Impact of xerostomia and the use of dental prosthesis on the quality of life of elderly: a cross-sectional study

Aim: To evaluate the impact of xerostomia, edentulism, use of dental prosthesis, and presence of chronic diseases on quality of life in relation to oral health in institutionalized elderly individuals. Methods: This is a cross-sectional study. A questionnaire was administered containing the following instruments: Oral Health Impact Profile (OHIP-14), which measures the quality of life related to oral health; the Summated Xerostomia Inventory questionnaire (SXI-PL) for evaluation of xerostomia, sociodemographic data, clinical description, and patient-reported factors was assessed (edentulism, use of dental prostheses, and chronic diseases). Results: Most elderly individuals did not have any teeth in their mouths and used dental prosthesis. The impact on quality of life, considering the mean of the OHIP-14 scores, was positive in 58.3% of the elderly. Those who used a dental prosthesis were three times more likely to have their oral health negatively impacted (OR=3.09; 95%CI =1.17 8.11), compared to those who did not use, and individuals with xerostomia were more likely to have their oral health negatively impacted (OR=1.57; 95%CI=1.25-1.98) compared to those without xerostomia. There was no difference in the quality of life of individuals with and without chronic diseases. Conclusions: The feeling of dry mouth and use of dental prostheses negatively impacted the quality of life in relation to oral health of the elderly

Principales factores biopsíquicos relacionados con la rehabilitación protésica dental en ancianos institucionalizados / Main biopsychic factors related to the dental prosthetics rehabilitation in institutionalized elderly

Introducción: El envejecimiento constituye la transformación demográfica más importante del mundo actual. La mayor proporción de personas de edad avanzada en la comunidad supone un reto de extraordinaria trascendencia en cuanto a la satisfacción de sus demandas sociales, sanitarias, económicas y culturales. Objetivo: Determinar los factores biopsíquicos relacionados con la rehabilitación protésica dental en ancianos. Métodos: Se realizó un estudio descriptivo y transversal de 60 ancianos pertenecientes a la Casa de Abuelos "Corazones contentos" del reparto Sueño -categorizados en adaptados y resistentes según factores psicológicos-, quienes acudieron al Departamento de Prótesis de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, desde marzo del 2018 hasta enero de 2020. Resultados: En la serie primaron los pacientes de 80 y más años de edad y del sexo femenino. Como característica biológica relevante figuró el desdentamiento total y como enfermedad crónica no trasmisible fue más frecuente la diabetes mellitus. De igual modo, el mayor número de ancianos correspondió a la categoría psicológica de resistente. Conclusiones: La mayoría de los ancianos se caracterizaron por un perfil psicológico resistente, determinado por un estilo de afrontamiento pasivo, expresión emocional negativa e inexistencia de autonomía, lo que condicionaba una actitud dañina hacia su salud bucal.

Introduction: Aging constitutes the most important demographic transformation nowadays. The higher proportion of elderly in the community supposes a challenge of extraordinary transcendence as for the satisfaction of their social, sanitary, economic and cultural demands. Objective: To determine the biopsychic factors related to the dental prosthetics rehabilitation in elderly. Methods: A descriptive and cross-sectional study of 60 elderly was carried out in "Corazones contentos" Home for the elderly at Sueño neighborhood -categorized in adapted and resistant according to psychological factors- who went to the Prosthesis Department of Mártires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba, from March, 2018 to January, 2020. Results: In the series there was prevalence of 80 years and over patients from the female sex. As outstanding biological characteristic there is the total dental loss and as chronic non transmissible disease the diabetes mellitus was more frequent. In a same way, the higher number of elderly corresponded to the psychological category of resistant. Conclusions: Most of the elderly are characterized by a resistant psychological profile, determined by a style of passive confrontation, negative emotional expression and lack of autonomy, what conditioned a harmful attitude toward their oral health.

Sense of coherence and impact of oral health on quality of life in adults and elderly in Southern Brazil / Senso de coerência e impacto da saúde bucal na qualidade de vida em adultos e idosos do sul do Brasil

Abstract This cross-sectional study aimed to investigate the association between the Sense of Coherence and impact of oral health on the quality of life. Was conducted with a sample of 720 individuals of both sexes, between the ages of 50 and 74 years, selected through multistage proportional random sampling. The data collection instruments used were: short version of the Sense of Coherence Scale (SOC-13), Oral Impacts on Daily Performances (OIDP) questionnaire, oral clinical examination and questionnaire containing socio demographic and use of dental services information. Bivariate and multivariate analyses were performed through Poisson regression adjusted for robust variance, with level of significance p < 0.05. Oral impacts were reported by 416 participants (57.8%). In the adjusted model, those with strong SOC were more likely of not having any impact when compared with individuals with weak SOC (PR=1.30). Need for dental prosthesis was also associated with the outcome, individuals who did not require prosthesis had less impact (PR=1.50). The findings showed that SOC is associated with OIDP, supporting the hypothesis that individuals with strong SOC present a lower impact of oral health on the quality of life, suggesting that SOC is a determinant that can provide protection against that impact.

