Dental caries experience in older people over time: what can the large cohort studies tell us?
BACKGROUND
Little was known of the natural history of dental caries among older adults until recently, but reports from a number of large cohort studies have now enabled better understanding of the nature and determinants of dental caries in older people. The aim of this review is to examine and compare findings from established population-based longitudinal studies of older adults in order to determine their preventive implications.


METHODS
The dental literature was reviewed in order to identify reports on dental caries incidence from large, population-based dental longitudinal studies of older adults (age 50+) with at least 3 years of follow-up.


RESULTS
Reports were identified from four studies (in Iowa, North Carolina, Ontario and South Australia) which met the criteria; four reports dealt with coronal caries, and five with root surface caries. When annualised, coronal and root surface caries increments were combined and compared with those reported for adolescents, the caries experience of older people over time (between 0.8 and 1.2 new surfaces affected per year) exceeded that reported from cohort studies of adolescents (between 0.4 and 1.2 surfaces per year). The only caries risk factor common to all four studies was the wearing of a partial denture (for root surface caries only).


CONCLUSIONS
Older people are a caries-active group, experiencing new disease at a rate which is at least as great as that of adolescents.


CONCLUSIONS
Dentate older people should be the target of intensive monitoring and preventive efforts at both the clinical practice and public health levels. There is no easily identifiable 'magic bullet' for preventing caries in that age group, but the use of evidence-based preventive interventions (such as fluoride) should suffice.
Thomson
W M
WM
Dental Public Health, School of Dentistry, The University of Otago, PO Box 647, Dunedin, New Zealand. mthomson@gandalf.otago.ac.nz
D000293:Adolescent; D015331:Cohort Studies; D004245:DMF Index; D003731:Dental Caries / Q000209:etiology / Q000517:prevention & control; D003733:Dental Caries Susceptibility; D003829:Denture, Partial; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D017213:Root Caries / Q000209:etiology / Q000517:prevention & control