Dental geriatrics and periodontitis

Abstract

The present literature review is focused on two main areas: (i) periodontal conditions in older individuals; and (ii) the scientific data available on periodontal treatment outcomes in individuals ≥ 75 years of age. The population of older people is increasing but the data on periodontal therapies and their efficacy in this population are limited and need to be carefully reviewed. Although life expectancy has increased, this does not mean that older people are medically healthy. Several chronic systemic diseases are associated with periodontitis, and the prevalence of most chronic diseases increases with age. Furthermore, older people are challenged by impaired immunity (immune senescence) with a decline in the numbers of naïve T-cells in peripheral blood and lymphoid tissues. The most frequent significant correlates with successful ageing include not smoking and the absence of disability, arthritis and diabetes mellitus. Periodontal diseases in older individuals may have specific features that are not consistent with periodontal diseases. In this respect, data suggest that gingival lesions in older individuals develop differently from gingival lesions in younger adults. The progression of periodontitis may be slower in older individuals, and older individuals with periodontitis may benefit from more conservative treatment approaches. Diagnostic criteria used for the assessment and diagnosis of periodontitis in younger adults may not be fully applicable in older individuals. In summary, declining health, perception of treatment needs, dietary changes, comorbidity with other diseases and immune senescence are challenging factors to clinicians and researchers, in terms of therapies and in understanding periodontitis etiology in older individuals.

Effect of advanced age and/or systemic medical conditions on dental implant survival: A systematic review and meta‐analysis

“…Among other symptoms, Type 2 diabetics can experience microvascular and vascular damage as well as an impaired wound healing. Patients are more susceptible to periodontitis and tooth loss (Persson, ). The main marker of glycemic control in diabetic patients is hemoglobin A 1C (HbA 1c ), and numerous studies identified in this review demonstrate that HbA 1c levels above 8% may result in reduced implant survival compared to lower levels.…”

Needs for gerodontological treatment in the elderly living in Lower Silesia

“…No such criterion of qualification for specialist periodontal treatment had been found in the available literature. However, this choice was driven by the desire to avoid measuring the position of the attachment in such a qualification, which at this age, regardless of periodontopathies, is moving apically, 22 which obviously may lead to an overestimation of therapeutic needs. In the 5-year cohort study, the most important risk factors for the progression of periodontitis in the 60-81 age group were identified -current nicotinism, elementary or secondary education, being single or divorced, and diabetes.…”

Peer Review #1 of "IL-6 and TNF-α salivary levels according to the periodontal status in Portuguese pregnant women (v0.1)"

“…Periodontal diseases continue to be a major public health problem worldwide, but there is evidence that the initiation, progression and severity does not affect all people in the same way (Dye, 2012;Petersen & Ogawa, 2012;Baelum & López, 2013;Persson, 2017). Some epidemiological studies have demonstrated that gingival inflammation affects 60 to 75% of pregnant women (Löe & Silness, 1963;Silness & Löe, 1964;Tilakaratne et al, 2000;Michalowicz et al, 2008;Ho & Chou, 2016), although not all present the same gingival inflammatory pattern and the symptoms can range from mild inflammation to severe hyperplasia, pain and profuse bleeding.…”