scholarly journals How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement

2020 ◽  
Vol 54 (5-6) ◽  
pp. 459-465
Author(s):  
Sebastian Paris ◽  
Avijit Banerjee ◽  
Peter Bottenberg ◽  
Lorenzo Breschi ◽  
Guglielmo Campus ◽  
...  
Keyword(s):  
Older Adults ◽  
Antimicrobial Agents ◽  
Salivary Flow ◽  
Root Caries ◽  
Delphi Consensus ◽  
Restorative Treatment ◽  
Increased Risk ◽  
The Individual ◽  
Systemic Health ◽  
Caries Lesions

<b><i>Aim:</i></b> To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. <b><i>Methods:</i></b> A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. <b><i>Results:</i></b> Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient’s individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual.

scholarly journals Association between Root Caries and Depressive Symptoms among Elders in Carlos Barbosa, RS, Brazil

2017 ◽  
Vol 28 (2) ◽  
pp. 234-240 ◽  
Author(s):  
Otávio Pereira D’Avila ◽  
Eliana Wendland ◽  
Juliana Balbinot Hilgert ◽  
Dalva Maria Pereira Padilha ◽  
Fernando Neves Hugo
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Independent Living ◽  
Negative Binomial ◽  
Depression Scale ◽  
Salivary Flow ◽  
Community Dwelling ◽  
Depression Symptoms ◽  
Root Caries ◽  
Male Sex

Abstract The aim of this study was to evaluate the association between depressive symptoms and root caries among independent-living older persons. All community-dwelling older adults (not hospitalized and not bedridden) living in Carlos Barbosa, RS, Brazil, were invited to participate, and 785 completed the study protocol (standardized questionnaire assessing socio-demographic information and health behavior, Geriatric Depression Scale [GDS] - brief version, and oral examination [DMFT-Root index, Visible Plaque Index and stimulated salivary flow]). Out of them, 390 participants with at least one natural tooth were included in the present analysis. The outcome of interest was the ratio between the number of decayed roots and the number of roots at risk. The association between independent variables (depression and socioeconomic aspects) and the outcome was assessed using negative binomial regression models. Results: The final, fully adjusted model revealed that age (β=0.03, p=0.001), female sex (β=-0.23, p=0.08), living in a rural area (β=0.25, p=0.008), tooth brushing frequency (β=0.43, p=0.025) and stimulated salivary flow (β=-0.012, p<0.0001) were significantly associated with the presence of root caries. In addition, the interaction between male sex and the presence of depression symptoms (β=-0.99, p=0.012) was also independently and significantly associated with root caries. The interaction between male sex and depression symptoms was associated with root caries, suggesting that psychological mechanisms may be involved indirectly in the development of root caries in older adults.

Reversal of primary root caries lesions after daily intake of milk supplemented with fluoride and probiotic lactobacilli in older adults

2011 ◽  
Vol 69 (6) ◽  
pp. 321-327 ◽  
Author(s):  
Lars G. Petersson ◽  
Kerstin Magnusson ◽  
Ulf Hakestam ◽  
Amir Baigi ◽  
Svante Twetman
Keyword(s):  
Older Adults ◽  
Primary Root ◽  
Daily Intake ◽  
Root Caries ◽  
Probiotic Lactobacilli ◽  
Caries Lesions

scholarly journals Elderly at Greater Risk for Root Caries: A Look at the Multifactorial Risks with Emphasis on Genetics Susceptibility

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Daniel Gati ◽  
Alexandre R. Vieira
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
At Risk ◽  
Oral Hygiene ◽  
The Elderly ◽  
Salivary Flow ◽  
Oral Disease ◽  
Root Caries ◽  
Poor Oral Hygiene ◽  
Medical Factors

Root caries is one of the most significant dental problems among older adults today. Many studies have demonstrated that older adults are at greater risk for developing root caries. Here we examine what risk factors older adults are prone to and explain how they contribute to higher rates of oral disease, in particular root caries. The elderly are at risk for root caries due to dentures, lack of dexterity, a shift from complex to simple sugars, and poor oral hygiene. Decreased salivary flow and its manifestations with other social/behavioral and medical factors may provide a more comprehensive explanation to a higher frequency of root caries in older adults.

scholarly journals Atraumatic vs conventional restorative treatment for root caries lesions in older patients: Meta‐ and trial sequential analysis