Resumo Este estudo transversal objetivou investigar a associação entre Senso de Coerência (SOC) e o impacto da saúde bucal na qualidade de vida. Foi realizado com uma amostra de 720 indivíduos de ambos os sexos, com idade entre 50 e 74 anos, selecionados por amostragem aleatória proporcional em múltiplos estágios. Os instrumentos de coleta de dados foram: versão curta da Sense of Coherence Scale, questionário Oral Impact on Daily Performance (OIDP), exame clínico bucal e questionário sociodemográfico e de uso de serviços odontológicos. As análises bivariadas e multivariadas foram realizadas por regressão de Poisson ajustada para variância robusta, com nível de significância p < 0,05. O impacto da saúde bucal foi relatado por 416 participantes (57,8%). No modelo ajustado, aqueles com SOC forte foram mais propensos a não ter nenhum impacto, comparados aos indivíduos com SOC fraco (PR=1,30). A necessidade de prótese dentária também foi associada ao desfecho e os indivíduos que não necessitavam prótese tiveram menor impacto (PR=1,50). Os resultados mostraram que o SOC está associado ao OIDP, apoiando a hipótese de que os indivíduos com SOC forte apresentam menor impacto da saúde bucal na qualidade de vida, sugerindo que o SOC é um determinante que pode proporcionar proteção contra esse impacto.

Impact on the Quality of Life of Older Adults Who Use Inadequate Dental Prostheses: A Cross-Sectional Study

Abstract Objective: To investigate the impact of inadequate prostheses on older adult's quality of life at the Integrated Health Center for Older Adults in the northeastern city of Brazil. Material and Methods: A cross-sectional study involving 147 older adults aged 60-90 years old in João Pessoa, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and gender) and clinical dental measures (use of inadequate upper and/or lower dental prosthesis) and Oral Health Impact Profile (OHIP-14 Questionnaire). The Pearson Chi-square and Fisher's exact tests were used to evaluate the association between the OHIP-14 dimensions and the use of unsatisfactory prostheses (p<0.05). Results: The sample consisted of 90.5% of women being a mean age of 69.86 (± 6.60) years. Individuals with inadequate prostheses had a higher impact on quality of life, with a predominant prevalence ratio for developing physical pain (PRR = 3.52; CI = 4.69-2.65), psychological discomfort (PRR = 5.0; CI = 5.85-4.26) and psychological inability (PRR = 1.71; CI = 2.56-1.14). Conclusion: The use of inadequate prostheses had a negative impact on the quality of life of the older adult population. Therefore, services, which provide health care for older adults, should overcome this reality by providing broad access to oral rehabilitation that is appropriate to the needs of each individual.

Impact of seniors centers on oral health-related quality of life of older adults

ABSTRACT OBJECTIVE This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC). METHODS Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics—Sense of Coherence (SOC), anxiety and depression using HADS, happiness—, and oral clinical evaluation—use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05). RESULTS In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0-4.2) for older adults who did not participate in SC. CONCLUSION Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.

Autopercepção das condições alimentares de idosos usuários de prótese dentária / Autoperception of food conditions of elderly dental prosthetic users

RESUMO Objetivo Avaliar a autopercepção das condições alimentares de idosos usuários de prótese dentária, verificando sua interferência na alimentação. Método Participaram 60 idosos com idade entre 60 e 88 anos, usuários de prótese dentária total ou parcial, que frequentam assiduamente o Centro de Convivência Nair Ventorin Gurgacz - FAG em Cascavel, Paraná. Todos os indivíduos responderam a um questionário de identificação e ao protocolo Índice de Determinação da Saúde Bucal Geriátrica (GOHAI). Resultados Os idosos do estudo, maioria mulheres e usuários de prótese removível bimaxilar com mais de 30 anos, classificam sua alimentação como "boa" e não possuem preferência por consistência alimentar, embora frequentemente sintam dor ao mastigar os alimentos. A média pontuada no protocolo GOHAI foi classificada como "ruim" e o maior prejuízo dos idosos ocorreu no domínio físico, que engloba questões relacionadas à mastigação, deglutição e fala. Não foram constatadas relações entre o tempo de utilização da prótese dentária com a idade e os escores do GOHAI. Conclusão Embora os idosos raramente tenham queixa sobre o modo de se alimentar, referindo desconforto ou constrangimento, apresentam uma média abaixo do esperado no protocolo, indicando que, ainda que não relatem, muitas modificações podem estar acontecendo, gradativamente, e que soam como naturais, gerando prejuízos à qualidade de vida em alimentação do idoso.

