Oral health conditions of institutionalized older adults and associated factors / Condições de saúde bucal de idosos institucionalizados e seus fatores associados

INTRODUCTION: The growth of the Brazilian older adult population has influenced the increased demand for institutionalization for this public, which usually has poor oral health conditions such as edentulism. OBJECTIVE: To characterize the oral health conditions and verify the variables related to the edentulism of institutionalized older adults and verify the relation of the time of institutionalization with oral health. METHODS: It was a cross-sectional study conducted with 512 institutionalized older adults in which the sociodemographic profile, general health conditions, and oral health care and conditions were evaluated by clinical exams, consultations of medical records, and structured questionnaires. The data were analyzed in the Statistical Package for Social Sciences using the Pearson Chi-square and Fisher's Exact tests and a logistic regression model using a 95% confidence level. RESULTS: A high DMFT (29.4), high prevalence of complete edentulism (61.3%), high need for maxillary (73.6%), and mandibular oral rehabilitation (56.8%) were observed. Edentulism was associated with older age (p<0.001), lower schooling (p<0.001) and non-retirement (p=0.031). It was found that longer institutionalization time remained associated with edentulism even when adjusted by sociodemographic and general health variables (p=0.013). It was also associated with the absence of brushing (p=0.024) and a lower frequency of tooth, gum, and prosthesis brushing (p<0.001). CONCLUSION: It is suggested to establish oral health care routines within long-term institutions for the effective maintenance of oral health throughout the institutionalization time.

INTRODUÇÃO: O crescimento da população idosa brasileira tem influenciado no aumento da procura por institucionalização para esse público, que costuma apresentar precárias condições de saúde bucal como o edentulismo. OBJETIVO: Caracterizar as condições de saúde bucal e verificar as variáveis relacionadas ao edentulismo de idosos institucionalizados, além verificar a relação do tempo de institucionalização com a saúde bucal. MÉTODOS: Trata-se de um estudo transversal realizado com 512 idosos institucionalizados em que o perfil sociodemográfico, as condições gerais de saúde e os cuidados e condições de saúde bucal foram avaliados por meio de exames clínicos, consultas a prontuários e questionários estruturados. Os dados foram analisados no Statistical Package for the Social Sciences por meio dos testes Qui-quadrado de Pearson e Exato de Fisher e um modelo de regressão logística com nível de confiança de 95%. RESULTADOS: Observou-se alto CPOD (29,4), alta prevalência de edentulismo total (61,3%), alta necessidade de reabilitação oral maxilar (73,6%) e mandibular (56,8%). O edentulismo esteve associado a maior idade (p<0,001), menor escolaridade (p<0,001) e ausência de aposentadoria (p=0,031). Verificou-se que o maior tempo de institucionalização permaneceu associado ao edentulismo mesmo quando ajustado por variáveis sociodemográficas e de saúde geral (p=0,013). Além disso, também esteve associado à ausência de escovação (p=0,024) e menor frequência de escovação de dentes, gengivas e próteses (p<0,001). CONCLUSÃO: Sugere-se estabelecer rotinas de atenção à saúde bucal nas instituições de longa permanência para a manutenção efetiva da saúde bucal ao longo do tempo de institucionalização.

Oral disorders among older Chileans: prevalence, incidence, and years lived with disability / Prevalência, incidência e anos vividos com incapacidade por doenças bucais no Chile

