A Review of the Factors Associated with Periodontal Disease in the Elderly

  • Abdul Gani Soulissa Department of Periodontic, Faculty of Dentistry, Trisakti University, Indonesia


The world’s elderly population is growing faster than other age groups. The World Health Organization states that in 2020, Indonesia’s elderly population will reach 11.34% of the total population, or around 28.8 million people. The increasing number of elderly people can be a challenge for clinicians due to the degenerative changes caused by chronic diseases, treatment of chronic diseases, systemic conditions, and oral health care accessibility. The purpose of this study was to analyze the factors that increase the risk of periodontal disease in the elderly. Over the last few years, a lot of research has focused on identifying the relationship between periodontal disease and systemic disease as well as the link between periodontal disease and aging. Increased age relates directly and proportionally with increased prevalence and severity of periodontal disease. Furthermore, an increase in age causes a decrease in motoric function and an increase in comorbidities and their treatments in the elderly. The aging process causes cementum surface irregularities, inhibition of osteoblast activity, and reduction in the number of fibroblasts. Loss of attachment and alveolar bone resorption was affected by frequent exposure to other risk factors. The risk factors that influence the development of periodontal disease in the elderly include systemic diseases, such as diabetes mellitus and osteoporosis, systemic conditions, such as obesity, metabolic syndrome, and stress, treatment of systemic diseases, and limited access to oral health care. Although the potential link between periodontal disease and systemic disease has been established, the extent of this relationship has not yet been clearly explained. Understanding the factors that influence periodontal disease in the elderly is important because it may provide a better understanding of the treatment. The multiple risk factors that cause periodontal disease in elderly patients require special attention involving multidisciplinary teams.


