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

• Published in: Caries Research
• Main Authors: Paris, Sebastian, Banerjee, Avijit, Bottenberg, Peter, Breschi, Lorenzo, Campus, Guglielmo, Doméjean, Sophie, Ekstrand, Kim, Giacaman, Rodrigo, A., Haak, Rainer, Hannig, Matthias, Hickel, Reinhard, Juric, Hrvoje, Lussi, Adrian, Machiulskiene, Vita, Manton, David, Jablonski-Momeni, Anahita, Santamaria, Ruth, Schwendicke, Falk, Splieth, Christian, H., Tassery, Hervé, Zandona, Andrea, Zero, Domenick, Zimmer, Stefan, Opdam, Niek
• Other Authors: Charité - UniversitätsMedizin = Charité - University Hospital Berlin, King‘s College London, Vrije Universiteit Brussel (VUB), Alma Mater Studiorum Università di Bologna = University of Bologna (UNIBO), Universität Bern / University of Bern (UNIBE), Università degli Studi di Sassari = University of Sassari Sassari (UNISS), Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne 2017-2020 (UCA 2017-2020 ), IT University of Copenhagen (ITU), Universidad de Talca, Leipzig University / Universität Leipzig, University of Saarland / Universität des Saarlandes Homburg, Germany, Ludwig Maximilian University Munich = Ludwig Maximilians Universität München (LMU), University of Zagreb, Universitäts Klinikum Freiburg = University Medical Center Freiburg (Uniklinik), Lithuanian University of health Sciences (LSMU), University Medical Center Groningen Groningen (UMCG), University of Melbourne, Philipps Universität Marburg = Philipps University of Marburg, Universität Greifswald - University of Greifswald, Aix-Marseille Université - Faculté d'odontologie (AMU ODONTO), Aix Marseille Université (AMU), Tufts University Medford, University of Indianapolis, Universität Witten/Herdecke, Radboud University Nijmegen
• Format: Article in Journal/Newspaper
• Language: English
• Published: HAL CCSD 2020
• Subjects: Caries prevention; Caries treatment; Older adults; Root caries; Seniors; [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie; Orca
• Online Access: https://uca.hal.science/hal-03376057; https://uca.hal.science/hal-03376057/document; https://uca.hal.science/hal-03376057/file/Paris2020How-CCBYNC.pdf; https://doi.org/10.1159/000510843

International audience 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.