ABSTRACT Purpose To evaluate the self-perception of the food conditions of elderly users of dental prosthesis, in order to verify the interference that dental prosthesis has in their feeding. Methods The present study counted with 60 elderly, participants of the Centro de Convivência Nair Ventorin Gurgacz (Community Center), aged between 60 and 88 years old. All participants answered to a questionnaire elaborated by the researchers and the Geriatric Oral Health Assessment Index (GOHAI). Results The elderly who participated in this study, mostly women, used a bimaxillary removable prosthesis for over 30 years; although they classified their nutrition as "good" and did not present preference for specific food consistency, they frequently felt pain while chewing. The average score of the GOHAI was 29.73, considered "low", the index dimension with worst score was physical function, that includes eating, speaking and swallowing. No relation was observed between time of use of dental prosthesis, age and the GOHAI scores. Conclusion The elderly rarely complaint about discomfort or embarrassment on feeding, however, they present an average lower than expected in the GOHAI index, which indicates that, although they do not report it, many deteriorations, that seem to be natural may be happening and may be the cause of worst quality of life.

Fatores associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros / Factors behind self-perceived need for dental treatment and prosthesis in Brazilian elderly people

Resumo Este estudo teve como objetivo identificar fatores individuais e contextuais associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros. Foram utilizados dados secundários de 7.619 indivíduos idosos do levantamento epidemiológico SB Brasil 2010. As associações entre as variáveis dependentes e os fatores individuais e contextuais foram estimadas através da razão de chances (odds ratio - OR) e intervalo de confiança de 95%, obtidas por regressão logística multinível. Dos idosos avaliados pelo SB Brasil 2010, 3.848 (50,5%) afirmaram necessitar de tratamento odontológico e 4.236 (55,6%) acreditavam necessitar de prótese. Os resultados da regressão logística multinível mostraram que sexo, cor da pele autorreferida, renda e cobertura pelas equipes de saúde bucal na Estratégia de Saúde da Família estiveram associados à autopercepção. O presente trabalho evidenciou maior influência de fatores individuais na autopercepção da necessidade de tratamento odontológico e de prótese entre idosos brasileiros. Essas informações podem auxiliar na identificação de desigualdades que afetam essa parcela da população e na definição de prioridades para o planejamento dos serviços de saúde.

Abstract The scope of this study was to identify individual and contextual factors associated with the self-perceived need for dental treatment and for prostheses among elderly Brazilians. An analysis was performed with data from the SB Brazil 2010 epidemiological survey conducted by the Ministry of Health with a sample of 7,619 elderly individuals. Multilevel logistic regression models of mixed random and fixed effects were used to the estimate odds ratio (OR) with 95% confidence interval (95% CI) between the dependent variables and individual and contextual factors. Of the individuals assessed, 3,848 (50.5%) reported a need for dental treatment and 4,236 (55.6%) believed they have the need for prostheses. The results of multilevel logistic regression showed that gender, self-reported skin color, income and coverage by the oral health teams in the Family Health Program were associated with self-perception. This study revealed a greater influence of individual factors on the self-perceived need for dental treatment and prostheses by elderly Brazilians. This information can help to identify the inequalities that affect this population group and in setting priorities for the planning of health services.

Saúde bucal em usuários da atenção primária: análise qualitativa da autopercepção relacionada ao uso e necessidade de prótese dentária / Oral health in primary care users: qualitative analysis of self-perceived associated to use and need of dental prosthesis

