Aim: To provide recommendations for dental clinicians for
the management of dental caries in older adults with special
emphasis on root caries lesions. Methods: A consensus
workshop followed by a Delphi consensus process were
conducted with an expert panel nominated by ORCA, EFCD,
and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a
two-stage Delphi process. Results: Demographic and epidemiologic changes will significantly increase the need of
management of older adults and root caries in the future.
Ageing is associated with a decline of intrinsic capacities
and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the
patient’s individual abilities for self-care and cooperation
and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root
lesions may comprise local biofilm control, application of
highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well
as the ability of the senior patient to cooperate. If optimum
restorative treatment is impossible or inappropriate, longterm stabilization, e.g., by using glass-ionomer cements,
and palliative treatments that aim to maintain oral function
as long and as well as possible may be the treatment of
choice for the individual