OBJECTIVE: Prior epidemiological surveys revealed that Chile experiences a high burden of oral diseases. However, no prior study has reported estimates of untreated dental caries, periodontitis, and edentulism over a three-decade period for the country. Using estimates of the Global Burden of Diseases Study (GBD) 2019, the objective of this study is to report the trends of prevalence, incidence, and years-lived with disability (YLDs) due to untreated dental caries, periodontitis, and edentulism in Chilean older adults between 1990 and 2019. METHODS: Estimates of prevalence, incidence, and YLDs due to dental caries, periodontitis, and edentulism were produced for Chile, by age and sex, between 1990 and 2019, using Dismod-MR 2.1. Trends of oral disorders were analyzed using generalized linear regression models applying the Prais-Winsten method. RESULTS: Untreated dental caries and periodontal disease showed an increase in prevalence and YLDs, whereas edentulism prevalence, incidence, and YLDs decreased in all older adults age groups. The incidence of dental caries decreased in the younger groups and increased in the older age groups; while the incidence of periodontal disease increased in the younger and decreased in the older age groups. CONCLUSIONS: Overall, the burden of oral diseases in older Chileans increased between 1990 and 2019. This was particularly relevant for untreated caries and periodontal disease. Future estimates of oral diseases burden in Chile require concerted efforts to produce national health surveys that incorporate oral diseases metrics. These estimates are essential to inform policy formulation, implementation and evaluation. (AU)

OBJETIVO: Pesquisas epidemiológicas anteriores revelaram que o Chile apresenta uma elevada carga de doenças bucais. No entanto, nenhum estudo anterior relatou estimativas de cárie dentária não tratada, periodontite e edentulismo ao longo de um período de três décadas para o país. Usando estimativas do Global Burden of Diseases Study (GBD) 2019, o objetivo deste estudo é relatar as tendências de prevalência, incidência e anos vividos com incapacidade (YLDs) devido a cárie dentária não tratada, periodontite e edentulismo em idosos chilenos entre 1990 e 2019. METODOLOGIA: Estimativas de prevalência, incidência e YLDs devido à cárie dentária, periodontite e edentulismo foram produzidas para o Chile, por idade e sexo, entre 1990 e 2019, usando o Dismod-MR 2.1. Tendências de distúrbios bucais foram analisadas usando modelos de regressão linear generalizada aplicando o método Prais-Winsten. RESULTADOS: A cárie dentária não tratada e a doença periodontal mostraram um aumento na prevalência e nos YLDs, enquanto a prevalência, incidência e YLDs do edentulismo diminuíram em todas as faixas etárias de idosos. A incidência de cárie dentária diminuiu nos grupos mais jovens e aumentou nos grupos etários mais velhos; enquanto a incidência de periodontite aumentou nos grupos mais jovens e diminuiu nos grupos etários mais velhos. CONCLUSÕES: No geral, a carga de doenças bucais em idosos chilenos aumentou entre 1990 e 2019. Isso foi particularmente relevante para cárie não tratada e periodontite. As estimativas futuras da carga de doenças bucais no Chile exigem esforços concentrados para produzir pesquisas nacionais de saúde que incorporem métricas de doenças bucais. Essas estimativas são essenciais para informar a formulação, implementação e avaliação de políticas. (AU)

Prevalence of horizontal alveolar changes in edentulous patients: a retrospective tomographic study

Abstract Horizontal bone loss after tooth extraction is a common finding that demands bone reconstruction in various cases. The aim of this study was to assess the horizontal alveolar status in partially and completely edentulous patients using cone-beam computed tomography (CBCT). In total, 1516 CBCT scans of 1404 adult patients were analyzed. Assessment of the images was performed in accordance with the previously published horizontal alveolar change (HAC) classification, which categorizes horizontal bone defects into four classes: HAC 1, HAC 2, HAC 3 and HAC 4 (from the least severe to the most severe condition). Analysis of 1048 scans from partially edentulous patients presented a distribution of 63.55%, 22.14%, 13.36% and 0.95% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Analysis of 468 scans from completely edentulous patient images presented a distribution of 19.87%, 28.63%, 41.67% and 9.83% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Based on these results, as in HAC 4, no cancellous bone was found between the cortical buccal and lingual/palatal bone plates, it seems reasonable to state that the absence of cancellous bone is higher in completely edentulous patients than in partially edentulous patients. Therefore, the absence of cancellous bone seems to be higher in completely edentulous than in partially edentulous patients.