Resumo Este estudo de caso de abordagem qualitativa propôs-se a analisar a autopercepção da saúde bucal em usuários da Atenção Primária de Porto Alegre que usam e/ou necessitam de prótese dentária. A coleta de dados aconteceu por meio da análise de prontuários odontológicos, diários de campo e entrevistas domiciliares semiestruturadas com 70 usuários do serviço de saúde nas faixas etárias de 15 a 19, 35 a 44 e 65 a 74 anos, que usam e/ou necessitam de prótese dentária (amostra intencional por saturação). Os relatos das entrevistas foram interpretados pela análise de conteúdo de Bardin com o apoio do software ATLAS.ti. A autopercepção positiva de saúde bucal foi percebida por adultos e idosos usuários de próteses bem adaptadas, que não machucavam a boca e não interferiam na mastigação, na fala e na comunicação. Houve grande valorização do uso de próteses pela possibilidade da reabilitação bucal. O desejo do uso de próteses esbarrou em seu alto custo e no acesso limitado a tal procedimento no serviço público do município. Essas informações permitem a análise do significado da saúde bucal para os usuários do Sistema Único de Saúde, podendo ser utilizadas como uma ferramenta de avaliação complementar da necessidade de tratamento odontológico.

Abstract This qualitative study aimed to perceive the self-perception of oral health in users of Primary Care in Porto Alegre who use and/or need dental prosthesis. Data collection performed by odontology records analysis, field diaries and semi-structured home interviews with 70 health service users in age groups 15-19, 35-44 and 65-74 years who use and/or need dental prosthesis (intentional sample saturation). The reports of interviews were interpreted by Bardin thematic content analysis and ATLAS.ti software to support. The positive self-perception of oral health was perceived by adults and elderly who use well-fitting dental prosthesis that do not hurt the mouth and did not interfere in chewing, speech and communication. There was great appreciation of the use dental prosthesis for the possibility of oral rehabilitation. The desire of using dental prosthesis bumped in their high cost and limited access in the public service of the municipality. This information allows the analysis of the significance of oral health to Unified Health System users and can be used as a tool assessment need for dental treatment.

Validade e utilidade da autopercepção de necessidade de tratamento odontológico por adultos e idosos / Validity and utility of self-perceived need for dental treatment by adults and elderly / Validez y utilidad de la auto-percepción respecto a la necesidad del tratamiento dental en adultos y ancianos

O objetivo deste trabalho foi determinar a validade das medidas de autopercepção como indicador de necessidades de tratamentos odontológicos em adultos e idosos. A amostra foi composta por indivíduos que participaram da Pesquisa Nacional de Saúde Bucal e da Pesquisa sobre as Condições de Saúde Bucal da População Mineira. A autopercepção da necessidade de tratamento dentário e de prótese total foi comparada com a necessidade determinada a partir do exame odontológico, considerado padrão-ouro. A qualidade das medidas foi avaliada por meio da sensibilidade, da especificidade e de valores preditivos. A sensibilidade variou de 51% a 90%, enquanto a especificidade ficou entre 56% e 90%. Os valores preditivos positivos foram de 11% a 95%, e os negativos, de 23% a 99%. A autopercepção de necessidade de tratamento dentário em adultos e de necessidade de próteses totais em idosos apresentou valores aceitáveis de validade. Por outro lado, a autopercepção da necessidade de tratamento por idosos e da necessidade de próteses totais por adultos não foi considerada útil devido a seu baixo desempenho.

This study aimed to determine the validity of self-rated measures as an indicator of dental treatment needs in adults and the elderly. The sample consisted of individuals that participated in the National Oral Health Survey and the Survey on Oral Health Conditions in Minas Gerais State. Self-rated needs for dental treatment and total prostheses were compared to need based on dental examination, defined as the gold standard. The quality of measures was assessed by sensitivity, specificity, and predictive values. Sensitivity varied from 51% to 90%, and specificity from 56% to 90%. Positive predictive values were 11% to 95% and negative predictive values were 23% to 99%. Self-rated need for dental treatment in adults and for total prostheses in the elderly showed acceptable validity. Meanwhile, self-rated need for dental treatment in the elderly and for total prostheses in adults were not considered useful, due to their low performance.

El objetivo de este estudio fue determinar la validez de las medidas de autopercepción como un indicador de necesidades de tratamiento dental en adultos y ancianos. La muestra se compone de personas que participaron en la Encuesta Nacional de Salud Oral y la investigación sobre el estado de salud oral de la población de Minas Gerais. Se evaluó la necesidad autopercibida para tratamiento dental y dentaduras. Estos fueron comparados con la necesidad evaluada en un examen dental, considerado el estándar de oro. La calidad de las medidas se evaluó por la sensibilidad, especificidad y valores predictivos. La sensibilidad varió de un 51% a un 90% y la especificidad de un 56% a un 90%. Los valores predictivos positivos fueron de un 11% a un 95% y los negativos de un 23% a un 99%. La autopercepción de necesidad de tratamiento dental en adultos y necesidad de dentaduras en ancianos mostraron niveles aceptables de validez. Por otro lado, la autopercepción de la necesidad de tratamiento dental de los ancianos y la necesidad de prótesis dentales para adultos no se consideraron útiles, debido a su bajo rendimiento.

