Ageing, dental caries and periodontal diseases

Aim: To review the burden of caries and periodontitis in the elderly, changes with age that can explain this burden, and the vulnerability to disease of elderly populations. Methods: An assessment of surveys in two populations was conducted. Indicators for caries were identified by updating a systematic review. Secular trends for smoking and type 2 diabetes were discussed. Results: Changes in the susceptibility to periodontitis with age may be explained by exposure to pro-inflammatory conditions and changes in the healing capacity of cells and tissues. Due to accumulated periodontal destruction, the number of surfaces at risk for caries increases. The sequels of restorative treatment contribute to an increased susceptibility for caries development. Population-based surveys in the United States and Germany demonstrate a high caries experience among elderly people. A comparison of surveys demonstrates a relative improvement of periodontal health among elderly during the last few decades. Nevertheless, prevalence estimates for periodontitis remain high. Risk indicators for root caries include caries experience, the number of surfaces at risk and poor oral hygiene. Secular trends of main risk factors for periodontitis and their likely influence on the future periodontitis burden in the elderly are discussed. Conclusion: Caries and periodontitis burden in the elderly remain high.