Dental caries remains highly prevalent in older adults and represents a growing public health concern due to increased tooth retention, polypharmacy, hyposalivation and functional limitations. Silver diamine fluoride (SDF) is widely used for caries arrest in this population but causes undesirable tooth staining. Nano Silver Fluoride (NSF) has emerged as a potential alternative, combining antimicrobial and remineralizing properties with improved aesthetics. However, its applicability in geriatric dentistry remains unclear. This scoping review aimed to identify and map existing evidence on the use of Nano Silver Fluoride for the prevention or management of dental caries in older adults. The review followed the PRISMA-ScR guidelines framework. A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and SciELO for articles published between January 2020 and December 2024. Studies were eligible if they involved human participants aged ≥ 60 years, evaluated NSF for caries prevention or treatment and were published in English, Spanish or Portuguese. Invitro studies, animal models, case reports, reviews, and studies on children or young adults only were excluded. A total of 157 records were identified; 14 full-text articles were assessed. None met the inclusion criteria, as all clinical studies involving NSF were conducted in paediatric or young adult populations, lacked older adult participants, or were laboratory-based. No clinical trials, observational studies, or reviews evaluating NSF in older adults were found. This scoping review reveals a complete absence of clinical evidence regarding the use of Nano Silver Fluoride in adults aged 60 years or older. Although NSF has shown promising results in younger populations and is chemically related to SDF, its effectiveness and safety in geriatric dentistry remain unknown. High-quality clinical studies in older adults are urgently needed.

Patient groups and policymakers are calling for the implementation of relationship-centred, co-ordinated care for vulnerable older people. Relationship-centred care highlights the significance of strong, quality relationships among residents, their families and the broader healthcare team. The present work performed a qualitative evidence synthesis to explore issues relating to the provision of relationship-centred dental care for older people living in care homes, as perceived by care home staff, dental professionals, family and residents. This builds on the existing evidence base and outlines areas for improvement of dental care provision within residential care homes. A 'best fit' framework synthesis of primary research was used to understand how and why current dental care might or might not be relationship-centred. A palliative healthcare-focused conceptual framework for relationship-centred care was used as the basis for the synthesis. The review focuses on qualitative primary research studies exploring dental care for care-home residents. Of 235 unique citations, fifteen qualitative primary research papers were included. The synthesis identified supporting evidence for all five of the broad a priori themes from the relationship-centred care coding framework: Relationship-centred care, Integration within the wider health and social care systems, Digital inclusion, Workforce support and Parity of esteem. Relationships between themes were articulated. This 'best-fit' framework synthesis found that care home staff identified numerous barriers to providing relationship-centred dental care for older residents. Dentists, families and residents were underrepresented, highlighting the need for further research into their perspectives. By acknowledging the complexity of dental care and addressing issues such as integration, workforce support, digital services and parity of esteem, the synthesis suggests that applying organisational change research may help improve oral health outcomes in care homes.

Unmet dental care is a key indicator of oral health inequality and is associated with oral functional decline and frailty in later life. Because oral function may influence dental care utilisation across age groups, age-stratified evaluation is warranted. This study examined age-specific factors associated with unmet dental care among Korean adults. This cross-sectional study analysed pooled data from the 2022 and 2024 Korean Community Health Surveys (n = 463,513). Participants aged ≥ 40 years were stratified into ≤ 64 and ≥ 65 age groups. Unmet dental care was defined as self-reported inability to receive needed dental treatment in the past year. Survey-weighted Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). The prevalence of unmet dental care was 16.1% (95% CI: 15.8-16.4) among adults aged ≤ 64 years and 14.6% (95% CI: 14.1-15.1) among those aged ≥ 65 years. Following these prevalence estimates, age-specific associations were identified. Among adults aged ≤ 64 years, higher education and economic activity were associated with a higher prevalence of unmet dental care, whereas physical activity and toothbrushing after lunch were associated with a lower prevalence. Among adults aged ≥ 65 years, female sex and toothbrushing after lunch were associated with a lower prevalence, while living with a spouse was associated with a higher prevalence. Poor subjective oral health and chewing difficulty were associated with unmet dental care in both age groups. A significant interaction between subjective oral health status and chewing difficulty was observed only in the ≤ 64 age group. Determinants of unmet dental care differ by age group, underscoring the need for age-tailored oral health strategies that incorporate oral functional assessment into community-based care.

