Caries incidence in patients with dementia

Abstract

One in ten persons over the age of 65 and as many as half the population aged 85 and over have Alzheimer's disease. Review of the literature reveals substantial decrements in oral health in persons with dementia as measured by denture hygiene, coronal decayed, missing and filled teeth, filled teeth (cervical), percentage of the population with caries, Oral Hygiene Index-simplified, and of sites with plaque, gingival bleeding and calculus. A study of caries incidence is described in 23 male veterans with moderate and advanced dementia of the Alzheimer's type, using a comparison group of male veterans from the Department of Veterans Affairs Dental Longitudinal Study, matching 2:1 for age, number of teeth and education. Baseline findings indicate significant differences in the numbers of coronal surfaces with decay, root decayed and/or filled teeth and root decayed and/or filled surfaces. Mean annual increments of coronal caries in the dementia group were 2.29 +/- 4.29 per 100 surfaces at risk, over twice that in the comparison group (0.88 +/- 1.14). For root caries, mean annual increments in the dementia group were 2.38 +/- 5.57 per 100 available surfaces, versus 0.31 +/- 0.69 in the comparison group. Despite these large mean differences, the marked variability in these small samples statistical significance in caries increments between the two groups. The article concludes by suggesting some potential modifications to clinical trials of caries preventive agents and some overall research issues in populations with dementia.

Increased frequencies of caries, periodontal disease and tooth loss in patients with Parkinson’s disease

“…[3][4][5][6] Among neurodegenerative disorders, Alzheimer's disease has been linked to poor oral hygiene. 7,8 Oral health of patients with Parkinson's disease (PD) has also been studied with contradictory results. [9][10][11][12][13] Patients with PD may experience difficulty in maintaining oral hygiene due to several factors: motor impairment, dysphagia, apathy, depression, dementia, hypersialorrhea, xerostomia and medication.…”

Three-Year Coronal Caries Incidence and Risk Factors in North Carolina Elderly

“…1988a,b;Soderholm and Birkhed, 1988;Drake et al, 1994], It has been well documented that the bulk o f the car ies tends to occur in frail older adults who are institutional ized [Slade et al. 1990;MacEntee et al, 1990MacEntee et al, ,1993Jones et al. 1993].…”

Facteurs environnementaux impliqués dans la maladie d’Alzheimer. Le mercure dentaire, probable déterminant majeur

“…Une étude de faible puissance a mis en évidence que des patients américains atteints de la MA avaient sept à huit fois plus de caries racinaires que les patients du groupe témoin (après appariement sur l'âge et sur le niveau d'éducation) [12].…”