Associação entre o uso de prótese dentária total e o tipo de serviço odontológico utilizado entre idosos edêntulos totais / Association between the use of total dental prosthesis (denture) and the type of oral health care service used by toothless elderly individuals

Resumo A reabilitação protética foi prevista pela política nacional de saúde bucal em função da alta prevalência de perda de todos os dentes e do baixo uso de prótese dentária entre idosos. Há necessidade de se avaliar o impacto dessa política de reabilitação. Portanto, objetivou-se investigar se o tipo de serviço odontológico utilizado foi um dos fatores associados ao uso de prótese dentária total entre idosos. Trata-se de um estudo transversal conduzido em uma amostra probabilística de idosos (60 anos ou mais) residentes na zona urbana de um município brasileiro de pequeno porte populacional por examinadores calibrados. Realizaram-se análises descritiva, bivariada e múltipla (Regressão logística - odds ratio - OR). Participaram 287 idosos, destes, 186 (64,8%) faziam uso de prótese dentária total. O uso de prótese dentária total foi associado a maiores chances de uso de serviços odontológicos supletivos ou particulares (OR = 4,19; p < 0,001) e a presença de lesão no palato (OR = 7,52; p = 0,002) e, também, a menores chances em idades maiores ou iguais a 73 anos (OR = 0,52; p = 0,023) e entre os com comprometimento na dimensão incapacidade física do OHIP-14 (OR = 0,20; p = 0,002). O uso de prótese dentária total foi associado ao tipo de serviço odontológico entre idosos, sendo maior o uso entre usuários dos serviços supletivos ou particulares.

Abstract Oral rehabilitation with dental prosthesis was mandated by national oral health policy in Brazil, due to the high prevalence of total teeth loss and low use of dental prosthesis among the elderly. There is a pressing need to assess the impact of this rehabilitation policy. An attempt was therefore made to investigate if the dental service used was one of the factors associated with the use of total dental prosthesis among the elderly. To achieve this, a cross-sectional study using a probabilistic sample of elderly (60 years and above) urban-area residents of a small city was conducted by qualified examiners. Descriptive, bivariate and multiple (logistic regression/odds ratio - OR) analyses were conducted on 287 elderly people, of which 186 (64.8%) used dental prosthesis. The use of total dental prosthesis was associated with a higher probability of being attended by private dental services (OR = 4.19; p < 0.001) and the presence of lesions on the palate (OR = 7.52; p = 0.002). Conversely, it was associated with lower probability in ages greater than or equal to 73 years (OR = 0.52; p = 0.023) and among those with impairment of OHIP-14 (OR = 0.20; p = 0.002) in the physical disability dimension. The use of total dental prosthesis was associated with the type of dental service used by the elderly, it being greater among private service users.

Uso regular de serviços odontológicos e perda dentária entre idosos / Regular use of dental services and dental loss among the elderly

Resumo Objetiva-se verificar a associação entre o uso regular de serviços odontológicos e a perda dentária por idosos vinculados a onze Unidades de Saúde da Família no sul do Brasil. Estudo transversal que avaliou 438 idosos. Um questionário padronizado foi utilizado e as variáveis clínicas de saúde bucal foram obtidas por um dentista treinado. O relato do uso regular dos serviços odontológicos, desfecho do estudo, foi obtido por meio de pergunta única. Foram realizadas análises descritivas e regressão de Poisson com o Stata 12.0. Analisando as variáveis de exposição e desfecho do estudo, na regressão não ajustada, houve associação positiva do relato do uso regular dos serviços de saúde bucal dos idosos com 9-11 anos de estudo (RP = 3,89; IC95%1,77-8,58) em comparação aos idosos com menos de 4 anos de estudo, com até 9 dentes (RP = 2,50;IC95%19,0-5,72) e 10 ou mais dentes (RP = 3,89;IC95%1,58-9,57) em comparação aos idosos sem dentes. Ao considerar a exposição principal, perda dentária, na análise ajustada, os indivíduos com 10 ou mais dentes (RP = 3,51;IC95%1,37-8,99) apresentavam maiores prevalências de relato de uso regular em comparação aos indivíduos sem dentes. O estudo identificou que ter dentes está associado positivamente ao relato do uso regular dos serviços de saúde bucal entre os idosos.