Gerodontology ◽  
2019 ◽  
Vol 36 (3) ◽  
pp. 285-293 ◽  
Author(s):  
Gerd Göstemeyer ◽  
Cristiane da Mata ◽  
Gerald McKenna ◽  
Falk Schwendicke
Keyword(s):  
Older Patients ◽  
Sequential Analysis ◽  
Trial Sequential Analysis ◽  
Root Caries ◽  
Restorative Treatment ◽  
Caries Lesions

scholarly journals Silver diamine fluoride treatment of active root caries lesions in older adults: A case series

2021 ◽  
Vol 105 ◽  
pp. 103561
Author(s):  
Chelsea Mitchell ◽  
Andrew J Gross ◽  
Peter Milgrom ◽  
Lloyd Mancl ◽  
David B Prince
Keyword(s):  
Older Adults ◽  
Case Series ◽  
Root Caries ◽  
Silver Diamine Fluoride ◽  
Fluoride Treatment ◽  
Caries Lesions ◽  
Active Root

scholarly journals Comparative Effectiveness of Two Nonsurgical Treatments to Reduce Oral Health Disparities From Untreated Tooth Decay in Older Adults: Protocol for a Cluster Randomized Trial (Preprint)

2020 ◽  
Author(s):  
Suchitra Nelson ◽  
Jeffrey M Albert ◽  
Peter Milgrom
Keyword(s):  
Older Adults ◽  
Dental Caries ◽  
Low Income ◽  
Cluster Randomized Trial ◽  
Fluoride Varnish ◽  
Atraumatic Restorative Treatment ◽  
Silver Diamine Fluoride ◽  
Restorative Treatment ◽  
Cluster Randomized ◽  
Caries Lesions

BACKGROUND The majority of dental caries lesions in older adults are at the gumline, at the edges of failed fillings and crowns, and in the surfaces of roots after gum recession. These lesions are difficult to restore with conventional surgical treatments using a dental drill and restorations often fail. Clinical guidelines are general and apply treatments that were designed for younger individuals in the dental care of older adults. OBJECTIVE This study will compare the effectiveness of 2 evidence-based nonsurgical strategies to manage dental caries lesions in adults aged 62 or older: (1) biannual topical application of silver diamine fluoride versus (2) atraumatic restorative treatment + biannual fluoride varnish. METHODS A cluster randomized clinical trial is being conducted in 22 publicly subsidized and other low-income housing facilities/sites (Arm 1: 11 sites, 275 participants; Arm 2: 11 sites, 275 participants). At baseline, participants will be screened for caries lesions. Those with nonurgent lesions will be treated according to the treatment arm to which the housing site was randomly assigned. The primary outcomes are caries lesion arrest, tooth sensitivity, and tooth pain at 52 weeks after treatment. Analytic methods for the primary aim include a generalized estimating equation approach to determine noninferiority of silver diamine fluoride relative to atraumatic restorative treatment + fluoride varnish treatment. RESULTS The trial was funded in April 2019. Enrollment began in September 2019 and results are expected in June 2023. CONCLUSIONS This study will inform the standard of care for treating caries lesions in older adults. If effective, either of these interventions has broad applicability in clinical and community-based settings. CLINICALTRIAL ClinicalTrials.gov NCT03916926; https://clinicaltrials.gov/ct2/show/NCT03916926 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17840

scholarly journals The accuracy of laser fluorescence (DIAGNOdent) in assessing caries lesion activity on root surfaces, around crown margins, and in furcations in older adults

BDJ Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chelsea Mitchell ◽  
Hiba Zaku ◽  
Peter Milgrom ◽  
Lloyd Mancl ◽  
David B. Prince
Keyword(s):  
Older Adults ◽  
Case Series ◽  
Laser Fluorescence ◽  
Root Caries ◽  
Single Center ◽  
Silver Diamine Fluoride ◽  
Caries Lesion ◽  
Caries Lesions ◽  
Root Surfaces ◽  
Active Root

AbstractThe authors conducted a case series to assess accuracy of DIAGNOdent (DD) in assessment of activity of dental caries lesions in root surfaces and in furcations and at crown margins. The study was a prospective, single center case series. The patients were 123 adults (age ≥ 55 years). To be included, a patient needed to have at least one active root caries lesion. The study was conducted at the Roseman College of Dental Medicine in South Jordan, Utah, USA and at area nursing homes. Lesions were rinsed and dried with air, and DD readings were obtained. Lesions were then isolated and 38% silver diamine fluoride was applied repeatedly for two minutes with a microbrush. DD readings and treatments were repeated every six months. Mean DD values were significantly different between active (unarrested) and inactive (arrested) caries for all comparisons, p-value < 0.0001. The optimal cut-off values for DD were between 20 and 35 except optimal cut-offs were higher for furcation and crown margin surfaces, particularly in the posterior (optimal cut-offs 40–45). This study demonstrates DD is a potentially valuable tool for assessing lesion activity in root surfaces, at restoration margins, and in furcations.