Salivary dysfunction, including xerostomia and drooling, is common in Parkinson's disease and further impairs oral health and quality of life, which are already compromised in this population. Their effective management demands deeper insight into the complexity of salivary dysfunction. To examine the occurrence and associations of xerostomia and drooling complaints in individuals with Parkinson's disease. 111 individuals with Parkinson's disease (69.9 ± 7.7 years; 46.8% female) participated in an online survey. The questionnaire used validated scales (e.g., Xerostomia Inventory) and original questions. After descriptive analyses, multiple linear regression analyses identified factors (e.g., severity of motor impairment) associated with severity of xerostomia and drooling. Xerostomia (64.9%) and drooling (27.0%) were common, with 18.0% of the individuals experiencing both concurrently. Xerostomia was associated with the presence of jaw symptoms (B = 4.63; 95% CI 1.86-7.40), chewing gum usage (B = 1.27; 95% CI 0.52-2.02), swallowing difficulties (B = 0.41; 95% CI 0.04-0.78) and taste alterations (B = 0.15; 95% CI 0.00-0.30). Drooling was associated with the severity of motor impairment (B = 0.40; 95% CI 0.18-0.60) and with swallowing difficulties (B = 0.64; 95% CI 0.14-1.15). Xerostomia and drooling complaints frequently co-occur in individuals with Parkinson's disease. To prevent further deterioration of the oral health-related quality of life, a comprehensive evaluation of the underlying aetiology of salivary issues in people with Parkinson's disease is crucial to assist in determining suitable treatment.

To systematically review the impact of periodontitis on clinical oral health outcomes and oral health-related quality of life (OHRQoL) in older adults (≥ 60 years). Global evidence shows that severe periodontitis prevalence peaks in the 60s, yet how periodontitis relates specifically to oral health outcomes in older adults has not been comprehensively synthesised. Prior reviews in mixed-age populations demonstrate strong links with tooth loss but less consistent associations with OHRQoL. This systematic review followed PRISMA guidelines and was registered on PROSPERO (CRD420251010568). Searches of PubMed, MEDLINE, Embase, Scopus, and Cochrane Library (to May 2025) identified studies of adults ≥ 60 years with periodontitis reporting oral health outcomes or OHRQoL. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Forty-three studies met inclusion criteria: 18 longitudinal studies on clinical outcomes and 25 cross-sectional studies on OHRQoL. Clinical studies consistently demonstrated that deeper baseline periodontal pockets, greater clinical attachment loss, and higher CPI/CPITN scores predicted adverse outcomes over 18 months to 12 years follow-up, including tooth loss, further attachment loss, and functional decline. OHRQoL studies showed inconsistent findings, with roughly equal numbers reporting significant associations versus no relationship. In adults ≥ 60 years, periodontitis consistently predicts tooth loss and continued periodontal breakdown, whereas OHRQoL associations are inconsistent and appear mediated primarily through downstream consequences such as tooth loss and functional impairment, though direct effects may occur in advanced disease. These findings emphasise the importance of periodontal prevention and management in older adults.

