Dental caries experience in older people over time: what can the large cohort studies tell us?
ABSTRACT Little was known of the natural history of dental caries among older adults until recently, but reports from a number of large cohort studies have now enabled better understanding of the nature and determinants of dental caries in older people. The aim of this review is to examine and compare findings from established population-based longitudinal studies of older adults in order to determine their preventive implications.
The dental literature was reviewed in order to identify reports on dental caries incidence from large, population-based dental longitudinal studies of older adults (age 50+) with at least 3 years of follow-up.
Reports were identified from four studies (in Iowa, North Carolina, Ontario and South Australia) which met the criteria; four reports dealt with coronal caries, and five with root surface caries. When annualised, coronal and root surface caries increments were combined and compared with those reported for adolescents, the caries experience of older people over time (between 0.8 and 1.2 new surfaces affected per year) exceeded that reported from cohort studies of adolescents (between 0.4 and 1.2 surfaces per year). The only caries risk factor common to all four studies was the wearing of a partial denture (for root surface caries only).
Older people are a caries-active group, experiencing new disease at a rate which is at least as great as that of adolescents.
Dentate older people should be the target of intensive monitoring and preventive efforts at both the clinical practice and public health levels. There is no easily identifiable 'magic bullet' for preventing caries in that age group, but the use of evidence-based preventive interventions (such as fluoride) should suffice.
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ABSTRACT: In this narrative review paper, we summarise what is known about the oral health of older people, with a specific focus on the most common oral conditions in that age group. After that, the implications for older people׳s oral care are considered, along with ways of developing and maintaining a gerodontologically capable and responsive workforce and oral care delivery system. Copyright © 2014. Published by Elsevier B.V.Singapore dental journal 12/2014; 35C:3-8. DOI:10.1016/j.sdj.2014.10.001
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ABSTRACT: Resin composites have become the first choice for direct posterior restorations and are increasingly popular among clinicians and patients. Meanwhile, a number of clinical reports in the literature have discussed the durability of these restorations over long periods. In this review, we have searched the dental literature looking for clinical trials investigating posterior composite restorations over periods of at least 5 years of follow-up published between 1996 and 2011. The search resulted in 34 selected studies. 90% of the clinical studies indicated that annual failure rates between 1% and 3% can be achieved with Class I and II posterior composite restorations depending on several factors such as tooth type and location, operator, and socioeconomic, demographic, and behavioral elements. The material properties showed a minor effect on longevity. The main reasons for failure in the long term are secondary caries, related to the individual caries risk, and fracture, related to the presence of a lining or the strength of the material used as well as patient factors such as bruxism. Repair is a viable alternative to replacement, and it can increase significantly the lifetime of restorations. As observed in the literature reviewed, a long survival rate for posterior composite restorations can be expected provided that patient, operator and materials factors are taken into account when the restorations are performed.Dental Materials 01/2012; 28(1):87-101. DOI:10.1016/j.dental.2011.09.003 · 4.16 Impact Factor
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ABSTRACT: Limited information is available about the oral health of elderly people living in “Pondok” in Kelantan. This study aimed to assess the dentition status of elderly population staying in Islamic Religious Community Setup, “Pondok” in Kelantan. A cross sectional study involving 369 elderly people was carried out. A simple random sampling method was utilized for the selection of the subjects. Oral examination was done to assess the dentition status and data was analyzed using SPSS 11.5 version. The response rate was 95.6%. Majority of the subjects were edentulous (81.0%). The mean number of natural teeth, functional natural teeth, decayed teeth (D), missing teeth (M) and teeth indicated for extraction (X) were 3.22 (SD 7.54), 2.75 (SD 6.70), 0.06 (SD 0.48), 28.80 (SD 7.51) and 0.41 (SD 1.60) respectively. Among 70 dentate subjects, the mean number of natural teeth, functional natural teeth, occluding pair of functional natural teeth, decayed teeth (D), missing teeth (M), teeth indicated for extraction (X) and DMFX(T) index were 17.1 (SD 8.00), 14.5 (SD 8.11), 6.3 (SD 4.22), 0.3 (SD 1.06), 15.1 (SD 8.20), 2.2 (SD 3.14) and 17.6 (SD 8.08) respectively. There was no teeth had been filled (F). The proportion of subjects having minimum 20 functional natural teeth was 7.3%. The above results indicate that dental caries status of elderly people living in “Pondok” in Kelantan was unsatisfactory with high percentage of edentulism, contributing to the high value of the mean DMFX(T) index, 29.3 (SD 6.63).