In a water fluoridated area, annual application of SDF solution or SDF/KI solution can arrest dental root caries in elders. In the long term, application of KI does not reduce the blackening of arrested caries lesions caused by SDF.

The study aimed to describe and compare the psychosocial and functional impact of oral disease on the quality of life of the institutionalized and non-institutionalized elderly in Hong Kong. A total of 268 institutionalized and 318 non-institutionalized elderly aged 60-80 years took part. The 49-statement Oral Health Impact Profile (OHIP) was administered in a structured interview format and sociodemographic information collected prior to a clinical, oral examination. A greater number of the institutionalized were edentulous (19%); they also had more untreated dental disease. The number of elderly reporting negative impacts was generally low. The percentage of institutionalized elderly reporting a negative impact was significantly lower in one of the OHIP subscales (handicap, P < 0.001) and similar in the other six. The main factors affecting the OHIP score were living location, socio-economic status, dental disease and treatment seeking behaviour. In conclusion, the psychosocial and functional impact of oral conditions was low and similar in the institutionalized and non-institutionalized elderly although the pattern of oral disease was different. Life events and socially and culturally derived values appeared to affect the elderly perception of the impact of oral disease.

Oral health-related quality of life status was significantly poorer in halitosis patients than in non-halitosis patients. Halitosis patients may experience some degree of psychological discomfort and disability.

Dental root caries is a common disease among elders. More efforts on preventing this disease are needed. Silver diammine fluoride (SDF) is known to be able to prevent dental caries in primary teeth. However, clinical evidence of its efficacy in preventing root surface caries is limited. This clinical trial aimed to compare the effectiveness of SDF in preventing root caries among elders in a water fluoridated area. A total of 323 elders who had at least five teeth with exposed root surfaces and had self-care ability were randomly allocated into 3 intervention groups as follows: Gp1 (placebo control)-annual application of tonic water; Gp2-annual application of SDF solution; Gp3-annual application of SDF solution immediately followed by potassium iodide (KI) solution. Oral hygiene instructions and fluoride toothpaste were provided to all subjects. Status of dental root surface was assessed every 6 months by the same independent examiner. After 30 months, 257 (79.6%) elders were reviewed. The mean numbers of root surface with new caries experience in the control, SDF, and SDF/KI groups were 1.1, 0.4, and 0.5 respectively (ANOVA, p<0.001). Scheffe's multiple comparison showed that elders who received placebo developed more new root caries lesions (p<0.05) while the difference between the SDF and SDF/KI groups was not statistically significant (p>0.05). Moreover, elders who had higher visible plaque index scores at 30-month examination (ANCOVA, p<0.001) and those who had higher baseline DMFT scores (ANCOVA, p=0.005) developed more new root caries. It is concluded that annual application of SDF or SDF/KI solution is effective in preventing root caries among community-dwelling elders in a fluoridated area. (Clinicaltrials.gov # NCT02360124) pg. 2

Cevimeline hydrochloride, a specific agonist of the M3 muscarinic receptor, is beneficial in the treatment of symptoms of xerostomia and xerophthalmia associated with Sjögren's syndrome (SS). Cevimeline has not been evaluated in southern Chinese patients. Furthermore, the effects of cevimeline on health-related quality of life and oral health status are not known. In this randomised, double-blind, placebo-controlled crossover study, patients received cevimeline 30 mg or matched placebo three times per day over 10 weeks followed by a 4-week washout period before treatment crossover. Participants self-completed the following questionnaires: Xerostomia Inventory (XI), the General Oral Health Assessment Index (GOHAI), the Ocular Surface Disease Index (OSDI) and the Medical Outcomes Short Form (SF-36). Clinical assessments included sialometry, examination of the oral cavity for the degree of xerostomia and dental complications of xerostomia. Fifty patients (22 primary SS and 28 secondary SS) were enrolled in the trial. Forty-four patients completed the study. There was a significant improvement in the XI and GOHAI scores as well as the objective rating of xerostomic signs of the oral cavity after treatment with cevimeline. However, there was no improvement in salivary flow rates and dry eye symptoms. SS patients had lower SF-36 scores, but these did not improve after treatment with cevimeline.