Journal of the Canadian Dental Association

The elderly population includes increasing propor-tions of dentate and partially dentate people, whichsuggests that this group will have an increasing need for dental services.1-3 Gingivitis and periodontitis increased with the number of retained teeth in a cross-sectional study of elderly subjects.4 Xerostomia as a result of a direct physiological change (because of Sjorgren’s syndrome or radiation to the salivary glands, for example) or secondarily as a side effect of medications has been associated with increases in caries in elderly people.5 Medications may directly reduce salivary flow and thus reduce the buffering capacity to such an extent that caries occur even with a normal diet. Alternatively, medications may create a perception of dry mouth, leading the person to seek relief by sucking or chewing confectionery products containing sugars, which indirectly increases the risk of caries.6 Older subjects, women in particular, reportedly take more medications and experience more root caries.7 Salivary and plaque samples can be used to detect the pres-ence and numbers of Streptococcus mutans and Lactobacillus and thus identify elderly subjects at high risk of caries.8 Higher salivary levels of S. mutans and Lactobacillus have been associated with increased prevalence of coronal and root caries in elderly multiracial populations.9 Hospitalized elderly subjects are at considerable risk of dental diseases and conditions, yet they experience greater barriers to receiving dental care than their independent counterparts.10 Such barriers to dental care include cost, lac