The aim of this study was to examine salivary flow rate and its association with the use of medication in a representative sample of 76-, 81-, and 86-year-old subjects, totaling 368. In this study, 23% (n = 80) of the subjects were unmedicated. From one to three daily medications were used by 47% (n = 168) and more than four medications by 30% (n = 104). The most commonly used medications were nitrates, digitalis or anti-arrhythmic drugs (47.7%), analgesics and antipyretics (32.6%), and diuretics (29.5%). The mean number used daily was significantly higher in 86-year-olds than in the two younger age groups (p < 0.01). No significant differences in this respect were found between genders. Among the unmedicated subjects, 76-year-olds had significantly higher stimulated salivary flow rates than did the 81-year-olds (p < 0.05). Unmedicated women showed significantly lower unstimulated (p < 0.01) and stimulated flow rates than did men (p < 0.05). Stimulated salivary flow rate was also significantly higher in the 76-year-old medicated subjects than in the medicated 86-year-old subjects (p< 0.05). No statistically significant differences were found in unstimulated salivary flow rates among the three age groups. Medicated women showed significantly lower unstimulated salivary flow rates than men (p < 0.001), although the difference in stimulated saliva flow was not significant. A statistically significant difference in unstimulated and stimulated salivary flow rates was found between unmedicated persons and those who took from four to six, or more than seven, prescribed medications daily.

Among the edentulous, chronic infections like denture-related mucosal lesions are important determinants of elevated CRP, comparable to periodontal disease in the dentate. Elevated CRP per se and edentulism were not significantly associated with increased mortality. Periodontal disease was, however, still associated with a two-fold CVD mortality in this very old population.

summary A large epidemiological health investiga tion, the Helsinki Ageing Study (HAS), was performed in 1989-1991 in Helsinki, Finland. We report here the prevalence of oral mucosal lesions in 338 76-, 81-and 86-year-old home-living elderly people, w ho com pleted the oral health investigation at the Institute of Dentistry, University of Helsinki. One or more lesions were found in 128 subjects (38%). Fifty-one per cent of the edentulous com plete-denture wearers and 31% of the elderly w ith some natural teeth had mucosal lesions* The m ost common finding was inflammation under the denture, w hich occurred alone or combined with other lesions in 25% of the denture wearers. The three m ost common mucosal changes not related to denture wearing were coated changes of the tongue (7%), angular cheilitis (6%) and varicose veins under the tongue (4%). No differences were found in the number of mucosal lesions among the three age groups. Angular cheilitis and inflammation under removable dentures were more frequent in w om en than in men. However, no other differences w ere found in the presence of mucosal lesions betw een sexes. The total number of mucosal lesions correlated J positively with the number of medications used daily. Ninety-six per cent of the subjects w ith complete dentures, and 98% of those w ith som e natural teeth reported cleaning their dentures at least once a day. Of the denture wearers, 88% reported cleaning their oral mucosa also, as part of their oral hygiene routine. The presence of mucosal lesions was related to self-reported cleaning of th e denture-bearing mucosa. However, no association was observed between cleaning frequency and presence of mucosal changes.

The aim of this 12-month parallel design controlled clinical trial was to assess the effect of the Braun Oral-B Plak Control electric toothbrush on supragingival plaque and gingival health, and to compare it with a conventional soft manual toothbrush (Jordan). A total of 111 patients aged between 20 and 63 years, from a general population, with bleeding on probing at 30% or more of all sites examined were entered into the study. At baseline, immediately after periodontal examination, all volunteers received a thorough scaling of their teeth. Volunteers in both groups were told to brush their teeth for 2 min 2 x a day. Oral hygiene instruction was given at the start of the study and was not repeated. At 3, 6 and 12 months, assessments were carried out by a single clinician who was not aware which group the volunteers belonged to. Analysis of results demonstrated that over the 12 months of the study, the Braun Oral-B Plak Control was significantly more effective in improving gingival health than the manual toothbrush. There was, however, no difference between the 2 groups in terms of plaque removal, with the number of sites with visible plaque decreasing by a similar amount in both groups. In conclusion, results indicate that the Braun Oral-B Plak Control toothbrush is safe and more effective than a manual toothbrush in improving gingival health.

High scores of chair-side salivary microbial tests have been found to be related to an increased prevalence and incidence of coronal and root caries. Many elderly face an increased risk of the growth of oral microbes, and previous studies have reported high salivary microbial counts in elderly populations. The aim of this follow-up study was to compare, at five-year intervals, stimulated salivary flow rates with the numbers of selected salivary micro-organisms (mutans streptococci, lactobacilli, and yeasts) in a group of home-dwelling elderly in Helsinki. A further aim was to study the influence of baseline microbial counts on five-year root caries increments and rates of tooth loss. The baseline study population was comprised of 270 subjects who were all participants in the population-based Helsinki Aging Study. Salivary flow rates and microbial conditions were determined as part of their dental examination at the Institute of Dentistry, University of Helsinki, in 1990-1991. Of these subjects, 110 underwent a follow-up examination in 1995-1996. Commercially available kits (Dentocult SM strip mutans for mutans streptococci, Dentocult LB for lactobacilli, and Oricult N for yeasts) were used for the enumeration of micro-organisms, after the collection of paraffin-wax-stimulated whole saliva. The stimulated whole saliva flow rates of the subjects were significantly lower at the follow-up than at baseline (paired t test, difference -0.16 mL/min; p < 0.05), whereas buffer capacity was higher (paired t test, difference 0.19 on a three-unit scale; p < 0.05). Apart from lower salivary lactobacilli counts at follow-up (paired t test, difference -0.44 CFUs/mL of saliva; p < 0.001), no changes were found in salivary microbial levels. Salivary microbial counts were clearly associated with the subjects' dentition types: More denture-wearers had high microbial counts than persons with natural dentitions. None of the salivary factors correlated with the root caries incidence or the number of teeth lost during the five-year follow-up.