As populations age globally, effective geriatric oral health interventions require a workforce equipped with the necessary knowledge, attitudes and skills. In Malaysia, geriatric dentistry is not yet a recognised speciality and training opportunities remain limited within undergraduate curricula and continuing professional development. To assess the knowledge, attitudes, practices (KAP) and perceived barriers of dental practitioners in providing care for older adults, as baseline evidence for developing educational interventions. A cross-sectional survey was conducted among 260 dental practitioners from the Ministry of Health in Selangor, Malaysia. A validated self-administered questionnaire assessed knowledge, attitudes, practices and barriers across domains such as treatment complexity, polypharmacy, functional status and time demands. Preparedness was defined as the combined score of the KAP domains. Descriptive and inferential analyses, including modified Poisson regression, were conducted. Respondents were mainly female (91.2%) and over half were aged 32 or older (51.9%). Most practitioners demonstrated good knowledge (96.2%), while attitudes were moderate (68.1%). The mean barrier score was 3.8 (±0.4), with the most frequently reported obstacles being disease complexity, polypharmacy and functional limitations of older adults. Modified Poisson regression revealed that higher knowledge (PR = 3.68, p < 0.05) was significantly associated with greater recognition of barriers, suggesting heightened awareness but not necessarily preparedness. Despite strong knowledge levels, moderate attitudes and recognition of significant barriers, this highlights the urgent need for structured educational interventions in geriatric dentistry. Integrating geriatric-focused modules into undergraduate curricula, expanding continuing professional development and fostering interprofessional learning are critical to preparing a competent workforce for ageing populations.

Burning mouth syndrome (BMS) is occasionally accompanied by denture intolerance. An 80-year-old woman with complaints of residual and relapsed intraoral pain and denture intolerance due to BMS was improved by olanzapine without severe adverse events, and her eating ability was successfully restored. This case suggests that olanzapine may be an optional treatment for denture intolerance as well as BMS pain in older adult patients.

The final remaining tooth in an otherwise edentulous mouth embodies a unique intersection of biology, psychology, and identity. Beyond its limited functional role, it serves as a powerful symbol of continuity and selfhood, making its extraction an emotionally charged event for many patients. This narrative review explores the concept of 'Romanticising the Last Tooth', emphasising its psychosocial and clinical significance within geriatric and prosthodontic practice. The discussion integrates evidence on emotional attachment, bone preservation, proprioception, and overdenture strategies to illustrate how the final tooth can influence both treatment planning and patient adaptation. Ethical dilemmas surrounding tooth retention and patient autonomy are examined, highlighting the need for empathy driven, shared decision making to guide clinicians. Recent literature emphasises advances in implant-supported rehabilitation, digital workflows, and biomaterials in full-arch prosthetic management, which can influence decisions regarding the last tooth. The R.O.M.A.N.T.I.C. framework (Retain Or Move Ahead: Navigating the Tooth In Context) is introduced, offering structured parameters for deciding whether to preserve or extract the last tooth. This approach underscores a broader vision of prosthodontics one that harmonises technical precision with human understanding to restore not only function but dignity and confidence in the ageing patient.

To explore informal caregivers' perspectives concerning support in oral care for frail home-dwelling older persons (FHOPs), while identifying their needs and barriers at the IC-FHOP as well as the IC-healthcare professional level. FHOPs' oral health is a global concern. Health determinants ranging from the individual up to the public policy level shape oral health. Informal caregivers' perspectives on these topics are underexamined for oral health, despite their key role in supporting FHOPs and connecting them to professional care. Semi-structured interviews were conducted with informal caregivers of older adults from urban and rural areas in Flanders (Belgium), with a Groningen Frailty Index equal to or greater than 4. Interviews were recorded, transcribed, and analysed using a reflexive thematic approach. The sample comprised 19 informal caregivers (ICs) aged 53-87 years. Four themes were identified: (1) When words matter: the (un)spoken role of oral care in informal caregiving, (2) Balancing care and independence: the role of ICs in FHOPs' daily oral care, (3) Between necessity and accessibility: the role of ICs in FHOPs' dental visits, and (4) Ensuring oral health together: the collaboration with professionals. ICs' oral care involvement varied, influenced by knowledge, confidence, and support. This study emphasises the vital role of ICs in supporting FHOPs' oral care, yet they often lack role clarity, confidence, and guidance. Enhancing education and support for both ICs and healthcare professionals is essential to promote person-centred oral care and collaboration.