Abstract This study aimed to investigate the association between regular use of dental services and tooth loss by elderly linked to eleven Family Health Facilities in southern Brazil. This cross-sectional study evaluated 438 elderly. A standard questionnaire was used and oral health clinical variables were obtained by a trained dentist. The main study outcome, namely, the regular use of dental services, was obtained through a single question. Descriptive analyses and Poisson regression using Stata 12.0 were performed. The analysis of the exposure variables and the outcome in the unadjusted regression analysis revealed a positive association between regular use of oral health services for the elderly with 9-11 years of schooling (PR = 3.89; 95%CI 1.77-8.58) compared to individuals with 4 years of schooling, up to 9 teeth (PR = 2.50; 95%CI 19.0-5.72) and 10 or more teeth (PR = 3.89; 95%CI 1.58-9.57) compared to individuals who do not have teeth. When considering the primary exposure, tooth loss, through adjusted analysis, individuals with 10 or more teeth (PR = 3.51; 95%CI 1.37-8.99) have a higher prevalence of regular use of oral health services compared to individuals without teeth. The study identified that having teeth is positively associated with regular use of oral health services among the elderly.

Condição de saúde bucal autopercebida, capacidade mastigatória e longevidade em idosos / Self-perceived oral health status, chewing ability and longevity in the elderly

Resumo O objetivo deste artigo é verificar a condição bucal e a capacidade mastigatória autopercebidas em idosos longevos (≥ 80 anos). Foram utilizados dados do estudo multicêntrico FIBRA. A amostra foi composta por 2.341 indivíduos com ausência de déficit cognitivo, com idade ≥ 65 anos, no período entre 2008 e 2009, quando os idosos foram submetidos à coleta de dados. Quanto ao desfecho, a idade foi dicotomizada em 65-79 e 80 anos ou mais. A associação entre longevidade e as variáveis sociodemográficas, comportamentais, de saúde geral e bucal e a capacidade mastigatória autopercebida foram avaliadas pela regressão de Poisson. Dados completos disponíveis para 2.126 idosos. A idade média foi 70,91 (DP = ±4,11) anos entre os idosos jovens e 82,70 (DP = ±2,61) entre os longevos. A amostra de idosos com idade ≥ 80 anos foi de 11,7%. Baixa escolaridade, estado civil solteiro e ausência de trabalho estiveram associados à longevidade, assim como autorrelato de não possuir dentes naturais e dificuldade ou dor ao mastigar alimentos duros. Os resultados sugerem a associação entre longevidade com características sociodemográficas e de saúde bucal.

Abstract The scope of this article is to assess the oral health conditions and self-perceived chewing ability among the elderly seniors (≥ 80 years). Data from the FIBRA multicentric study were used. The sample consisted of 2,341 individuals with no cognitive impairment, aged ≥ 65 years, between 2008 and 2009, where the elderly were subjected to data collection. Regarding the outcome, age was dichotomized into 65-79 and 80 and over. The association between longevity and the socio-demographic and behavioral variables, general and oral health and self-perceived chewing ability was assessed by Poisson regression. Complete data are now available for 2,126 seniors. The mean age was 70.91 (SD =± 4.11) years among the young elderly and 82.70 (SD =± 2.61) among the elderly seniors. The sample of individuals aged ≥ 80 years was 11.7%. Low education, single marital status and lack of work were associated with longevity, as well as self-reporting of having no natural teeth and difficulty or pain when chewing hard foods. The results suggest an association between longevity with sociodemographic characteristics and oral health.

