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Roberts WE, Mangum JE, Schneider PM. Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions. Curr Osteoporos Rep 2022; 20:90-105. [PMID: 35129809 PMCID: PMC8930910 DOI: 10.1007/s11914-022-00722-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE OF THE REVIEW Compare pathophysiology for infectious and noninfectious demineralization disease relative to mineral maintenance, physiologic fluoride levels, and mechanical degradation. RECENT FINDINGS Environmental acidity, biomechanics, and intercrystalline percolation of endemic fluoride regulate resistance to demineralization relative to osteopenia, noncarious cervical lesions, and dental caries. Demineralization is the most prevalent chronic disease in the world: osteoporosis (OP) >10%, dental caries ~100%. OP is severely debilitating while caries is potentially fatal. Mineralized tissues have a common physiology: cell-mediated apposition, protein matrix, fluid logistics (blood, saliva), intercrystalline ion percolation, cyclic demineralization/remineralization, and acid-based degradation (microbes, clastic cells). Etiology of demineralization involves fluid percolation, metabolism, homeostasis, biomechanics, mechanical wear (attrition or abrasion), and biofilm-related infections. Bone mineral density measurement assesses skeletal mass. Attrition, abrasion, erosion, and abfraction are diagnosed visually, but invisible subsurface caries <400μm cannot be detected. Controlling demineralization at all levels is an important horizon for cost-effective wellness worldwide.
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Affiliation(s)
- W. Eugene Roberts
- grid.257413.60000 0001 2287 3919Indiana University & Purdue University at Indianapolis, 8260 Skipjack Drive, Indianapolis, IN 46236 USA
| | - Jonathan E. Mangum
- grid.1008.90000 0001 2179 088XDepartment of Biochemistry and Pharmacology, Dentistry and Health Sciences, University of Melbourne, Corner Grattan Street and Royal Parade, Parkville, Victoria 3010 Australia
| | - Paul M. Schneider
- grid.1008.90000 0001 2179 088XMelbourne Dental School, University of Melbourne, 720 Swanston St, Melbourne, Victoria 3010 Australia
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Jiang CM, Chu CH, Duangthip D, Ettinger RL, Hugo FN, Kettratad-Pruksapong M, Liu J, Marchini L, McKenna G, Ono T, Rong W, Schimmel M, Shah N, Slack-Smith L, Yang SX, Lo ECM. Global Perspectives of Oral Health Policies and Oral Healthcare Schemes for Older Adult Populations. FRONTIERS IN ORAL HEALTH 2022; 2:703526. [PMID: 35048040 PMCID: PMC8757822 DOI: 10.3389/froh.2021.703526] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to present a concise summary of the oral health policies and oral healthcare schemes for older adult populations in a number of selected countries around the world. In this paper, the current and planned national/regional oral health policies and oral healthcare schemes of nine countries (Australia, Brazil, China including Hong Kong, India, Japan, Switzerland, Thailand, the United Kingdom, and the United States) are reported. Barriers and challenges in oral health promotion in terms of devising oral health policies, implementing oral health schemes, and educating the future dental workforce are discussed. In response to the aging of population, individual countries have initiated or reformed their healthcare systems and developed innovative approaches to deliver oral health services for older adults. There is a global shortage of dentists trained in geriatric dentistry. In many countries, geriatric dentistry is not formally recognized as a specialty. Education and training in geriatric dentistry is needed to produce responsive and competent dental professionals to serve the increasing number of older adults. It is expected that oral health policies and oral healthcare services will be changing and reforming in the coming decades to tackle the enduring oral health challenges of aging societies worldwide.
