It is necessary to first clearly define the cases with the risk of occurrence of caries, and then to develop a method of predicting the occurrence of caries, in order to take the necessary preventive measures against the occurrence of caries in the elderly.
The present study was performed to determine whether the occurrence of caries could be predicted in the elderly based on the results of caries activity tests of saliva and oral examination, which have been routinely used in clinical cases. A total of 62 patients, who visited the geriatric dental clinic of the Nippon Dental University Hospital and showed tooth root exposure, were enrolled in the study after they gave the informed consent. They were aged 61-82 (mean 71.4 years); 31 patients were male, and the other 31 were female.
The relationship between the baseline test results, obtained from 6 salivary tests, including 3 microbiological tests, and oral examination, and the occurrence of caries on the exposed root surface during one year was investigated, and the following results were obtained:
1) At the initial examination, caries was present in the crown in 42.0% of the patients and on the exposed root surface in 50.0%. At one year after the baseline tests, caries had occurred in the crown and on the exposed root surface in 19.4% and 32.3% of cares respectively.
2) The occurrence of caries on the exposed root surface was significantly higher in Streptococci mutans (SM)-positive and/or occult blood-positive patients, compared with those negative for these 2 parameters.
3) The rate of saliva secretion was significantly lower in patients with caries occurring on the exposed root surface, compared with those without such caries.
4) The accuracy of prediction of the occurrence of caries on the exposed root surface was improved by the use of a combination of SM, occult blood, and saliva secretion rate.
5) Of patients with caries occurring on the exposed root surface at one year after baseline tests, 67.0% had already had caries at the initial examination.

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With an increasing elderly population, the number of overdenture cases will increase. It has been recommended that the exposed dentine of non-coping abutments should be treated with chemical prophylaxis to prevent caries.
Tannin-fluoride preparation (HY agent), which strengthens both organic and inorganic materials, was used for caries prevention of overdenture abutments, because dentine contains both organic and inorganic materials. In this study, tannin cement (HYc), which contains a high percentage of HY agent, was used to prevent abutment caries of ovredentures.
1. The abutments were cut and the cavities at root openings were prepared. HYc was put at the bottom of the cavities, adhesive composite resin restorations were filled in the cavities, and abutment surfaces were smoothed.
2. The results of GI, GCF and probing depth indicate good gingival health around the abutments.
3. One tooth showed high PlI and caries activity test scores, and so this tooth needs caries prevention until the components of HYc become effective.
4. With this method, there is no need for treatment of the denture base for caries prevention.
5. It is suggested that this method is effective for prosthetic treatment for the elderly.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The oral health in adults who used mass dental health check-ups in Matsubara city was analyzed. The service was planned and performed by the local dental association with the aim of gathering dental health information for planning comprehensive dental care in the community.
The number of missing teeth increased by age, while no remarkable increase was found in decay and treated teeth. The result indicated the need for the prevention of dental caries in younger age-groups, continuing care for adults with caries risk and professional care against periodontal diseases in the community.

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Caries experience in adults who used mass dental health check-ups was compared to the general health status of the subjects obtained by questionnaires. For those who were treated currently by a physician, the mean number of missing teeth and DMFT in all the age groups as a whole and the mean number of missing teeth in 20-39 year olds were higher than for the subjects who were not treated. The mean index of dental decay and DMFT in aged 20-39 year old were higher for those who claimed to have ever had a serious disease or surgical operation than for other subjects

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[in Japanese]

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As a means of promoting the dental health of the elderly, the Osaka Higashiyodogowa Ward Dental Association has been conducting dental examination and monitoring the oral health of the elderly. A survey was conducted from October to November in 1996 to determine the general physical and oral health status of the elderly, who utilize the day care services at 6 homes for the elderly located in Higashiyodogawa Ward. A total of 124 subjects, 45 male (36.3 %) and 79 female (63.7%) were examined. The mean age was 75.75±8.19 years, and about 60.5% were observed to have the following conditions; diabetes mellitus (19.4%), cerebrovascular diseases (15.3%), cardiac diseases (13.7%), and hypertension (12.1%).
The percentage of subjects who has previously received instruction in proper tooth brushing techniques was 21.3%. Twelve subjects (12.9%) considered dental treatment to be “frightening/painful”, and 17 (13.7%) received regular dental care at dental clinics. The status of oral health was not satisfactory, with soft tissue disease observed in 32 (25.8%), dental plaque in 74 (59.7%), and dental calculus in 71 (57.3%). The mean number of teeth per subject was 10.5±3.2, and although a difference was observed by age group, no sex difference was observed. Dental caries were observed in 47.6% of subjects, and the relation of the dental caries rate to total number of remaining teeth was 18.7%. This was lower than the rate observed in a survey conducted in 1993 on the bedridden elderly. Twenty-nine subjects (23.4%) were edentulous, and 80 (64.5%) has dentures of whom 16 (20.4%) were observed to have improper fit. As a result, it was recognized that prosthetic treatment for missing teeth, treatment for periodontal disease, and improvement in oral cleaning were required in 45.2%, 48.4%, and 66.9% of subjects, respectively. These results will be utilized to achieve an improvement in the quality of life and to promote the dental health of the elderly.

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[in Japanese]

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[in Japanese]

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