Efficacy of non-invasive and minimally invasive techniques for the prevention/management of root caries in older adults - A literature review

Purpose: To summarize the effectiveness of non-invasive and minimally invasive root caries preventive interventions in older adults. Methods: An electronic search was conducted in PubMed up to February 18, 2021. Only randomized controlled trials (RCTs) published in English language with root caries...

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Main Authors: Nisha Sundaragopal, Lisa Hou, Reyes Enciso
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:Dentistry Review
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772559622000268
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author Nisha Sundaragopal
Lisa Hou
Reyes Enciso
author_facet Nisha Sundaragopal
Lisa Hou
Reyes Enciso
author_sort Nisha Sundaragopal
collection DOAJ
description Purpose: To summarize the effectiveness of non-invasive and minimally invasive root caries preventive interventions in older adults. Methods: An electronic search was conducted in PubMed up to February 18, 2021. Only randomized controlled trials (RCTs) published in English language with root caries outcomes measured on older adults were included in this review. Studies were eligible if assessing the efficacy of either topical fluoride varnish/gel, chlorhexidine (CHX), atraumatic restorative treatment (ART), or silver diamine fluoride (SDF) to prevent and/or arrest root caries in older adults. Results: A total of 16 RCTs were included in this review. No significant differences were found between conventional therapy with rotary instruments and ART with hand instruments in survival rates of restorations in four studies. 1% CHX varnish (every 3 months), 5% sodium fluoride (NaF) varnish (every 3 months) and 38% SDF solution applied annually in addition to OHI were more effective preventing new root caries than OHI alone over a period of 3 years (with no differences between the 3 interventions). A 0.2% neutral NaF mouth rinse used daily reduced the incidence of caries among elders in long-term facilities and performed better than 0.12% CHX. The number of new lesions in the 1.2% acidulated phosphate fluoride (APF) gel group was significantly lower than in the placebo rinse group (P < 0.05), however the fluoridated mouth rinse group had more reversed root lesions. 38% SDF solution applied annually in combination with oral health education (OHE) every 6 months was efficacious in arresting and preventing root caries among older adults. The combination of Cervitec™ (1%CHX/1% thymol varnish) and fluoride varnish was successful in arresting exisiting root caries in a group of frail older adults compareed to fluoride varnish alone. Conclusions: Multiple minimally invasive interventions showed significant improvements in arresting and preventing root carious lesions in older adults compared to control groups, including the use of 0.2% neutral NaF mouth rinse, 1% CHX varnish, Cervitec™, APF gel and annual application of SDF combined with oral health education. However, further studies are needed to confirm these results as few studies could be found for each intervention.
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spelling doaj.art-b12b01e966be45bc9805ec8a5a658d672022-12-22T03:52:19ZengElsevierDentistry Review2772-55962022-12-0124100061Efficacy of non-invasive and minimally invasive techniques for the prevention/management of root caries in older adults - A literature reviewNisha Sundaragopal0Lisa Hou1Reyes Enciso2Graduate Student, Master of Science Program in Geriatric Dentistry, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USADepartment of Geriatrics, Special Needs and Behavioral Sciences, Herman Ostrow School of Dentistry of University of Southern California, 925 W. 34th St. DEN 4268, Los Angeles, CA 90089-0641, USADepartment of Geriatrics, Special Needs and Behavioral Sciences, Herman Ostrow School of Dentistry of University of Southern California, 925 W. 34th St. DEN 4268, Los Angeles, CA 90089-0641, USA; Corresponding author.Purpose: To summarize the effectiveness of non-invasive and minimally invasive root caries preventive interventions in older adults. Methods: An electronic search was conducted in PubMed up to February 18, 2021. Only randomized controlled trials (RCTs) published in English language with root caries outcomes measured on older adults were included in this review. Studies were eligible if assessing the efficacy of either topical fluoride varnish/gel, chlorhexidine (CHX), atraumatic restorative treatment (ART), or silver diamine fluoride (SDF) to prevent and/or arrest root caries in older adults. Results: A total of 16 RCTs were included in this review. No significant differences were found between conventional therapy with rotary instruments and ART with hand instruments in survival rates of restorations in four studies. 1% CHX varnish (every 3 months), 5% sodium fluoride (NaF) varnish (every 3 months) and 38% SDF solution applied annually in addition to OHI were more effective preventing new root caries than OHI alone over a period of 3 years (with no differences between the 3 interventions). A 0.2% neutral NaF mouth rinse used daily reduced the incidence of caries among elders in long-term facilities and performed better than 0.12% CHX. The number of new lesions in the 1.2% acidulated phosphate fluoride (APF) gel group was significantly lower than in the placebo rinse group (P < 0.05), however the fluoridated mouth rinse group had more reversed root lesions. 38% SDF solution applied annually in combination with oral health education (OHE) every 6 months was efficacious in arresting and preventing root caries among older adults. The combination of Cervitec™ (1%CHX/1% thymol varnish) and fluoride varnish was successful in arresting exisiting root caries in a group of frail older adults compareed to fluoride varnish alone. Conclusions: Multiple minimally invasive interventions showed significant improvements in arresting and preventing root carious lesions in older adults compared to control groups, including the use of 0.2% neutral NaF mouth rinse, 1% CHX varnish, Cervitec™, APF gel and annual application of SDF combined with oral health education. However, further studies are needed to confirm these results as few studies could be found for each intervention.http://www.sciencedirect.com/science/article/pii/S2772559622000268Root cariesOlder adultsElderlyTopicalFluorideAtraumatic restorative treatment
spellingShingle Nisha Sundaragopal
Lisa Hou
Reyes Enciso
Efficacy of non-invasive and minimally invasive techniques for the prevention/management of root caries in older adults - A literature review
Dentistry Review
Root caries
Older adults
Elderly
Topical
Fluoride
Atraumatic restorative treatment
title Efficacy of non-invasive and minimally invasive techniques for the prevention/management of root caries in older adults - A literature review
title_full Efficacy of non-invasive and minimally invasive techniques for the prevention/management of root caries in older adults - A literature review
title_fullStr Efficacy of non-invasive and minimally invasive techniques for the prevention/management of root caries in older adults - A literature review
title_full_unstemmed Efficacy of non-invasive and minimally invasive techniques for the prevention/management of root caries in older adults - A literature review
title_short Efficacy of non-invasive and minimally invasive techniques for the prevention/management of root caries in older adults - A literature review
title_sort efficacy of non invasive and minimally invasive techniques for the prevention management of root caries in older adults a literature review
topic Root caries
Older adults
Elderly
Topical
Fluoride
Atraumatic restorative treatment
url http://www.sciencedirect.com/science/article/pii/S2772559622000268
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