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Affiliation(s)
- Chloe Meng Jiang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | | | - Ronald L Ettinger
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, United States
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Jian Liu
- Peking University School & Hospital of Stomatology, Beijing, China
| | - Leonardo Marchini
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, United States
| | - Gerry McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Wensheng Rong
- Peking University School & Hospital of Stomatology, Beijing, China
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Naseem Shah
- Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Stella X Yang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Edward C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Chan AKY, Tamrakar M, Jiang CM, Lo ECM, Leung KCM, Chu CH. A Systematic Review on Caries Status of Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010662. [PMID: 34682414 PMCID: PMC8535396 DOI: 10.3390/ijerph182010662] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 12/18/2022]
Abstract
The aim of this systematic review was to provide an update on caries prevalence in older adults aged 60 years or above around the globe. Two independent reviewers performed a systematic literature search of English publications from January 2016 to December 2020 using Pubmed, Scopus, Embase/Ovid and Web of Science. The MeSH terms used were “dental caries”, “root caries”, “DMF index”, “aged” and “aged 80 and over”. Further searches in Google Scholar retrieved eight additional publications. The epidemiological surveys reporting the prevalence of dental caries or root caries or caries experience using DMFT (decayed, missing and filled teeth) and DFR (decayed and filled root) in older adults aged 60 years or above were included. Quality of the publications was assessed using the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. Among the 5271 identified publications, 39 articles of moderate or good quality were included. Twenty studies were conducted in Asia (China, India, Vietnam, Singapore and Turkey), ten in Europe (Ireland, Norway, Finland, Germany, Portugal, Poland, Romania and Kosovo), three in North America (USA and Mexico), one in South America (Brazil), two in Oceania (Australia) and three in Africa (Malawi, Egypt and South Africa). The prevalence of dental caries ranged from 25% (Australia) to 99% (South Africa), while the prevalence of root caries ranged from 8% (Finland) to 74% (Brazil) in community dwellers. The situation was even worse in institutionalised older adults of which the mean DMFT score varied from 6.9 (Malawi) to 29.7 (South Africa). Based on the included studies published in the last 5 years, caries is still prevalent in older adults worldwide and their prevalence varies across countries.
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Affiliation(s)
| | | | | | | | | | - Chun Hung Chu
- Correspondence: ; Tel.: +852-28590287; Fax: +852-28582532
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Chu KY, Cockrell D, Naganathan V, Stanaway F, Wright F. Oral health status of newly admitted residents living in residential aged care. Aust Dent J 2021; 66:391-396. [PMID: 34146422 DOI: 10.1111/adj.12864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND It is important to understand whether older people are admitted into residential care with existing dental diseases or their oral health deteriorates while residing in residential care. There is, however, little research available exploring the oral health status of people newly admitted into residential care. Understanding this disease trend would lead to effective prevention and treatment strategies to be trialled and implemented prior to admission. In this cross-sectional study, we hypothesize that older people with one or more natural teeth might have poor oral health prior to admission to residential care. METHOD The study was carried out using the de-identified oral health assessment database of an established domiciliary oral health care program in metropolitan New South Wales, Australia. Four hundred and nine participants with mean participant age of 85.56 years from 13 facilities from 2015 to 2018 fulfilled the inclusion criteria for this study. CONCLUSION This study confirmed that dentate, newly admitted residents to residential care had pre-existing dental problems and oral health concerns. Almost half of the newly admitted residents had an unsatisfactory oral cleanliness score when examined in their residential care setting.
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Affiliation(s)
- K-Y Chu
- Centre for Education and Research on Ageing, University of Sydney, Concord West, New South Wales, Australia.,Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord West, New South Wales, Australia
| | - D Cockrell
- Centre for Education and Research on Ageing, University of Sydney, Concord West, New South Wales, Australia.,Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord West, New South Wales, Australia.,Discipline of Health Sciences (Oral Health), University of Newcastle, Ourimbah, New South Wales, Australia
| | - V Naganathan
- Centre for Education and Research on Ageing, University of Sydney, Concord West, New South Wales, Australia.,Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord West, New South Wales, Australia.,Concord Clinical School of Medicine, University of Sydney, Concord West, New South Wales, Australia
| | - F Stanaway
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Fac Wright
- Centre for Education and Research on Ageing, University of Sydney, Concord West, New South Wales, Australia
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