Aging of the world population has occurred at an unprecedented rate in the twentieth century and is forecasted to increase further. Given the increase of general health problems with aging and the presence of many interactions between general health and oral health, an increase of oral health problems is to be expected. Common oral health problems in older people are caries, periodontitis, reduced salivary flow, candida, and mucosal lesions. In developed countries, caries has a high prevalence in older adults with a mean number of decayed and filled coronal surfaces ranging from 22 to 35 and a mean number of decayed and filled root surfaces ranging from 2.2 to 5.3. Furthermore, periodontal disease is frequently present in older adults. Specifically, mild periodontitis, with periodontal pockets of 4–5mm, is present in 62–97% of the older persons. More severe periodontitis, with pockets of 6 mm or more, is present in 20–48% of the older persons. In addition, the prevalence of oral dryness increases with age, affecting approximately 30% of the older adults. Salivary flow rate decrease can result in difficulties with swallowing, eating, and communication. Moreover, reduced salivary flow can cause halitosis, a higher prevalence of inflammation of the mucosa and parotid, candidiasis, dental caries in dentate persons, and frictional lesions in denture wearers. The majority of oral diseases, including oral cancer, occur in older adults. Among oral mucosal lesions, denture-related lesions, such as stomatitis, angular cheilitis, ulcers, and hyperplasia, are most common. The above-mentioned oral health problems do not only affect oral health and functioning but may also cause orofacial pain or discomfort, and can have a negative impact on the quality of life. Compared to older people who are cognitively intact, older people who develop dementia are at increased risk of establishing oral health problems, as a result of decline in self-care and motor skills. Conversely, tooth loss and periodontitis may be risk factors for cognitive decline, although the exact presence and causality of the association between oral health problems and the development of dementia remains unclear. Several studies described oral disease as a risk factor for the development of dementia, but did not provide separate oral health data for the group of participants with dementia. It is important to have an up-to-date overview of the oral health of older people with already present dementia, because the number of older people with natural dentition and possible risk factors for dementia is still increasing. Therefore, the aim of this study was to provide an up-to-date overview of studies about oral health in people with dementia. A previous review focused on dental hard tissues and this review will aim at the oral soft tissues and oral hygiene of older people with dementia.

Regards
Sarah eve

Editorial Assistant

Journal of Oral Hygiene and Health