Indonesia. Populasi lansia diperkirakan terus meningkat hingga tahun 2020 [Internet]. Jakarta: Kementrian Kesehatan RI; 2013. [cited 2019 August 8]. Available from: http://www.depkes.go.id/article/ view/13110002/populasi-lansia-diperkirakan-terus-meningkat-hingga-tahun-2020.html
Indonesia. Indonesia masuki periode aging population [Internet]. Jakarta: Kementrian Kesehatan RI; 2019 [cited 2019 August 12]. Available from: http://www.depkes.go.id/article/view/19070500004/indonesia-masuki-periode-aging-population.html
Zein RPS, Rachmadi P, Putri DKT. Tingkat kebutuhan perawatan periodontal pada lansia di Panti Sosial Tresna Werdha Budi Sejahtera Banjarbaru. Dentino Jurnal Kedokteran Gigi. 2014;2(2):189-195.
Permana FH, Made S, Imron R. Hubungan penurunan fungsi gerak lansia terhadap strategi koping stres lansia di Panti Jompo Welas Asih Kecamatan Singaparna Kabupaten Tasikmalaya. Jurnal Keperawatan Soedirman. 2009;4(3):125-130.
Sharma S, Manjit T, Gaurav M. Prevalence of dental caries and periodontal disease in the elderly of chandigarh – A hospital based study. J Indian Assoc. 2012;6(2):78-82.
Darby I. Periodontal considerations in older individuals. Aust Dent J. 2015;60:14-19.
World Health Organization. The WHO global oral health data bank [Internet]. Geneva: WHO; 2007 [cited on 2019 Augus 12]. Available from: http://www.who.int/oral_health.
Tang I. Clinical analysis of the aged with periodontitis community health. Guide Chin Med. 2012;36(4):185-186.
Petersen PE, Kandelman D, Arpin S, Ogawa H. Global oral health of older people. Community Dental Health. 2010;27(2):257-268.
Yang H, Xiao L, Zhang L, Deepa S, Ye G, Zhang X. Epidemic trend of periodontal disease in eldery Chinese population 1987-2015: a systematic review and meta-analysis. Sci Rep. 2017;7:1-11.
Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol 2000. 2013; 62(1):59-94.
Beikler T, Flemmig TF. Oral biofilm-associated diseases: Trends and implications for quality of life, systemic health and expenditures. Periodontol 2000. 2011;55:87-103.
Yu-Kang T, Gilthorpe MS. Comentary: Is tooth loss good or bad for general health? Int J Epidemiol. 2005;34:475-476.
Aljehani YA. Risk factors of periodontal disease: review of the literature [Internet]. Int J Dent. 2014;2014:182513.
Foltyn P. Ageing, dementian, and oral health. Australian Dental Journal. 2015;60(1):86-94.
Ettinger RL. Treatment planning concepts dor te ageing patient. Australian Dental Journal. 2015;60(1):71-85.
Nazir MA. Prevalence of periodontal disease, its association with systemic disease and prevention. Int J Health Sci. 2017;11(2):72-80.
International Diabetes Federation. Diabetes Atlas 4th Ed [Internet]. Brussel: International Diabetes Federation. 2009 [cited 2019 August 23]. Available from: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/21-atlas-4th-edition.html
Corbet EF, Leung WK. Epidemiology of periodontitis in the Asia and Oceania Regions. Periodontol 2000. 2011;56(1):25-64.
Boehm TK, Scannapieco SA. The Epidemiology, consequences and management of periodontal disease in older adults. J Am Dent Assoc. 2008;139(3):252-253.
Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus [Internet]. Cochrane Database of Systematic Reviews. 2015 [cited 2019 August 27]. Available from: https://www.cochrane library.com/cdsr/doi/10.1002/14651858.CD004714.pub3/epdf/full
Kyrgidis A, Tzellos TG, Toulis K, Antoniades K. The Facial Skeleton in Patients with Osteoporosis: A Field for Disease Signs and Treatment Complications [Internet]. J of Osteoporosis; 2011 [cited 2019 August 27]. Available from: https://www.hindawi.com/journals/jos/2011/147689/#B1
Tiossi R, Costa PP, Watanabe PCA. The Influence of Osteoporosis in Oral Health. In Osteoporosis: Risk Factors, Symptoms and Management. Pena AR, Perez VO (eds). Nova Science Publisher, Brazil. 2012, pp.1-32.
Razak PA, Richard KMJ, Thankachan RP, Hafiz KAA, Kumar KN, Sameer KM. Geriatric oral health: A review article. J Int Oral Health. 2014;6(6):110-116.
Bhardwaj A, Bhardwaj SV. Effect of menopause on women’s periodontium. J Midlife Health. 2012;3(1):5-9.
Silva RF, Sasso GRD, Cerri ES, Simoes MJ, Cerri PS. Biology of bone tissue: structure, function, and factors that influence bone cells [Internet]. Biomed Research Int. 2015. [cited 2019 August 16]. Available from: https://www.hindawi.com/journals/ bmri/2015/421746/
Salazar CR. The role of stress in periodontal disease progression in older adults. Postdoc Journal. 2013;1(11):15-26.
Dahiya P, Kamal R, Gupta R. Obesity, periodontal and general health : Relation and management. Indian J Endocrinol Metab. 2012;16(1):88-93.
Aboy, Soulissa AG. Perbedaan status periodontal antara obesitas dan non-obesitas. Jurnal Ilmiah Kedokteran Gigi Terpadu. 2017;3(2):70-73.
Paredes-Rodríguez VM, Torrijos-Gómez G, González-Serrano J, López-Pintor-Muñoz RM, López Bermejo M ángel, Hernández-Vallejo G. Quality of life and oral health in elderly. J Clin Exp Dent. 2016;8(5):590–596.
Holm-Pedersen P, Walls A, Ship J. Textbook of geriatric medicine. 3rd Ed. Oxford: Wiley Blackwell; 2015. p. 61-64.
Huttner EA, Machado DC, Oliveria RB, Antunes AGF, Hebling E. Efects of human aging on periodontal tissues. Spec Care Dentist. 2009;29(4):149-153.
Bhadbhade S. Aging and periodontium. Int J Dent Oral Sci. 2015;2(6):79-83.
Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, et al. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012;55(1):21-31.
Negrato CA, Tarzia O, Jovanovic L, Chinellato LEM. Periodontal disease and diabetes mellitus. J Appl Oral Sci. 2013;21(1):1-12.
Dharmawati IGAA, Raiyanti IGA. Hubungan antara faktor resiko (umur dan jenis kelamin) dengan kelainan jaringan periodontal pada penderita diabetes melitus yang berkunjung ke poliklinik penyakit dalam RSUD Sanjiwani Gianyar Tahun 2014. Jurnal Kesehatan Gigi. 2015;3(2):61-65.
Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: A two-way relationship. Annals of Periodontol. 1998; 3(1): 51-61.
Bersell CH. Access to Oral Health Care: A National Crisis and Call for Reform. J of Dental Hygiene. 2017; 91(1): 6-14.
Slack-Smith L, Lange A, Paley G, O’Grady M, French D, Short L. Oral health and access to dental care: a qualitative investigation among older people in the community. Gerodontology. 2010; 27(2): 104-113.
How to Cite
SOULISSA, Abdul Gani. A Review of the Factors Associated with Periodontal Disease in the Elderly. Journal of Indonesian Dental Association, [S.l.], v. 3, n. 1, p. 47-53, feb. 2020. ISSN 2621-6175. Available at: <http://jurnal.pdgi.or.id/index.php/jida/article/view/448>. Date accessed: 05 apr. 2020. doi: https://doi.org/10.32793/jida.v3i1.448.
Review Article