Dental cares experience in older people over time: what can the large cohort studies tell us?
Dental cares experience in older people over time: what can the large cohort studies tell us?
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DOI：
10.1038/sj.bdj.4810900
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发表时间：
2004-01-24
影响因子：
2.6
通讯作者：
Thomson, WM
中科院分区：
文献类型：
--
作者：
Thomson, WM
背景：直到最近，人们对老年人龋齿的自然病史知之甚少，但一些大型队列研究的报告现在已经使人们能够更好地了解老年人龋病的性质和决定因素。这篇综述的目的是检查和比较已建立的基于人群的老年人纵向研究的结果，以确定它们的预防意义。方法回顾牙科文献，以确定大型、基于人群的老年人(50岁以上)牙科纵向研究中关于龋齿发病率的报告，并进行至少3年的随访。结果从4项研究(在爱荷华州、北卡罗来纳州、安大略省和南澳大利亚州)确定了符合标准的报告；4份报告涉及冠状龋病，5份报告涉及根面龋病。当将每年、冠面和根面龋齿增量合并在一起并与青少年报告的龋齿增量进行比较时，随着时间的推移，老年人的龋齿经历(每年影响0.8到1.2个新表面)超过了青少年队列研究报告的(每年0.4到1.2个表面)。所有四项研究的唯一共同的龋病危险因素是佩戴局部义齿(仅适用于根面龋齿)。结论老年人是龋病活跃人群，患新疾病的几率至少与青少年相同。老年人牙齿的实际影响应成为临床实践和公共卫生层面加强监测和预防的目标。在这个年龄段，没有容易识别的预防龋齿的“灵丹妙药”，但使用循证的预防干预措施(如氟化物)应该就足够了。
Background Little was known of the natural history of dental caries among older adults until recently, but reports from a number of large cohort studies have now enabled better understanding of the nature and determinants of dental caries in older people. The aim of this review is to examine and compare findings from established population-based longitudinal studies of older adults in order to determine their preventive implications.Methods The dental literature was reviewed in order to identify reports on dental caries incidence from large, population-based dental longitudinal studies of older adults (age 50+) with at least 3 years of follow-up.Results Reports were identified from four studies (in Iowa, North Carolina, Ontario and South Australia) which met the criteria; four reports dealt with coronal caries, and five with root surface caries. When annualised, coronal and root surface caries increments were combined and compared with those reported for adolescents, the caries experience of older people over time (between 0.8 and 1.2 new surfaces affected per year) exceeded that reported from cohort studies of adolescents (between 0.4 and 1.2 surfaces per year). The only caries risk factor common to all four studies was the wearing of a partial denture (for root surface caries only).Conclusions Older people are a caries-active group, experiencing new disease at a rate which is at least as great as that of adolescents.Practice implications Dentate older people should be the target of intensive monitoring and preventive efforts at both the clinical practice and public health levels. There is no easily identifable 'magic bullet' for preventing caries in that age group, but the use of evidence-based preventive interventions (such as fluoride) should suffice.