Trends, awareness, and attitudes of patients towards replacement of missing teeth at University College of Dentistry

This study was carried out among the out patients seen in the University College of Dentistry [UCD] with the aim to assess their trends and attitudes towards tooth replacement. Patients with at least one missing tooth [excluding the third molars] were included. The study was conducted using a questionnaire. Majority of the patients [n=180] did not have previous experience of any sort of prosthesis. Although most of the patients preferred to have fixed partial denture [n=195] some of them responded that they would be comfortable with removable partial denture [n=33]. Low felt need was the most common reason among this study group for delay in seeking dental replacement, while 5% patients were in the post extraction healing period. Dentists were found to be the most important d riving force for patient awareness regarding replacement of teeth. Majority of the patients agreed that dental visits should be regular. Some patients [8.8%] did not appreciate the importance of restoring teeth while 62.5% of the patients had the perception that artificial teeth were not equivalent to natural teeth

Association between self-rated oral appearance and the need for dental prostheses among elderly Brazilians

We investigated the association between poor self-rated oral appearance and the need for dental prostheses among elderly Brazilians. National data from an epidemiological survey on oral health in Brazil conducted from 2002 to 2003 by the Ministry of Health (SB, Brazil) with a multistage random sample of 4,839 individuals aged 65–74 years in 250 towns were analyzed. The dependent variable was self-rated oral appearance, dichotomized into “poor” (poor∕very poor) and “good” (fair∕good∕very good). The main independent variable was the need for an upper or lower dental prosthesis. Other variables included sociodemographic characteristics, approach to dental care, oral health conditions, and self-reported oral disadvantage. Data were analyzed using the chi-square test and Poisson regression models at a 95% significance level. The prevalence of poor self-rated oral appearance was 20.6% and was higher in the elderly who needed a partial or complete upper or lower prosthesis, independent of other variables. This prevalence was associated with age, the use of dental services, access to information about oral disease prevention, number of decayed teeth, self-perception of the need for treatment, dental pain, chewing ability, and the perception that oral health affects relationships with other people. The elderly who needed dental prostheses had a higher prevalence of poor self-rated oral appearance than those who did not need any.

Factors related to poor self-perceived oral health among community-dwelling elderly individuals in São Paulo, Brazil / Fatores associados à autopercepção de saúde bucal ruim entre idosos não institucionalizados do Município de São Paulo, Brasil

The present study investigated the prevalence of poor self-perceived oral health and its association with oral health, general health and socioeconomic factors among elderly individuals from São Paulo, Brazil. The sample consisted of 871 elderly individuals enrolled in the Health, Wellbeing and Aging cohort study. Self-perceived oral health was measured by the question: "How would you rate your oral health?". Most subjects self-rated their oral health as good. Among dentate individuals, poor oral health was related to depression, poor self-rated health, dental treatment, dental checkups and the psychosocial subscale scores of the Geriatric Oral Health Assessment Index. Edentulous individuals were more likely to report poor oral health, whereas those with higher psychosocial scores were less likely to report poor self-rated oral health. Poor self-rated oral health is associated with general health factors and the psychosocial impact of oral health on quality of life, regardless of socioeconomic and clinical health measures.

Este estudo avaliou a prevalência de autopercepção de saúde bucal como ruim em idosos de São Paulo, Brasil, e investigou sua relação com a saúde bucal, saúde geral e fatores socioeconômicos. A amostra foi composta por 871 idosos do estudo de coorte Saúde, Bem-Estar e Envelhecimento. A autopercepção da saúde bucal foi medida pela pergunta: "Como você classifica a sua saúde bucal?". A maioria dos idosos apresentou autoavaliação de saúde bucal boa. A autopercepção de saúde bucal como ruim, entre indivíduos dentados, foi relacionada à depressão, autoavaliação de saúde ruim, check-up odontológico, tratamento dentário e dimensão psicossocial do Geriatric Oral Health Assessment Index. Desdentados com autoavaliação de saúde ruim apresentaram maior probabilidade de relatar saúde bucal ruim, enquanto aqueles com maior pontuação na dimensão psicossocial tiveram menor chance de autoavaliação ruim. A autoavaliação de saúde bucal ruim foi associada com fatores de saúde geral e com o impacto psicossocial da saúde bucal na qualidade de vida, independentemente de medidas socioeconômicas e clínicas de saúde bucal.

