Predictors of caries in old age

This study measured the incidence of dental caries for one year and identified factors associated with the risk of caries in a sample of 156 elderly subjects. The subjects were examined at baseline and after one year to record the number of missing, filled and decayed teeth, to measure oral hygiene and flow of saliva, and to estimate the numbers of Streptococcus mutans and Lactobacilli cultured from samples of saliva. All subjects were interviewed on both occasions for information on their use of medications and dental services and on their ingestion of sugar. At baseline the elders had a mean of 19 natural teeth with 5 decayed surfaces (DS), 38 filled surfaces and a mean Plaque Index (PI) of 1. The independent group, on average, had more teeth and fillings but a lower PI and less caries. At the end of the year more than two-thirds (71%) of the 98 institutionalised subjects and over half (59%) of the 58 independent subjects had at least one new decayed/filled surface (DFS). The mean net DFS increment per subject was 4.6 and 2.0 respectively. Regression analyses on multivariate models identified caries at baseline, residence in long term care facilities, high numbers of Lactobacilli, poor oral hygiene and frequent sugar consumption as the variables contributing most significantly to the risk of caries in old age.