A Survey On Root Caries Of 513 Elderly In Guangzhou And Analysis On Its Relationship With Saliva

BackgroundDental caries is a kind of progressive chronic breakdown of teeth hard tissue due to multiple factors, mainly bacteria. World Health Organization has listed Dental Caries with tumor and cardiovascular disease as Top Three Prevention and Treatment Diseases due to its features of high incidence and wide distribution. Dental Caries among the elderly has its unique characteristics. As people grow older, the gingival tissue gradually shrinks and the oral bacteria colonize in exposure part of tooth neck, adjacent surface and root surface. Dental Root Caries refers to the caries damage occurred in the cementum of teeth root. The premise of Dental Root Caries forming is gingival atrophy, cementum or dentin exposure. Due to some certain degrees of periodontal attachment loss, it forms a progressive lesion on the root surface of oral environment.The third epidemiological survey of oral health in our country shows that in Guangdong province, the prevalence rate of Dental Root Caries in the age group of 65～74 is 66.4% and the prevalence rate of Dental Root Caries in the age group of 35～44 is 31.1%, which fully indicates that Dental Root Caries is the high incidence disease among the elderly. In recent years, Chinese scholars reported that the the prevalence rate of Dental Root Caries is between 24.58%-79.2%. In 2014, an epidemic disease longitudinal study on Dental Root Caries in Japan indicated that, 53.3% of old men over 60 years old had one or more Dental Root Caries. As is well known, the elderly are often bothered by thinking ability slowing down, physical coordinate ability decreasing, changing in diet structure and habits, systematic disease and long-term drug use, all of which will influence the oral environment and increase the risk of caries prevalence. Since the Dental Root Caries located in hidden places like gingival margin, back teeth adjacent surface, they are closer to pulp tissues than coronal caries, so the preparation of cavity form will increase the risk of bacterial invading pulp tissues. Even after being filled in, secondary caries may easily form due to dental plaque accumulation in the margin of the filling body. As for dentists, the treatment of Dental Root Caries is far more difficult than coronal caries. Most elderly are difficult to get about, so it is hard for them to cooperate with doctors in the link of diagnosis and treatment. All those mentioned above make it difficult to diagnosis and treat Dental Root Caries. According to the data from State Statistics Bureau, till 2014, people over 65 years old in China are about 140million, accounting for 10.1% of total national population. The content of Report on People’s Republic of China Elderly Service Industry Development in 2014 pointed out that:our country has entered into the early stage of aging society, so it is urgent to improve the living quality of the elderly. Proper social intervention on oral diseases of the elderly should be one of the key points of elderly prevention work.Objectives:Epidemiological survey and relevant risk factor analysis were conducted on the Dental Root Caries prevalence condition of 513 students from elderly college in Haizhu region, Guangzhou city, aged about 65～74. On one aspect, the Dental Root Caries prevalence and prevention materials of local elderly were supplemented; one the other hand, proper tested crowds for further study were determined. By analyzing the flow ratio of saliva, saliva pH value, saliva buffer ability of elderly students with Dental Root Caries and elderly students without Dental Root Caries, try to find out the relation between saliva and Dental Root Caries and provide scientific evidence for the prevention and treatment of Dental Root Caries.Materials and Methods:Chapter One A Survey on Root Caries of 513 Elderly513 people (aged 65-74) in Guangzhou LingHai Elderly University Haizhu campus were selected on a voluntary basis for cross-sectional survey of root caries. Clinical examination included root caries prevalence of jaw teeth. Diagnosis was conducted according to the ICDAS-Ⅱ root caries diagnosis criteria. In the questionnaire design, Ritter’s summary of pathogenesis modes of root caries and the research results of root caries risk factors among the elderly at home and abroad in recent years were referred. Moreover, the survey scoring method of the third oral epidemiology elderly group was referred. Structured questionnaire, face-to-face interview and on-spot recording were adopted. Questionnaire contents included social statistical data, dietary habits, oral health behavior, body health, medical behavior and psychological status. Descriptive statistics was applied to the analysis of prevalence of root caries among the 513 old people in Guangzhou. Chi-square test was used for the single factor analysis of relevant factors. And logistic regression analysis was used for the multiple factors analysis of relevant factors.Chapter Two Study of the Relationship between Root Caries and Saliva14 old people with root caries and 15 old people without root caries (qualified and with matching gender) were selected from the 513 ones in Guangzhou who had completed the examination of root caries. Then, unstimulated saliva and stimulated saliva were collected. The saliva flow rate was calculated. The pH value unstimulated saliva and stimulated saliva was measured through pH precision test paper color measurement. Besides, Ericsson method was applied to test the buffering capacity of stimulated saliva. The unstimulated saliva and stimulated saliva flow rate, pH, buffering capacity of the old people with root caries and without root caries were compared through independent sample t-test. The intra-group indexes of unstimulated saliva and stimulated saliva of the two groups were compared through paired samples t test. The related new analysis between root caries index and the properties of saliva of old people with root caries adopted Pearson correlation test.Results:1. The prevalence of root caries of 513 elderlies in Guangzhou was 65.7%, of which 68.8% in males and 62.7% in females. DFRoot was 2.34±2.01 and 1.98±1.75;2. Most frequently affected teeth were the mandibular first premolar and followed by the first molar and the second premolar in the maxillary;3. The most frequently afflicted surface was the mesial surfaces (31.77%) followed by distance surface (31.32%)4. Root surface caries involving 1 root surface accounted for 83.2%, involving 2 root surfaces accounted for 14.3%, involving 3 root surfaces and the above is only 2.5%;5. According to the single factor analysis method, the compassion results of variables in the questionnaire and oral clinical examination index on the differences of 513 people in Guangzhou with root caries group and without root caries group include:plaque index (P=0.025), edible cake dessert frequency (P= 0.033), food impaction (P= 0.026), dry mouth symptoms (P= 0.009). There was no significant difference in the age of root surface caries between the elderly and without root caries in the elderly with the social demographic data and general health;6. Multivariate logistic regression analysis showed that frequent dry mouth symptoms, food impaction more frequently, older people are more susceptible to root caries;7. There was statistically significant difference among unstimulated and stimulated salivary characteristics between the root caries group and the control group (P=0.007). No significant difference was found between men and woman either (P>0.05). There was no statistical difference of stimulated salivary buffering capacity between two groups by T-test (P>0.05). Most elderly presented good salivary characteristics. By paired-samples T test comparison, unstimulated and stimulated salivary parameters were analyzed within groups. There was a significant increase in flow rate, pH, and buffering capacity of two groups after stimulation (P>0.05);Conclusions:1. Good oral hygiene habits and eating habits are the guarantee of oral health;2. Root caries is related to symptoms of dry mouth and food impaction. The science popularization activities should be increased for old people;3. Unstimulated saliva flow rate has a certain connection with root caries. Other salivary characteristics seemed to have no important impact on root caries of our study samples. There was no significant difference was found between male and female either. The saliva can protect the dentin against caries, however, the effect was not significant different between the elderly with root caries and without root caries;...