Prevalence of oral lesions and chronic non-communicable diseases in a sample of chilean institutionalized versus non-institutionalized elderly

Chile is experiencing a process of demographic aging with an increase in the number of elderly people, a percentage of which resides in long-term establishments for the elderly (LEE). however, there is little information on the reality of the elderly in these long-term care facilities, so this study was conducted to compare the epidemiological profile of the prevalent oral pathologies as well as chronic non-communicable diseases (NCDs), of institutionalized versus non-institutionalized elderly subjects. seventy-six institutionalized and forty-three non-institutionalized subjects were examined intraorally, and their clinical health record, gender and age were obtained, according to inclusion/exclusion criteria. the results indicate that female gender is the most common, with an average age of 78.5 year, with those 80 years old and above comprising the predominant group. the most prevalent oral lesions within the institutionalized group were denture stomatitis and irritative hyperplasia, while in the non-institutionalized these two lesions were found less frequently. as for the presence of xerostomia, there was no difference between the groups. the most common condition in both groups was total maxillary and mandibular edentulous, with the latter variable present more frequently in the institutionalized group (p<0.05). the predominant NCD for both groups were arterial hypertension, arthritis-osteoarthritis and diabetes mellitus (p>0.05), and depression was the most prevalent NCD in the non-institutionalized group (p<0.05). this study provides valuable information on the epidemiology of elderly´s oral lesions and NCDs to inform the decision-making process of public health policies.

Life course socioeconomic inequalities and oral health status in later life: ELSI-Brazil

ABSTRACT OBJECTIVE To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.

Autopercepção da necessidade de prótese dentária total entre idosos brasileiros desdentados / Self-perception of the need for full dental prosthesisamong toothless elderly Brazilians

Resumo Propõe-se estimar a prevalência da autopercepção da necessidade de prótese dentária total entre idosos (65 a 74 anos) brasileiros desdentados, assim como identificar seus fatores associados. Trata-se de estudo transversal com base no inquérito nacional das condições de Saúde Bucal da população brasileira, denominado SB Brasil – 2010. A variável dependente foi a autopercepção da necessidade de prótese dentária total, considerando a aquisição de prótese nova ou substituição da existente. Foram conduzidas análises descritivas, bivariadas e múltiplas. Foram incluídos 3514 idosos, destes, 2039 (55,0%) perceberam a necessidade de prótese total. A autopercepção da necessidade de prótese total foi maior entre os que necessitavam de prótese dentária inferior e que estavam insatisfeitos com as suas condições de saúde bucal. Além da alta prevalência da autopercepção da necessidade de prótese identificada, os resultados permitiram identificar que condições normativas e subjetivas de saúde bucal se mantiveram associadas a esta autopercepção entre idosos brasileiros.

Abstract The objective is to estimate the prevalence of self-perception of the need for a full dental prosthesis among toothless elderly Brazilians aged 65 to 74, as well as identify the associated factors. It is a cross-sectional study based on the national survey of oral health conditions of the Brazilian population, called SB Brazil – 2010. The dependent variable was the self-perceived need for full dental prosthesis, considering the purchase of new or replacement of the existing prosthesis. Descriptive bivariate and multiple analyses were conducted on 3514 elderly people, of which 2039 (55%) elderly self-perceived the need for a full denture. The self-perception of the need for a full denture was higher among those who needed dental prosthesis and who were dissatisfied with their oral health conditions. In addition to the high prevalence of self-perception of the need for prosthesis identified, the results identified that normative and subjective conditions of oral health remained associated with this self-perception among elderly Brazilians.

Edentulismo en adultos de Pachuca, México: aspectos sociodemográficos y socioeconómicos / Edentulism in Mexican adults: sociodemographic and socioeconomic aspects

Introducción La pérdida de dientes se ha convertido en un problema de salud pública bucal. Objetivo Determinar la prevalencia y distribución del edentulismo, así como las variables sociodemográficas y socioeconómicas asociadas en individuos de 35 años y más. Materiales y métodos Se realizó un estudio transversal en 656 sujetos seleccionados de forma aleatoria. En el estudio se incluyeron hombres y mujeres de 35 años y más, asistentes a las clínicas de atención dental de la Universidad Autónoma del Estado de Hidalgo (UAEH), una universidad pública de México. Para la realización de este estudio los examinadores fueron capacitados en la cumplimentación de los cuestionarios y estandarizados en el criterio diagnóstico de la pérdida de dientes. La variable dependiente fue el edentulismo. Los datos fueron analizados en Stata 11. Resultados El promedio de edad fue de 49,06 ± 10,33. Los individuos fueron principalmente mujeres (63,3%). La prevalencia general de edentulismo fue de 15,7% (IC 95%: 12,9-18,5); entre las mujeres fue de 17,6% y en los hombres de 12,5% (p = 0,081). La prevalencia de edentulismo fue mayor entre los sujetos de más edad (p < 0,001). Se observó que a mayor escolaridad (p < 0,001), a mejor nivel socioeconómico (p < 0,001) y en quienes tuvieron automóvil en el hogar (p < 0,05), la prevalencia de edentulismo fue menor. Conclusiones La prevalencia de edentulismo en adultos mayores de 35 años que acuden a las clínicas de esta universidad fue del 15,7%. Se observó diferencia de la prevalencia de edentulismo por edad, pero no por sexo. Se observaron diferencias socioeconómicas, sugiriendo ciertas desigualdades en salud bucal.

