Oral health is associated with general health, morbidity, and mortality in older adults and is crucial for healthy aging. Dental caries induces pain and infection and is a predominant reason for tooth loss, which negatively affects aesthetics, chewing efficiency, speech, and social interaction, resulting in low self-esteem and quality of life. Almost half of the adults over 60 are affected by dental caries.
This study aimed to systematically review the effectiveness of professionally applied fluoride therapy in preventing and arresting dental caries in adults aged 60 years or older.
Study selection/results
Five hundred and twenty-seven studies were identified, and seven were finally included. Five studies were rated as having ‘low risk’. The root caries-prevented fraction of 38% silver diamine fluoride (SDF) solution, 5% sodium fluoride (NaF) varnish, and 1.23% acidulated phosphate fluoride (APF) gel were 25-71%, 64%, and 32%, respectively. Meta-analysis indicated a decrease in the number of new root caries by 0.55 (95% CI: 0.32–0.78; p < 0.001) and an overall proportion of arrested root caries of 42% (95% CI: 33% to 49%; p < 0.001) after receiving 38% SDF application at the 24-month follow-up.
Conclusions
According to the study findings, 5% NaF varnish and 1.23% APF gel prevented root caries, whereas 38% SDF solution prevented and arrested root caries in older adults. More well-designed clinical trials should be conducted to investigate various methods of caries prevention and arrest in older adults.
Clinical significance
Preventive measures effective in other age groups may not suit older adults, as caries type and associated risk factors vary. To date, no systematic review has evaluated professionally applied fluoride therapy in older adults. Evidence from clinical trials in older adults could aid clinical practice and public health measures.
