in the principles of critical thinking. The ICF is a framework that captures body functions and structures, activities, and participation, along with environmental and personal factors, as interactive components. In home care settings in particular, the success or failure of prosthodontic intervention hinges on whether daily management tasks — such as handling, cleaning, and storing the denture — can be sustained, and whether a support system to enable this can be established. Furthermore, as an outcome (i.e., the definition of success), the value of dentures must be evaluated not only in terms of restoring the ability to eat, but also as a means of restoring social participation. At the same time, since the denture itself is not the end goal but rather a means of supporting the recovery of life functions, there are cases in which the decision not to intervene prosthodontically is the appropriate course of action. Even in such cases, the decision should not be framed as an all-or-nothing choice; instead, graded and conditional applications should also be considered. Moreover, intervention and reassessment tailored to each phase of the disease trajectory are essential, and “proactive intervention during the recovery phase with an eye toward the future maintenance phase and home care” represents a particularly important option.
By systematically organizing these elements through the ICF framework, this paper aims to contribute to improving both the quality and the explanatory power of decision-making regarding the appropriateness of prosthodontic intervention for home care patients.
