Minimal intervention dentistry: part 1. Strategies for addressing the new caries challenge in older patients.
The aging of the population combined with increased retention of natural teeth into old age means that clinicians now face a new caries challenge in older dentate patients. An increase in the onset of dental caries is evident among patients who may not have had high levels of caries in the past and who may have undergone extensive restorative procedures during their lifetimes. Minimal intervention dentistry (MID), a modern evidence-based approach to caries management in dentate patients, uses the medical model, whereby disease is controlled by the "oral physician" and an affiliated dental team. The main components of a geriatric approach to MID are assessment of the risk of disease, with a focus on early detection and prevention; external and internal remineralization; use of a range of restorations, dental materials and equipment; and surgical intervention only when required and only after disease has been controlled. This first in a series of 2 articles describes and illustrates oral disease management in geriatric MID, which involves the assessment and management of a diverse range of primary and modifying factors, integrated with an evaluation of the plaque-biofilm interface and the resultant dynamic oral disease process.
Chalmers
Jane M
JM
Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa USA 52242, USA. jane-chalmers@uiowa.edu
D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002327:Cariostatic Agents / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D016321:Dental Care for Aged / Q000379:methods*; D003731:Dental Caries / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D003773:Dental Plaque / Q000382:microbiology / Q000517:prevention & control; D003793:Dental Restoration, Permanent / Q000379:methods; D005459:Fluorides / Q000627:therapeutic use; D005850:Geriatric Dentistry / Q000379:methods*; D006801:Humans; D014089:Tooth Remineralization / Q000379:methods; D014987:Xerostomia / Q000150:complications
D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D005459:Fluorides; D002710:Chlorhexidine