Introduction Tooth loss has become a problem of oral health. Objective To determine the prevalence and distribution of edentulism, as well as the associated sociodemographic and socioeconomic variables in subjects aged 35 and older. Materials and methods A cross-sectional study was conducted on 656 randomly selected subjects. The study included men and women aged 35 years and older attending dental care clinics at a public university in Mexico. Examiners were trained in filling out questionnaires and receiving training in order to standardise the criteria of tooth loss. The dependent variable was the presence of edentulism. The data were analysed using Stata 11. Results The mean age of the population was 49.06 ± 10.33 years, and the majority (63.3%) were women. The overall prevalence of edentulism was 15.7% (95% CI: 12.9-18.5%); the prevalence among women was 17.6% and the prevalence among men was 12.5% (P = .081). The prevalence of edentulism was higher among older subjects (P < .001). The prevalence of edentulism was lower among individuals with higher levels of education (P < .001), those with higher socioeconomic status (P < .001), and those who had a car at home (P < 0.05) Conclusions The prevalence of edentulism in adults over 35 years of age attending dental care clinics at this public university was 15.7%. Differences were observed in the prevalence of edentulism by age, but not by gender. Socioeconomic differences were observed, suggesting certain oral health inequalities.

Edentulism in Brazil: trends, projections and expectations until 2040 / Edentulismo no Brasil: tendências, projeções e expectativas até 2040

Abstract The aim of this study was to examine the edentulism rates in Brazil and make projections for the next years. Data were collected from three national oral health surveys. The percentage of edentulous jaws was calculated. Projections were made for the years 2020, 2030 and 2040, assuming that edentulism follows a logistic function. Population projections were also performed. Annual change in proportion of edentulous jaws was -0.04% for teenagers, -0.96% for adults and 0.76% for the elderly. By 2040, edentulous jaws will be virtually zero among teenagers, 1.77% among adults and 85.96% among the elderly. Teenagers will slightly decrease in number; adults will increase and subsequently decrease; the elderly will continue to increase. In teenagers and adults, the number of edentulous jaws will decrease, being approximately 616,000 in 2040. In the elderly, it will increase alarmingly, reaching over 64 million in 2040. Edentulism is declining in Brazil among teenagers and middle-aged adults, but is still increasing and will continue to increase for the next decades among the elderly.

Resumo O objetivo deste estudo foi examinar as taxas de edentulismo no Brasil e fazer projeções para os próximos anos. Os dados foram coletados de três censos nacionais de saúde bucal. O percentual de arcadas edêntulas foi calculado. Foram feitas projeções para 2020, 2030 e 2040, assumindo que o edentulismo segue uma função logística. Também foram realizadas projeções populacionais. A variação anual da proporção de arcadas edêntulas foi de -0,04% para jovens, -0,96% para adultos e 0,76% para idosos. Até 2040, o percentual de arcadas edêntulas será virtualmente zero entre jovens, 1,77% entre adultos e 85,96% entre idosos. O número de jovens vai diminuir levemente; o de adultos vai aumentar e depois diminuir; e o de idosos vai continuar aumentando. Para jovens e adultos, o número de arcadas edêntulas vai diminuir, aproximando-se de 616.000 em 2040. Para os idosos, este número vai aumentar alarmantemente, alcançando mais de 64 milhões em 2040. O edentulismo está diminuindo no Brasil entre jovens e adultos, mas está aumentando e continuará a aumentar nas próximas décadas entre os idosos.

