Diagnosing “terminal dentition” presents a significant challenge in clinical dentistry, requiring an understanding of advanced oral pathologies. Pathologies may arise from damage to either tooth structure or the periodontal hard and soft tissues. When a dentition is terminal, it is not a simple binary question; issues such as whether the dentition is terminal now or will be in the future must be evaluated. Maybe the better question is, “How have we established a diagnosis of a terminal dentition.” Is the diagnosis based on subjective data centered on what a patient expresses, or is the diagnosis based on state-of-the-art algorithms that offer a structured diagnostic approach that includes objective data? An algorithm based on critical criteria such as stage IV periodontitis, rampant caries that result in unrestorable teeth, and/or extensive tooth loss should be the cornerstone for a terminal dentition diagnosis and subsequent treatment. This multifactorial approach should integrate evidence-based clinical...

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