Abstract

The aim of this study was to develop a Preventive Oral Health Exam for Elderly People (EDePAM), using the e-Delphitechnique, to diagnose oral health problems in people 65 or older. Thee-Delphi technique was used with experts in multiple stages, and in afinal workshop, where an agreement on an examination protocol wasreached for diagnosing dental caries, oral mucosa lesions, periodontaldiseases, and masticatory function disorders. Quantitative analyses ofall the rounds of the e-Delphi method were conducted. It was agreedthat the International Caries Detection and Assessment System (ICDAS)should be used together with a modified version of the Nyvad criteriato detect and assess caries lesions. It was also agreed that an assessmentwas needed of the different factors involved in determining caries risk,namely socioeconomic level, access to fluoride, level of dependence/functionality, salivary flow, history of head and neck cancer treatment,use of medications that decrease salivary flow, diet, use of removabledental prostheses, exposure of root surfaces, and caries history.Furthermore, patients would be required to undergo an examinationof the oral mucosa, where any existing lesion should be described interms of its clinical appearance, location, and risk potential. It was alsoagreed that an assessment of masticatory function should be performedusing the Leake index, together with chewing-gum combined with acolor scale to categorize masticatory performance. The number of pairsof occluding antagonist teeth was considered as the best predictor ofmasticatory function. The 2018 classification by the American Academyof Periodontology (AAP) / European Federation of Periodontology(EFP) was accepted as the standard to assess periodontal status, andit was agreed that this assessment should include an evaluation ofclinical attachment loss and bleeding on probing. The novel EDePAMwas considered as appropriate for conducting a functional assessmentof oral health by providing a comprehensive diagnosis of oral diseases