Root-surface decay associated with gingival recession is a particular concern in older adults. Periodontal diseases and caries are the predominant causes of tooth loss. Numerous clinical trials have demonstrated that personal oral hygiene measures can help control plaque and gingivitis in most individuals. Progression of periodontal diseases can be retarded by the combination of excellent personal oral hygiene practices and regular professional care. Routine use of dentifrices with fluoride has been shown to prevent both coronal and rootsurface caries in adult populations.
Oral cancer is also a major concern among adults.
Use of tobacco in all forms and heavy consumption of alcohol are major causal factors. See chapter 19 for information on counseling children and adolescents on dental and oral health. See chapter 30 for a discussion of the oral cavity examination. When examining the mouth, clinicians should be alert for obvious signs of untreated tooth decay or mottling, inflamed or cyanotic gingiva, loose teeth, and severe halitosis and for signs and symptoms of oral cancer and premalignancy in persons who use tobacco or excessive amounts of alcohol. Encourage all patients to brush their teeth daily with a fluoride-containing toothpaste and to use dental floss each day.