Supporting data for "oral health care in older adults"
The global older adult population is expected to surge to 1.5 billion, 1 in 6 among the population, by 2050. Literature reviews showed that oral and general health were interrelated. Diabetes, hypertension, rheumatoid arthritis, Alzheimer’s disease, Parkinson’s disease and depression make older adults more vulnerable to oral diseases such as dental caries, periodontal diseases, tooth wear, xerostomia and tooth loss. Poor oral health was associated with nutritional intake, several systematic diseases, morbidity and mortality. Improving oral health of older adults will be the foremost public health issue in the coming decade.
A systematic review was performed to update the current global caries status of older adults. According to the thirty-nine included studies, the globe prevalence of dental caries was still high in older adults and half of them had untreated caries. Fluoride is well known on caries management in children and adolescents. Another systematic review was conducted to assess the clinical efficacy of professionally-applied fluoride therapy to prevent and arrest caries in older adults. Based on the findings of seven included clinical trials, 5% sodium fluoride varnish and 1.23% acidulated phosphate fluoride gel prevented root caries whereas 38% silver diamine fluoride (SDF) solution prevented and arrested root caries in older adults. Meta-analysis found a decrease in the number of new root caries by 0.55 (95% CI: 0.32-0.78; p<0.001) and an overall proportion of arrested root caries of 42% (95% CI: 33% to 49%; p<0.001) after 38% SDF application at the 24-month follow-up.
Exposed root surface and dental biofilm are the risk factors of root caries. Dentine hypersensitivity resulted from exposed root surface is a common symptom affecting oral hygiene practice. SDF has been cleared as desensitizing agent by the United States Food and Drug Administration since 2014, however the evidence on its clinical use in managing dentine hypersensitivity is lacking. A randomized double-blind clinical trial was conducted to evaluate the desensitizing effect of topically-applied 38% SDF solution on hypersensitive teeth with exposed root surface in older adults. The study recruited healthy older adults with dentine hypersensitivity. A trained examiner tested the most hypersensitive tooth-root surface of each participant with compressed cold air from a three-in-one syringe. The participant gave a sensitivity score (SS) on a visual analogue scale from 0 (no pain) to 10 (agonizing) at the baseline visit. The participants received 38% SDF or 5% potassium nitrate (control) solution as intervention on the most hypersensitive tooth-root surface every 4 weeks. The SS was collected at baseline after intervention and 4-week and 8-week follow-ups before intervention. The primary outcome was the reduction in SS at 8-week follow-up with reference to the SS at baseline before intervention. Mann–Whitney U tests were performed for data analysis following a normality test of SS. The results showed that 38% SDF solution reduced hypersensitivity on the exposed root surface of older adults. Improving oral health in older adults is imperative.
It is paramount to integrate oral health into general healthcare services and make oral health care more accessible, available and affordable to older adults
