Maurizio S Tonetti1,2, Peter Bottenberg3, Georg Conrads4, Peter Eickholz5, Peter Heasman6, Marie-Charlotte Huysmans7, Rodrigo López8, Phoebus Madianos9, Frauke Müller10, Ian Needleman11, Bente Nyvad12, Philip M Preshaw6, Iain Pretty13, Stefan Renvert14, Falk Schwendicke15, Leonardo Trombelli16, Gert-Jan van der Putten7, Jacques Vanobbergen17, Nicola West18, Alix Young19, Sebastian Paris15. 1. Faculty of Dentistry, University of Hong Kong, Hong Kong, China. 2. European Research Group on Periodontology, Genova, Italy. 3. Free University of Brussels, Brussels, Belgium. 4. Division of Oral Microbiology and Immunology, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH University Hospital Aachen, Aachen, Germany. 5. Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt, Germany. 6. Department of Restorative Dentistry, University of Newcastle, Newcastle, UK. 7. Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands. 8. Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark. 9. Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece. 10. Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland. 11. International Centre for Evidence-Based Oral Health, Unit of Periodontology, UCL Eastman Dental Institute, London, UK. 12. Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark. 13. Division of Dentistry, University of Manchester, Manchester, UK. 14. Department of Periodontology, Kristianstad University, Kristianstad, Sweden. 15. Department of Operative Dentistry, Charitè - Universitätsmedizin Berlin, Berlin, Germany. 16. Research Center for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy. 17. Community Dentistry and Oral Public Health, Ghent University, Ghent, Belgium. 18. Department of Oral and Dental Sciences, University of Bristol, Bristol, UK. 19. Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Abstract
BACKGROUND: Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems. AIMS: The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing. METHODS: Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion. RESULTS: Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders. CONCLUSIONS: Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders.
BACKGROUND: Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems. AIMS: The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing. METHODS: Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion. RESULTS: Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders. CONCLUSIONS: Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders.
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