How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement

Sebastian Paris*, Avijit Banerjee, Peter Bottenberg, Lorenzo Breschi, Guglielmo Campus, Sophie Doméjean, Kim Ekstrand, Rodrigo A Giacaman, Rainer Haak, Matthias Hannig, Reinhard Hickel, Hrvoje Juric, Adrian Lussi, Vita Machiulskiene, David Manton, Anahita Jablonski-Momeni, Ruth Santamaria, Falk Schwendicke, Christian H Splieth, Hervé TasseryAndrea Zandona, Domenick Zero, Stefan Zimmer, Niek Opdam

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    AIM: To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions.

    METHODS: A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process.

    RESULTS: Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient's individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual.

    Original languageEnglish
    Pages (from-to)459-465
    Number of pages7
    Issue number5-6
    Early online date8-Dec-2020
    Publication statusPublished - Dec-2020

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