- Email: [email protected]
Older adults’ subjective oral health
Fig 1.—pH change with various acidic additives in sugar-free confections. (Courtesy of Nadimi H, Wesamaa H, Janket S-J, et al: Are sugar-free confections really beneficial for dental health? Br Dent J 211:E15, 2011.)
health. The length of exposure to the products is important, with hard candies or lollipops especially harmful. Adding calcium and phosphate to the sugar-free product may counteract the erosive effect, but more study is needed.
Clinical Significance.—Numerous studies have found that substituting sugar-free sweeteners for sugar is a healthy choice from the perspective of preventing caries. However, products containing the sugar substitutes should be consumed in moderation. In addition, the acid flavoring and preservatives added to sugar-free
products can lower the salivary pH and cause dental erosion. Further study is needed to determine the actual risks presented by sugar-free products and whether their benefits exceed these risks.
Nadimi H, Wesamaa H, Janket S-J, et al: Are sugar-free confections really beneficial for dental health? Br Dent J 211:E15, 2011 Reprints available from S-J Janket, Henry M Goldman School of Dental Medicine, Boston Univ, 100 E Newton St, Boston, MA 02118; e-mail: [email protected]
Quality of Life Older adults’ subjective oral health Background.—Population health surveys are finding that older adults have better subjective oral health than young or middle-aged adults. This is surprising because clinical conditions such as tooth loss are more common in older than in younger persons. A study was undertaken to determine whether edentulism and denture-wearing influence associations between age and subjective oral health and to find whether self-reported toothache and clinical examination findings influence relationships between age and scores on the Oral Health Impact Profile (OHIP-14) questionnaire. Methods.—Data were taken from the 2004-2006 National Survey of Adult Oral Health in Australia. Interviews were conducted with 14,092 adults. Oral epidemiologic examinations were performed in dentate subjects, and participants completed the OHIP-14 questionnaire.
Results.—The prevalence of problems with eating or appearance showed no significant association with age in dentate persons with no dentures. However, dentate persons who wore dentures had prevalences ranging from 18.7% in individuals aged R65 years to 46.7% in persons aged 25 to 34 years. The OHIP-14 score was R1 in 84.9% of dentate adults, which indicates that there was some adverse impact from oral problems. The mean OHIP-14 score in dentate adults was 6.5 in individuals aged R65 years but 8.1 in individuals aged 45 to 54 years. The effects of five clinical conditions were analyzed: five or more missing teeth, dentures, untreated decay, moderate to severe periodontitis, and toothache. Mean OHIP-14 scores were weakly associated with age in people who had none of these conditions. However, people who had two or more conditions had
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a threefold inverse relationship between age and mean OHIP-14 score. Discussion.—Tooth loss and clinical conditions were more prevalent among older persons, but the subjective oral health of older adults was not poorer than that of younger adults. Younger Australian subjects had oral health status that varied widely depending on clinical status and symptoms. The signs and symptoms of oral disease appeared to be more deleterious to subjective oral health when occurring early in a person’s life than when occurring later.
would be the resilience of older adults as a result of experiences such as the Great Depression and World War II. This would be in contrast to the post-war generations, which were born into affluence and grew up with higher expectations and less ability to adapt to adverse circumstances. There may also be age-related differences in the perception of symptoms or in the willingness to report symptoms to health care providers. It is clear that dental disease has the potential to adversely affect everyone’s daily well-being, but the effect may be more pronounced in younger than in older persons.
Clinical Significance.—Why this paradox is true remains to be determined. It is possible that the elderly held a positive perception of oral health and had adapted to tooth loss. This may reflect the view that dental disease is a normal consequence of aging. Thus, cognitive processes served to buffer the effects of agerelated impairments. Another explanation
Slade GD, Sanders AE: The paradox of better subjective oral health in older age. J Dent Res 90:1279-1285, 2011 Reprints available from GD Slade, Dept of Dental Ecology, School of Dentistry, Univ of North Carolina, 2100 Old Dental Bldg, CB #7450, Chapel Hill, NC 27599-7450; e-mail: [email protected]
EXTRACTS TOXIC VITAMINS Vitamins and minerals are essential for proper nutrition, but excess intake does not add to the benefit. Supplements do not appear to provide a ‘‘safety net’’ for persons who do not consume enough of a given nutrient, but too much can be a problem according to a study done by the University of Minnesota of more than 38,000 women for 19 years. Subjects aged approximately 62 years at the study’s start in 1986. Women who took supplements averaged a 2.4% increased risk of dying compared with women who did not after adjusting for age and calorie intake. Dr Jaakko Mursu, an epidemiologist who authored the study, stated, ‘‘Our study, as well as other similar studies, have provided very little evidence that commonly used dietary supplements would help to prevent chronic diseases.’’ Multivitamins, vitamin B6, folic acid, iron, magnesium, zinc, and copper along with several other vitamins and minerals were linked to the slight mortality risk. Increased death rate may be related to higher concentrations of components than are found in food. Some compounds are toxic in higher amounts, especially with long-term consumption. Calcium supplements lowered women’s death risk by 3.8%, but higher amounts did not further decrease death risk. Drs Goran Bjelakovic and Christian Gluud of the Copenhagen University Hospital in Denmark commented on the study, noting, ‘‘We believe that for all micronutrients, risks are associated with insufficient and too-large intake. Low levels of intake increase the risk of deficiency. High levels of intake increase the risk of toxic effects and disease.’’ [J Brownstein: Some Common Vitamin Supplements Could Increase Death Risk, Study Finds. MyHealthNewsDaily, http://vitals.msnbc.msn.com/_news/2011/10/10/8256866-some-common-vitamin-supplements-could-increase-deathrisk-study-finds]
280
Dental Abstracts
health. The length of exposure to the products is important, with hard candies or lollipops especially harmful. Adding calcium and phosphate to the sugar-free product may counteract the erosive effect, but more study is needed.
