Oral Health Conditions of Older People: Focus on Balkan Countries

[btn url=”http://balkandentaljournal.com/wp-content/uploads/2016/02/Oral-Health-Conditions-of-Older-People-Focus-on-the-Balkan-Countries.pdf” text_color=”#ffffff” bg_color=”#81d742″ icon=”fa-file-pdf-o” icon_position=”start” size=”14″ id=”” target=”NewWindow”]Download Article[/btn]


1University of Minnesota, School of Dentistry, Advanced Education, Program in Periodontology, USA


Oral health plays a pivotal role in general health, especially in older people. Oral diseases may affect the development of systemic conditions, such as diabetes mellitus, cardiovascular disease, stroke and hypertension. The most important oral health conditions that have been recorded in dental literature for older population include tooth loss, dental caries, periodontal diseases, xerostomia (dry mouth) and oral cancer. Edentulism influences social life, either causing aesthetic problems or affecting functional abilities, such as speaking, chewing and eating. Dental caries in older people is similar to that in people in their thirties. Socio-economic status and living area play a key role in the development of dental caries. In addition, the accumulation of several risk factors, such as plaque or systemic diseases, acts synergistically in the onset of periodontal disease in seniors. Furthermore, older people, mainly due to their medications, exhibit a reduced amount of saliva. Xerostomia causes difficulties in chewing, speaking and swallowing, and it has a substantial impact on older people’s lives. The prevalence of oral cancer is 1-10 per 100,000 patients, and several factors (smoking, alcohol, education, economic status) play crucial role. Limited data exists today that evaluates oral health conditions of seniors in the Balkan countries. Aging and socio-economic status of seniors in the Balkans are significantly associated with oral health problems.

Keywords: Oral Health; Aging; Balkan Peninsula; Tooth Loss; Dental Caries; Periodontal Disease; Xerostomia; Oral Cancer


