Clinical Care for an Aging Population.

Pathologic changes in the oral cavity can portend the presence of systemic diseases and result in poor oral health and tooth loss, which are commonly symbolic of aging. Systemic diseases can have direct and indirect effects on oral health, and, likewise, poor oral health can impact general health and wellbeing. Negligence in oral care results in the accumulation of dental plaque and calculus, which eventually contributes to the onset of dental caries, periodontal disease, halitosis, tooth loss, and, ultimately, diminished oral function. Some oral pathology also increases in prevalence in older adults. However, diminished oral health and function is not a normal result of aging. Providing appropriate oral healthcare to frail and medically compromised adults requires an interprofessional approach to address the many diseases and conditions that can impact oral health and the safe and timely provision of care. As opportunities increase for oral healthcare professionals to function as integral members of interdisciplinary teams and to practice in nontraditional and more accessible settings, clinicians may gain better understanding of the dynamic balance between oral and general health, and how the social determinants of health can be leveraged to favor both.

A systematic review of silver diamine fluoride: Effectiveness and application in older adults.

OBJECTIVE: This systematic review examines the effectiveness of silver diamine fluoride (SDF) in the management of caries in older adults. BACKGROUND: Silver diamine fluoride has been extensively researched and proven effective for caries prevention and arrest in children. Limited studies support its effectiveness in adult and older adult populations. MATERIALS AND METHODS: Multiple databases were searched according to specified inclusion-exclusion criteria. Quality assessment used modified Centre for Evidence-Based Medicine worksheets. RESULTS: Three randomised controlled trials were identified that addressed the effectiveness of SDF on root caries in older adults, but none addressed coronal caries. Root caries prevented fraction and arrest rate for SDF were significantly higher than placebo. The prevented fraction for caries prevention for SDF compared to placebo was 71% in a 3-year study and 25% in a 2-year study. The prevented fraction for caries arrest for SDF was 725% greater in a 24-month study and 100% greater than placebo in a 30-month study. No severe adverse effects were observed. CONCLUSION: This systematic review evaluates the use of SDF for both root caries prevention and arrest in older adults. Existing reports of SDF trials support effectiveness in root caries prevention and arrest, remineralization of deep occlusal lesions and treatment of hypersensitive dentin.

Caring for Older Adults With Complex Needs: Drafting an Interdisciplinary Team.

Providing dental care for seniors with complex medical and/or social needs can seem daunting. Many dental providers may question their resources to manage such patients. However, many of these patients have teams in place that can be accessed to improve the efficacy and satisfaction in providing care to them. Seeking out patients' other health care providers, and understanding how to work effectively with them, is important to improve total patient care, comfort, function and dignity.