Clinical Significance.—Numerous studies have found that substituting sugar-free sweeteners for sugar is a healthy choice from the perspective of preventing caries. However, products containing the sugar substitutes should be consumed in moderation. In addition, the acid flavoring and preservatives added to sugar-free
products can lower the salivary pH and cause dental erosion. Further study is needed to determine the actual risks presented by sugar-free products and whether their benefits exceed these risks.
Nadimi H, Wesamaa H, Janket S-J, et al: Are sugar-free confections really beneficial for dental health? Br Dent J 211:E15, 2011 Reprints available from S-J Janket, Henry M Goldman School of Dental Medicine, Boston Univ, 100 E Newton St, Boston, MA 02118; e-mail: [email protected]
Quality of Life Older adults’ subjective oral health Background.—Population health surveys are finding that older adults have better subjective oral health than young or middle-aged adults. This is surprising because clinical conditions such as tooth loss are more common in older than in younger persons. A study was undertaken to determine whether edentulism and denture-wearing influence associations between age and subjective oral health and to find whether self-reported toothache and clinical examination findings influence relationships between age and scores on the Oral Health Impact Profile (OHIP-14) questionnaire. Methods.—Data were taken from the 2004-2006 National Survey of Adult Oral Health in Australia. Interviews were conducted with 14,092 adults. Oral epidemiologic examinations were performed in dentate subjects, and participants completed the OHIP-14 questionnaire.
Results.—The prevalence of problems with eating or appearance showed no significant association with age in dentate persons with no dentures. However, dentate persons who wore dentures had prevalences ranging from 18.7% in individuals aged R65 years to 46.7% in persons aged 25 to 34 years. The OHIP-14 score was R1 in 84.9% of dentate adults, which indicates that there was some adverse impact from oral problems. The mean OHIP-14 score in dentate adults was 6.5 in individuals aged R65 years but 8.1 in individuals aged 45 to 54 years. The effects of five clinical conditions were analyzed: five or more missing teeth, dentures, untreated decay, moderate to severe periodontitis, and toothache. Mean OHIP-14 scores were weakly associated with age in people who had none of these conditions. However, people who had two or more conditions had
Volume 57
Issue 5
2012
279
a threefold inverse relationship between age and mean OHIP-14 score. Discussion.—Tooth loss and clinical conditions were more prevalent among older persons, but the subjective oral health of older adults was not poorer than that of younger adults. Younger Australian subjects had oral health status that varied widely depending on clinical status and symptoms. The signs and symptoms of oral disease appeared to be more deleterious to subjective oral health when occurring early in a person’s life than when occurring later.
would be the resilience of older adults as a result of experiences such as the Great Depression and World War II. This would be in contrast to the post-war generations, which were born into affluence and grew up with higher expectations and less ability to adapt to adverse circumstances. There may also be age-related differences in the perception of symptoms or in the willingness to report symptoms to health care providers. It is clear that dental disease has the potential to adversely affect everyone’s daily well-being, but the effect may be more pronounced in younger than in older persons.
Clinical Significance.—Why this paradox is true remains to be determined. It is possible that the elderly held a positive perception of oral health and had adapted to tooth loss. This may reflect the view that dental disease is a normal consequence of aging. Thus, cognitive processes served to buffer the effects of agerelated impairments. Another explanation
Slade GD, Sanders AE: The paradox of better subjective oral health in older age. J Dent Res 90:1279-1285, 2011 Reprints available from GD Slade, Dept of Dental Ecology, School of Dentistry, Univ of North Carolina, 2100 Old Dental Bldg, CB #7450, Chapel Hill, NC 27599-7450; e-mail: [email protected]
EXTRACTS TOXIC VITAMINS Vitamins and minerals are essential for proper nutrition, but excess intake does not add to the benefit. Supplements do not appear to provide a ‘‘safety net’’ for persons who do not consume enough of a given nutrient, but too much can be a problem according to a study done by the University of Minnesota of more than 38,000 women for 19 years. Subjects aged approximately 62 years at the study’s start in 1986. Women who took supplements averaged a 2.4% increased risk of dying compared with women who did not after adjusting for age and calorie intake. Dr Jaakko Mursu, an epidemiologist who authored the study, stated, ‘‘Our study, as well as other similar studies, have provided very little evidence that commonly used dietary supplements would help to prevent chronic diseases.’’ Multivitamins, vitamin B6, folic acid, iron, magnesium, zinc, and copper along with several other vitamins and minerals were linked to the slight mortality risk. Increased death rate may be related to higher concentrations of components than are found in food. Some compounds are toxic in higher amounts, especially with long-term consumption. Calcium supplements lowered women’s death risk by 3.8%, but higher amounts did not further decrease death risk. Drs Goran Bjelakovic and Christian Gluud of the Copenhagen University Hospital in Denmark commented on the study, noting, ‘‘We believe that for all micronutrients, risks are associated with insufficient and too-large intake. Low levels of intake increase the risk of deficiency. High levels of intake increase the risk of toxic effects and disease.’’ [J Brownstein: Some Common Vitamin Supplements Could Increase Death Risk, Study Finds. MyHealthNewsDaily, http://vitals.msnbc.msn.com/_news/2011/10/10/8256866-some-common-vitamin-supplements-could-increase-deathrisk-study-finds]
280
Dental Abstracts