  1. Berkey D, Berg R. Geriatric oral health issues in the United States. Int Dent J, 2001; 51:254-264. [PubMed]
  2. Persson RE, Hollender LG, Powell LV, MacEntee MI, Wyatt CCL, Kiyak HA, Persson GR. Assessment of periodontal conditions and systemic disease in older subjects. I. Focus on osteoporosis. J Clin Periodontol, 2002; 29:796-802. [Crossref] [PubMed]
  3. British Geriatrics Society. Geriatric Medicine Defined. [online] Available at: http://www.bgs.org.uk/index.php?option=com_content&view=article&id=981:geriatricsdefined&catid=1:administration (accessed on March 25th, 2015).
  4. United Nations. World population Ageing 2013. Economic and social affairs. [online] New York: United Nations. Available at:http://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2013.pdf (Accessed March 25th, 2015).
  5. Petersen PE, Yamamoto T. Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol, 2005; 33:81-92. [Crossref] [PubMed]
  6. World health organization. Oral health fact sheet No 318. 2012 Apr; Available at: http://www.who.int/mediacentre/factsheets/fs318/en/index.html(Accessed on March 23rd, 2015).
  7. Nowjack-Raymer RE, Sheiham A. Association of edentulism and diet and nutrition in US adults. J Dent Res, 2003; 82:123-126. [Crossref]
  8. Idowu AT, Handelman SL, Graser GN. Effect of denture stability, retention, and tooth form on masticatory function in the elderly. Gerodontics, 1987; 3:161-164. [PubMed]
  9. Esan TA, Olusile AO, Akeredolu PA, Esan AO. Socio-demographic factors and edentulism: The Nigerian experience. BMC Oral Health, 2004; 4:3.[PubMed] [Crossref]
  10. Griffin SO, Griffin PM, Swann JL, Zlobin N. Estimating rates of new root caries in older adults. J Dent Res, 2004; 83:634-638. [Crossref] [PubMed]
  11. Broadbent JM, Thomson WM, Poulton R. Trajectory patterns of dental caries experience in the permanent dentition to the fourth decade of life. J Dent Res, 2008; 87:69-72. [PubMed] [Crossref] [Web of Science]
  12. Quinteros ME, Cáceres DD, Soto A, Mariño RJ, Giacaman RA. Caries experience and use of dental services in rural and urban adults and older adults from central Chile. Int Dent J, 2014; 64:260-268. [Crossref] [Web of Science]
  13. Page RC. Periodontal diseases in the elderly: a critical evaluation of current information. Gerodontology, 1984; 1:63-70. [Crossref]
  14. Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ (CDC Periodontal Disease Surveillance workgroup). Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res, 2012; 91:914-920.
  15. Orellana MF, Lagravere MO, Boychuk DG, Major PW, Flores-Mir C. Prevalence of xerostomia in population-based samples: a systematic review. J Public Health Dent, 2006; 66:152-158. [Crossref] [PubMed]
  16. Ship JA, Pillemer SR, Baum BJ. Xerostomia and the geriatric patient. J Am Geriatr Soc, 2002; 50:535-543. [Crossref] [PubMed]
  17. Napeñas JJ, Brennan MT, Fox PC. Diagnosis and treatment of xerostomia (dry mouth). Odontology, 2009; 97:76-83. [PubMed] [Web of Science][Crossref]
  18. Glick M, Johnson NW. Oral and oropharyngeal cancer: what are the next steps? J Am Dent Assoc, 2011; 142:892-894. [PubMed] [Crossref]
  19. Johnson NW, Warnakulasuriya KA. Epidemiology and aetiology of oral cancer in the United Kingdom. Community Dent Health, 1993; 10 (Suppl 1):13-29.
  20. Nalçaci R, Erdemir EO, Baran I. Evaluation of the oral health status of the people aged 65 years and over living in near rural district of Middle Anatolia, Turkey. Arch Gerontol Geriatr, 2007; 45:55-64. [Web of Science] [PubMed] [Crossref]
  21. Kossioni AE, Kossionis GE, Polychronopoulou A. Oral health status of elderly hospitalised psychiatric patients. Gerodontology, 2012; 29:272-283. [Web of Science] [Crossref] [PubMed]
  22. Kossioni AE, Kossionis GE, Polychronopoulou A. Self-reported oral complaints in older mentally ill patients. Geriatr Gerontol Int, 2013; 13:358-364.[Crossref] [PubMed] [Web of Science]
  23. Baderca F, Vincze D, Balica N, Solovan C. Mucosal melanomas in the elderly: challenging cases and review of the literature. Clin Interv Aging, 2014; 9:929-937. [PubMed] [Crossref] [Web of Science]
  24. Triantos D. Intra-oral findings and general health conditions among institutionalized and non-institutionalized elderly in Greece. J Oral Pathol Med, 2005; 34:577-582. [PubMed] [Crossref]
  25. Kossioni AE, Karkazis HC. Socio-medical condition and oral functional status in an older institutionalised population. Gerodontology, 1999; 16:21-28.[Crossref]
  26. Kossioni AE, Kossionis GE, Polychronopoulou A. Variation in oral health parameters between older people with and without mental disorders. Spec Care Dentist, 2013; 33:232-238. [PubMed]
  27. Erić J, Stančić I, Sojić LT, Jelenković Popovac A, Tsakos G. Validity and reliability of the Oral Impacts on Daily Performance (OIDP) scale in the elderly population of Bosnia and Herzegovina. Gerodontology, 2012; 29:e902-908. [Crossref] [Web of Science]
  28. Nazliel HE, Hersek N, Ozbek M, Karaagaoglu E. Oral health status in a group of the elderly population residing at home. Gerodontology, 2012; 29:e761-767. [Crossref]
  29. Doğan BG, Gökalp S. Tooth loss and edentulism in the Turkish elderly. Arch Gerontol Geriatr, 2012; 54:e162-166. [Crossref] [Web of Science]
  30. Namal N, Can G, Vehid S, Koksal S, Kaypmaz A. Dental health status and risk factors for dental caries in adults in Istanbul, Turkey. East Mediter Health J, 2008; 14:110-118.
  31. Özçaka Ö, Becerik S, Bıçakcı N, Kiyak AH. Periodontal disease and systemic diseases in an older population. Arch Gerontol Geriatr, 2014; 59:474-479.[Crossref] [Web of Science]
  32. Poverty, social exclusion and health systems in the WHO European Region. Copenhagen, WHO Regional Office for Europe, 2010.
  33. Kossioni A, Bellou O. Eating habits in older people in Greece: The role of age, dental status and chewing difficulties. Arch Gerontol Geriatr, 2001; 52:197-201. [Web of Science] [Crossref]
  34. Anastassiadou V, Heath MR. Food choices and eating difficulty among elderly edentate patients in Greece. Gerodontology, 2002; 19:17-24. [Crossref][PubMed]
Citation Information: Balkan Journal of Dental Medicine. Volume 19, Issue 2, Pages 59–64, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2015-0036, July 2015