Qualidade de vida em deglutição em idosos saudáveis / Quality of life in swallowing in healthy elderly

OBJETIVO: Conhecer a autopercepção de idosos saudáveis frente às possíveis dificuldades de deglutição. MÉTODOS: Participaram 104 idosos, 62 mulheres e 42 homens, com idades entre 60 e 88 anos, que autorreferiram bom estado de saúde geral, sem histórico de doenças degenerativas, neurológicas ou quaisquer outros acometimentos que pudessem influenciar na deglutição. Todos passaram por rastreios cognitivo e emocional e apresentaram condições satisfatórias em ambos. Foi aplicado um questionário para levantamento de dados gerais e de saúde, e o protocolo SWAL-QOL. Os dados foram analisados estatisticamente. RESULTADOS: A maior parte dos domínios do SWAL-QOL apresentou médias próximas ao valor máximo possível (100 pontos), indicando autopercepção positiva dos idosos quanto à qualidade de vida em deglutição. Idosos usuários de prótese dentária apresentaram melhores índices na maior parte dos domínios, quando comparados aos não usuários. Indivíduos que autorreferiram prótese mal adaptada obtiveram menores escores nos domínios deglutição como um fardo, duração da alimentação e frequência de sintomas. Homens e mulheres diferenciaram-se apenas nos domínios "Sono" e "Fadiga", em que mulheres apresentaram médias inferiores. Não houve correlação entre os escores obtidos no SWAL-QOL e as variáveis idade e renda. CONCLUSÃO: Idosos saudáveis, em geral, não autorreferem alterações significativas quanto à qualidade de vida em deglutição. Além disso, não há redução da qualidade de vida em deglutição à medida que há o avanço da idade. A prótese dentária, quando bem adaptada, minimiza prejuízos referentes à deglutição.

PURPOSE: To understand the self-perception of healthy elderly regarding possible swallowing difficulties. METHODS: Participants were 104 seniors, 62 women and 42 men, ranging in age from 60 to 88 years (mean 70.6), who reported good general health, no history of degenerative diseases, neurological or any other diseases that could influence swallowing participated. All subjects underwent cognitive and emotional screening and presented satisfactory conditions for both. A questionnaire to gather general and health information, and the protocol SWAL-QOL were applied. The data were statistically analyzed. RESULTS: Most domains of the SWAL-QOL showed mean numbers close to the maximum score (100 points), indicating a positive perception of the elderly about quality of life related to swallowing. Individuals with dentures showed better rates in most domains when compared to non-users. Individuals who self-reported ill-fitting dentures had lower scores for the domains "burden", "eating duration" and "frequency of symptoms". Men and women differed only in the domains "sleep" and "fatigue", for which women had lower mean scores. There was no correlation between the SWAL-QOL scores obtained and the variables age and monthly income. CONCLUSION: Healthy elderly, in general, do not self-report significant changes in the quality of life related to swallowing. Moreover, there is no reduction of quality of life related to swallowing as age advances. Well-adjusted dentures minimize impairment related to swallowing.

Factores asociados al uso de prótesis dentales o a problemas reportados en dientes o encías con uso de prótesis orales en adultos mayores de origen México Americanos / Associated factors with the use of dentures or reported dental and gum problems

El objetivo de este estudio fue determinar los factores asociados al uso de prótesis dentales o a problemas orales en dientes o encías al usar las prótesis dentales en adultos mayores de origen México Americanos del estudio EPESE (Established Populations for Epidemiologic Studies of the Elderly) hispano en los Estados Unidos. Se hizo un análisis transversal incluyendo 2992 hombres y mujeres de 65 años o mas entrevistados durante 1993-1994. El 44% de los ancianos reportaron el uso de prótesis dentales parciales o totales. Dentro de las personas que usan prótesis dentales, el 21% reportaron problemas orales con los dientes o las encías al comer. En análisis multivariados, las limitaciones en actividades instrumentales de vida diaria (AIVD) (odds ratios=OR 1.23, intervalo de confianza=IC 95% 1.04-1.45) estuvieron asociados con el uso de las prótesis orales. También, dentro de las personas que usan prótesis dentales, los síntomas depresivos aumentados (OR 1.42, IC 95% 1.04-1.95) y las limitaciones funcionales en AIVD (OR 1.58, IC 95% 1.15-2.17) estuvieron asociados a problemas orales con los dientes o las encías al comer. En conclusión, factores que usualmente afectan la calidad de vida en los adultos mayores, tales como la dependencia funcional y la depresión, están asociados al uso de prótesis dentales o a problemas orales en dientes o encías al usar las prótesis dentales.