scholarly journals Comparative Effectiveness of Two Nonsurgical Treatments to Reduce Oral Health Disparities From Untreated Tooth Decay in Older Adults: Protocol for a Cluster Randomized Trial

10.2196/17840 ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. e17840
Author(s):  
Suchitra Nelson ◽  
Jeffrey M Albert ◽  
Peter Milgrom
Keyword(s):  
Older Adults ◽  
Dental Caries ◽  
Low Income ◽  
Cluster Randomized Trial ◽  
Fluoride Varnish ◽  
Atraumatic Restorative Treatment ◽  
Silver Diamine Fluoride ◽  
Restorative Treatment ◽  
Cluster Randomized ◽  
Caries Lesions

Background The majority of dental caries lesions in older adults are at the gumline, at the edges of failed fillings and crowns, and in the surfaces of roots after gum recession. These lesions are difficult to restore with conventional surgical treatments using a dental drill and restorations often fail. Clinical guidelines are general and apply treatments that were designed for younger individuals in the dental care of older adults. Objective This study will compare the effectiveness of 2 evidence-based nonsurgical strategies to manage dental caries lesions in adults aged 62 or older: (1) biannual topical application of silver diamine fluoride versus (2) atraumatic restorative treatment + biannual fluoride varnish. Methods A cluster randomized clinical trial is being conducted in 22 publicly subsidized and other low-income housing facilities/sites (Arm 1: 11 sites, 275 participants; Arm 2: 11 sites, 275 participants). At baseline, participants will be screened for caries lesions. Those with nonurgent lesions will be treated according to the treatment arm to which the housing site was randomly assigned. The primary outcomes are caries lesion arrest, tooth sensitivity, and tooth pain at 52 weeks after treatment. Analytic methods for the primary aim include a generalized estimating equation approach to determine noninferiority of silver diamine fluoride relative to atraumatic restorative treatment + fluoride varnish treatment. Results The trial was funded in April 2019. Enrollment began in September 2019 and results are expected in June 2023. Conclusions This study will inform the standard of care for treating caries lesions in older adults. If effective, either of these interventions has broad applicability in clinical and community-based settings. Trial Registration ClinicalTrials.gov NCT03916926; https://clinicaltrials.gov/ct2/show/NCT03916926 International Registered Report Identifier (IRRID) DERR1-10.2196/17840

Association between Vitamins and Minerals with Antioxidant Effects and Coronary Artery Calcification in Adults and Older Adults: A Systematic Review

2019 ◽  
Vol 25 (22) ◽  
pp. 2474-2479 ◽  
Author(s):  
Alisson Diego Machado ◽  
Gustavo Rosa Gentil Andrade ◽  
Jéssica Levy ◽  
Sara Silva Ferreira ◽  
Dirce Maria Marchioni
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Serum Levels ◽  
Antioxidant Compounds ◽  
Increased Risk ◽  
Coronary Events ◽  
Antioxidant Effects

Background: Coronary Artery Calcification (CAC) is considered an important cardiovascular risk factor. There is evidence that CAC is associated with an increased risk of atherosclerosis, coronary events and cardiovascular mortality. Inflammation is one of the factors associated with CAC and despite the interest in antioxidant compounds that can prevent CAC, its association with antioxidants remains unclear. Objective: This study aimed to systematically review the association between vitamins and minerals with antioxidant effects and CAC in adults and older adults. Methods: We conducted a systematic review using PubMed for articles published until October 2018. We included studies conducted in subjects aged 18 years and older with no previous cardiovascular disease. Studies involving animal or in vitro experiments and the ones that did not use reference methods to assess the CAC, dietary intake or serum levels of vitamin or mineral were excluded. Results: The search yielded 390 articles. After removal of duplicates, articles not related to the review, review articles, editorials, hypothesis articles and application of the inclusion and exclusion criteria, 9 articles remained. The results of the studies included in this systematic review suggest that magnesium is inversely associated with CAC and results on the association between CAC and vitamin E have been conflicting. Conclusion: Additional prospective studies are needed to elucidate the role of these micronutrients on CAC.

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