The retention of natural teeth among the elderly is increasing and, in recent studies, dental caries has been identified as the main reason for teeth being extracted. The 5-year incidence of tooth loss and dental caries and the most crucial dental factors for tooth extraction were studied in a random sample of 60-, 70- and 80-year-old inhabitants of Gothenburg. Of the 208 persons examined at baseline, 148 (71%) participated in the follow-up examination: 69, 51 and 28 respectively in the different age groups. In all, 110 teeth had been extracted during the period in 40% of the participants. Only 9 persons had lost three or more teeth. The mean numbers of remaining teeth were 22. 18 and 15 respectively in the 60-, 70- and 80-year age groups and the mean numbers of teeth lost during the 5-year period increased with age from 0.4 in the 60-year-olds to 0.8 and 1.4 in the 70- and 80-year-olds (P < 0.05). The major reason for tooth extraction was dental caries and it was found in 60% of all cases and at a higher rate of 77% in the oldest age group. Fifty-one per cent had developed new coronal carious lesions and 61% had new root carious lesions, while 27% had not developed caries during the period. The mean 5-year increment in decayed and filled coronal surfaces increased with age from 2.3 in the 60-year-olds to 3.7 and 5.3 in the 70- and 80-year-olds (N.S.I. The increment in decayed and filled root surfaces was higher in women than men, 3.4 compared with 1.8 (N.S.), which also increased with age from 1.4 in the 60-year-olds to 2.4 and 5.5 in the 70- and 80-year-olds (P < 0.0001). It was concluded from this study that few teeth had been lost during the 5-year period but that dental caries still appeared to be a serious problem among some very elderly people.

The findings indicate that there is an increased risk of dental caries with age owing to unfavourable caries-related factors.

The aim of this study was to evaluate a caries risk assessment computer program, the Cariogram, by comparing the risk assessment of the program with the actual caries increment in a group of elderly individuals over a period of 5 years. The participants were examined and interviewed at baseline about their general health and dietary habits. Data on oral hygiene and use of fluoride were obtained and saliva analyses included mutans streptococci, lactobacilli, buffering capacity, and secretion rate. Based on the baseline recordings, the individuals were divided into 4 risk groups according to the Cariogram. Where the program predicted 0%±20% (high risk), 21%±40%, 41%±60%, and 61%±100% (low/rather low risk) ªchance of avoiding cariesº, 13, 32, 23, and 48% respectively, had no new DFS over 5 years and 18, 40, 72, and 84%, respectively, had no new lesions at the 5th year. The mean DMFS increment over 5 years was 12.8 in the high/rather high risk group (0%±40% ªchance of avoiding cariesº), which included 43% of the individuals. In the low/rather low risk group (61%±100% ªchance of avoiding cariesº), the corresponding value was 5.2%, and 21% of the participants were sorted to this group.

The objective of this study was to evaluate a new chemo–mechanical method (Carisolv™) for the removal of primary root caries in vivo in terms of efficiency, treatment time and patient perception. Thirty–eight patients participated in an open, randomised and controlled study. Of the 60 root carious lesions included, 34 were randomised for chemo–mechanical treatment and 26 for drilling. A within–subject comparison was used whenever the patient had two cavities, which was the case for 22 subjects. All the Carisolv–treated cavities became caries free, as did all but one of those treated with drilling, as judged by an independent examiner. Only 4 of 34 patients asked for anaesthesia in the Carisolv group compared with 6 of 26 patients in the drilling group. Of those who did not use anaesthesia, 12 individuals in the drilling group experienced some pain compared with none in the chemo–mechanical group (p<0.001). The mean treatment time for the Carisolv method was 5.9 ± 2.2 min, compared with 4.5 ± 2.0 min for drilling; time for anaesthesia excluded (p<0.05). No negative reactions or adverse effects were recorded during the study. All 55 teeth examined in the 1–year follow–up were found to be sensitive using an electric pulp tester, and there was no difference regarding the condition of fillings between the lesions treated with Carisolv and drilling. It can be concluded that root caries can be effectively removed using the Carisolv method. The longer treatment time was compensated by less need for anaesthesia.