The objective of this study was to determine factors associated with using dental prosthesis or oral problems related to their use among older Mexican Americans of the Hispanic Established Populations for Epidemiologic Studies of the Elderly EPESE) in the United States. A cross-sectional analysis was made with data of 2992 men and women aged 65 years and older interviewed during 1993-1994. Forty four % of subjects reported the use of partial or total dental prosthesis. Among those using dental prosthesis, 21% reported problems with teeth or gums when eating. In multivariate analyses, instrumental activities of daily living (IADL) limitations were associated with using dental prosthesis (OR = 1.23, 95% confidence interval - CI = 1.04-1.45). Also, among subjects using dental prosthesis, increased depressive symptoms (OR = 1.42, 95% CI 1.04-1.95) and IADL limitations (OR = 1.58, 95% CI 1.15-2.17) were associated with problems with teeth or gums when eating. In conclusion, factors usually affecting quality of life in older persons such as functional dependency and depression are associated with using dental prosthesis or oral problems with teeth or gums when eating.

Dental esthetic satisfaction, received and desired dental treatments for improvement of esthetics.

Aim: The purposes of this research were to investigate factors influencing patients' satisfaction with their present dental esthetic, received previous dental treatments on anterior teeth and basic treatments that they wanted to undergo to improve their dental appearance. Materials and Methods: A total of 1014 patients who attended a dental school in a major city in Turkey participated in the study. The participants were surveyed with a questionnaire containing questions about gender, age, education level, self-reported tooth appearance, received previous dental treatments on anterior teeth and desired basic esthetic dental treatments. Statistical analysis of the verifying data was made with descriptive statistics, χ2 test and multiple logistic regression analyses. Results: According to the analyses of the verifying data, 55.1% of the patients were dissatisfied with the color of their teeth, 42.7% with dental appearance, 29.9% with crowding of anterior teeth, 23.3% were hiding teeth while smiling, 16.1% had non-esthetic restorations and 11.9% thought that their anterior teeth were protruding. Esthetic restoration was found to be the most-performed treatment recently (29.0%) and whitening of teeth was the most-desired dental treatment (49.0%). Gender, age and education level had an effect on satisfaction and received previous and desired dental treatments for improvement of esthetics. Conclusion: Many of the Turkish patients surveyed in the study were dissatisfied and desired the improvement of dental esthetics. Therefore, dentists should consider this as an important dimension in their practice.

Impacto da prótese dentária total removível na qualidade de vida de idosos em Grupos de convivência de Belo Horizonte- MG / The impact of removable complete dental prostheses on the quality of life among individuals in elderly support Groups in the city of Belo Horizonte- MG, Brasil

Resultados de um recente estudo epidemiológico nacional de saúde bucal revelaram um alto percentual de idosos edêntulos, muitos destes, necessitando de reabilitação protética. O objetivo deste estudo foi avaliar o impacto da reabilitação com próteses totais removíveis na qualidade de vida de idosos, independentes, que participavam de atividades sociais. O universo de estudo foi constituído por idosos que participavam dos Grupos de Convivência conveniados com a Prefeitura de Belo Horizonte (Brasil) em 2004. O cálculo amostral foi feito pelo método de proporção (intervalo de confiança de 95%, erro a de 0,05 e um percentual de impacto de 80%). Depois de ajustado para uma população finita, o tamanho da amostra foi determinado em 245 indivíduos (n=245), proporcionalmente dividido pelas 9 regionais administrativas da cidade...

Results from a recent national epidemiological survey regarding oral health reveal high percentages of elderly with missing teeth, many of whom require prosthetic rehabilitation. The aim of the present study was to assess the impact of removable complete prosthesis rehabilitation on the quality of life of independent elderly individuals who participate in social activities. The present study’s sample was made up of elderly individuals who participated in support Groups sponsored by the City of Belo Horizonte (Brazil) in 2004. The sample calculation was determined by the proportion method (a 95% confidence interval, a α error of 0.05, and an 80% impact proportion). After adjusting to a finite population, the sample size was determined at n = 245, proportionately distributed among the nine administrative districts of the city. Individuals were interviewed at the location of the support Group meetings by a single researcher using the Geriatric Oral Health Assessment Index (GOHAI)...

