title: Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing - Consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases.
abstract: BACKGROUND
  Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems.
  
  
  OBJECTIVE
  The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing.
  
  
  METHODS
  Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion.
  
  
  RESULTS
  Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders.
  
  
  CONCLUSIONS
  Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders.
authors.affiliation: Faculty of Dentistry, University of Hong Kong, Hong Kong, China.|European Research Group on Periodontology, Genova, Italy.
authors.forename: Maurizio S
authors.initials: MS
authors.lastname: Tonetti
authors.affiliation: Free University of Brussels, Brussels, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Bottenberg
authors.affiliation: Division of Oral Microbiology and Immunology, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH University Hospital Aachen, Aachen, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Conrads
authors.affiliation: Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Eickholz
authors.affiliation: Department of Restorative Dentistry, University of Newcastle, Newcastle, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Heasman
authors.affiliation: Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Marie-Charlotte
authors.initials: MC
authors.lastname: Huysmans
authors.affiliation: Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: López
authors.affiliation: Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Phoebus
authors.initials: P
authors.lastname: Madianos
authors.affiliation: Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Frauke
authors.initials: F
authors.lastname: Müller
authors.affiliation: International Centre for Evidence-Based Oral Health, Unit of Periodontology, UCL Eastman Dental Institute, London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Needleman
authors.affiliation: Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
authors.forename: Bente
authors.initials: B
authors.lastname: Nyvad
authors.affiliation: Department of Restorative Dentistry, University of Newcastle, Newcastle, UK.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Preshaw
authors.affiliation: Division of Dentistry, University of Manchester, Manchester, UK.
authors.forename: Iain
authors.initials: I
authors.lastname: Pretty
authors.affiliation: Department of Periodontology, Kristianstad University, Kristianstad, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Renvert
authors.affiliation: Department of Operative Dentistry, Charitè - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Schwendicke
authors.affiliation: Research Center for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trombelli
authors.affiliation: Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: van der Putten
authors.affiliation: Community Dentistry and Oral Public Health, Ghent University, Ghent, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Vanobbergen
authors.affiliation: Department of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: West
authors.affiliation: Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
authors.forename: Alix
authors.initials: A
authors.lastname: Young
authors.affiliation: Department of Operative Dentistry, Charitè - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Paris
mesh_terms: D000367:Age Factors; D000368:Aged; D003731:Dental Caries / Q000517:prevention & control*; D006293:Health Promotion; D000073656:Healthy Aging; D006801:Humans; D008875:Middle Aged; D009909:Oral Health; D010510:Periodontal Diseases / Q000517:prevention & control*
keywords: ageing; dental caries; dependency; epidemiology; frailty; gerodontology; masticatory dysfunction; nutrition; older people; periodontal diseases; periodontitis; public health; root caries; senescence; tooth loss