Prevention and management of periodontal diseases and dental caries in the older adults

Abstract

As a result of aging populations, in the future, dental practitioners will be caring for more older adults than ever before. These older adults, especially in developed countries, will demand a greater number of dental services, driven by increased tooth retention and an expectation of excellent oral healthcare throughout the life course. Further, the global rise in the prevalence and incidence of chronic diseases will increase the risk and/or severity of oral diseases and add a layer of complexity to the management of oral diseases in older adults. More older adults will be at a higher risk of periodontal disease and root caries as a result of reduced tooth loss and edentulism. This article reviews information on periodontitis and root caries, oral diseases which reflect the cumulative risk of the individual, and which are best addressed through prevention. Oral healthcare providers must embrace the concept of lifelong emphasis on prevention, as well as participation as active members of a healthcare team which provides healthcare for older adults in various settings (eg, hospital/clinic‐based care, community‐based settings, and long‐term care facilities). National guidelines that address oral health are being considered by some countries, and if these are implemented they will increase the accessibility to oral health for older adults. In parallel to this, revisions of existing older adult insurance schemes (eg, the inclusion of routine oral healthcare in the US Medicare program) would promote the maintenance of a functional dentition that is pain‐free and conducive to general health. The opportunity exists to implement a holistic approach to oral health that will align oral health with general health and emphasize that true health can only be achieved with the inclusion of oral health.

Global, regional, and national burden of severe periodontitis, 1990–2019: An analysis of the Global Burden of Disease Study 2019

“…Unless the rates of severe periodontitis can be substantially reduced, demographic forces are poised to heighten the future global number of prevalent cases of severe periodontitis (Lopez et al, 2017; Vollset et al, 2020). The growing and ageing global population make it more important now than ever to address the oral healthcare needs of the old and vulnerable population (Glick et al, 2012; Al‐Nasser & Lamster, 2020). Addressing periodontal health of this population will likewise contribute to reducing the sobering oral health inequalities associated with socio‐demographic position.…”

Periodontitis and Accelerated Biological Aging: A Geroscience Approach

“…The relationship between periodontitis and aging has always been controversial. Aging is usually characterized by a progressive accumulation of periodontal risk factors, and the prevalence of periodontitis increases through life (Al-Nasser and Lamster 2020). However, susceptibility and resilience to periodontal diseases are very heterogeneously distributed, and it is possible to individuate periodontally healthy and diseased subjects across all age groups (Aimetti et al 2015).…”

Are Public Oral Care Services Evenly Distributed?—Nation-Wide Assessment of the Provision of Oral Care in Japan Using the National Database of Health Insurance Claims

“…Therefore, oral health care professionals must embrace the concept of lifelong emphasis on prevention and participate as active members of the healthcare team providing care to the increasing older people in a variety of settings (hospital and clinicbased care, community-based settings, long-term care facilities, etc. ), along with revisions to existing older adult insurance schemes [50].…”