Patients' self-perceived impacts and prosthodontic needs at the time and after tooth loss

Studies on self-perception have demonstrated that tooth loss is associated with esthetic, functional, psychological and social impacts for individuals. However, not all subjects seek treatment immediately after tooth loss, even when desire for replacement is strongly expressed. The aim of this study was to evaluate the perception of patients submitted to tooth extraction about factors associated with tooth loss and prosthodontic treatment, at the time and after extraction. A convenience sample of 211 consecutive patients were clinically evaluated and answered to a questionnaire about perceived impacts and prosthodontic treatment needs. Data were collected at the time of extraction and after a 3-month time interval. Perceived impacts were high (21 to 76 percent at the time and 35 to 87 percent after extraction). From 72.5 percent patients who expressed intention of immediate replacement of edentulous spaces, only 8.1 percent had actually been treated. Financial limitation was considered the most important factor that restricted access to treatment. Bivariate statistical analysis showed association between immediate dental replacement and anterior tooth loss (p=0.00) and extension of edentulous space (p=0.01). Position of lost teeth was associated to perceived functional limitation (p=0.03). Worsened appearance was associated to tooth loss in the maxillary arch (p=0.02), and desire of prosthodontic treatment was associated to the extension of edentulous space (p=0.05). Perceived impacts were more frequent in women than men. It was concluded that although patients usually expressed prosthodontic treatment needs, clinical and financial issues are determinant factors for tooth replacement.

Estudos de autopercepção têm demonstrado que a ausência de dentes pode resultar em impactos estéticos, funcionais, psicológicos e sociais, embora nem todos os indivíduos demandam por tratamento protético imediato após a perda dentária. O objetivo do estudo foi avaliar a percepção de pacientes submetidos a exodontia em relação a fatores associados à perda e ao tratamento protético, no momento e após a perda dos dentes. Uma amostra de conveniência de 211 pacientes consecutivos foi avaliada quanto à condição clínica, autopercepção dos impactos orais e necessidade de tratamento, por meio de exame clínico e questionário, no momento e após 3 meses da exodontia. A percepção de impactos da perda dentária foi alta (21-76 por cento no momento e 35-87 por cento após a exodontia). Dos 72,5 por cento pacientes que relataram pretender a reposição protética imediata apenas 8,1 por cento realizaram o tratamento. A motivação financeira foi relatada como o maior impedimento para o tratamento. A análise univariada mostrou associação entre reposição imediata e localização anterior da perda (p=0,00) e extensão do espaço desdentado (p=0,01), entre localização da perda e limitação funcional percebida (p=0,03). O incômodo com a aparência foi relacionado à localização da perda no arco superior (p=0,02), o desejo por tratamento protético foi relacionado à extensão do espaço desdentado (p=0,05). Na maioria dos aspectos avaliados a percepção de problemas associados à perda foi maior no sexo feminino. Conclui-se que, embora a necessidade percebida de tratamento protético seja alta, fatores clínicos e sócio-econômicos são determinantes para a realização do tratamento.

Impact of oral health on quality of life among the elderly population of Joaçaba, Santa Catarina, Brazil

O objetivo do presente estudo foi investigar o impacto da condição bucal na qualidade de vida dos idosos do município de Joaçaba - SC. Foi estudada a população de idosos que participa dos grupos da terceira idade a partir de amostra sistemática por conglomerados de 183 idosos. Foi realizado um levantamento epidemiológico utilizando os critérios de diagnóstico da OMS (Organização Mundial da Saúde) (1997) para verificar a condição bucal dos participantes (uso e necessidades de prótese). Foi aplicado o OHIP (Oral Health Impact Profile) para verificar o impacto da condição bucal na qualidade de vida. Para verificar a desigualdade social, foram utilizados critério Abipeme (Associação Brasileira dos Institutos de Pesquisa de Mercado), grau de escolaridade e número de pessoas que moram no domicílio. A maioria dos participantes era do sexo feminino (82%), e a média do OHIP foi de 10,35. Não se observou correlação entre OHIP e grau de escolaridade e OHIP e número de moradores por domicílio. Verificou-se correlação de 0,240 (p = 0,001) entre OHIP e Abipeme. A média do OHIP para as pessoas que não usavam prótese superior foi de 12,48 e, para os que usavam, 9,81 (p = 0,399). O OHIP médio para os que necessitavam de prótese superior foi de 13,00 e 8,88 para os que não necessitavam (p = 0,014). Foi verificada a mesma tendência para uso e necessidades de próteses inferior. Concluiu-se que a necessidade de prótese total, tanto superior quanto inferior, mostrou relação com o impacto na qualidade de vida.