Fatores associados à prevalência de edentulismo em pacientes com doença renal crônica em hemodiálise: um estudo transversal em Minas Gerais / Factors associated with the prevalence of edentulim in patients with chronic kidney disease on dialysis: a cross sectional study in Minas Gerais

Os indivíduos com doença renal crônica podem apresentar, além das alterações sistêmicas decorrentes da doença, um maior comprometimento da saúde bucal quando comparados à população geral. Dentre as manifestações bucais mais frequentes está a doença periodontal, a cárie, o acúmulo de cálculo dentário, a xerostomia e o edentulismo. A falta de informações relacionadas aos cuidados com a cavidade bucal e sobre a influência da saúde bucal na saúde geral, a baixa motivação com o cuidado dos dentes e uma maior preocupação com as condições sistêmicas são fatores que podem estar relacionados a uma higiene bucal precária em grande parte dessa população. Este estudo objetivou identificar a prevalência de edentulismo nos indivíduos com doença renal crônica, atendidos em um serviço de hemodiálise, e os fatores associados. Foi realizado um estudo transversal com 650 pacientes, na faixa etária de 18 a 90 anos, atendidos em duas clínicas de hemodiálise localizadas em Belo Horizonte e Contagem, região sudeste do Brasil. Enquanto os participantes eram submetidos à sessão de hemodiálise, os dados foram coletados por meio de questionário estruturado e exame clínico. O questionário continha itens sobre características gerais, hábitos de comportamento e história médica e odontológica dos participantes. O exame clínico identificou a presença de edentulismo e alterações da mucosa bucal. A calibração intra e inter-examinador, o teste/reteste do instrumento e um estudo piloto foram realizadas previamente ao estudo principal. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais. Os resultados revelaram que a média de idade dos pacientes foi de 53,9 anos (+14,3). A maior parte da amostra foi composta por indivíduos do sexo masculino (55,2%), negro ou pardo (80,2%), classe econômica mais favorecida/favorecida (84,0%) e com menos de 8 anos de escolaridade (72,3%)...

Individuals with chronic kidney disease may have, in addition to systemic consequences results from the disease, poor oral health compared to the general population. Most common oral manifestations are periodontal disease, caries, calculus, mouthdry and tooth loss. The lack of information related to dental care and the influence of oral health on overall health, low motivation for dental care and greater concern for systemic health are factors that may be related to precarious oral hygiene in a large part of this population. The study aimed to identify the prevalence of edentulism in people with chronic kidney disease on dialysis and factors associated. A cross-sectional studywasperformedin650 patients, aged 18-90 years treated in two dialysis centers located in Belo Horizonte and Contagem, southeastern of Brazil. While participants performed a hemodialysis session, data were collected using a structured questionnaire and clinical exam. The questionnaire included general characteristics, behavior habits and medical and dental history of the participants. Clinical exam identified the presence of edentulism ...

Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol-visual analog scale (EQ-VAS) / Edentulismo y prótesis dentales en el adulto mayor: impacto sobre la calidad de vida medido con euroqol – escala visual análoga (eq-vas)

El objetivo de este estudio fue medir el impacto del edentulismo y el uso de prótesis dentales en la calidad de vida de los adultos mayores en Bogotá, Colombia. El edentulismo es frecuente en los adultos mayores y afecta profundamente su calidad de vida. Actualmente existen pocos datos epidemiológicos disponibles sobre este tema en nuestro medio. Los datos fueron extraídos del estudio SABE-Bogotá, estudio transversal por conglomerados llevado a cabo en el 2012. Se uso el EQ-VAS (escala visual análoga) como instrumento de medición de la percepción de la calidad de vida. El estudio incluyó 2.000 individuos mayores de 60 años. Se usó el test de Sperman-Rho para analizar la correlación entre el EQ-VAS, el edentulismo y el uso de prótesis. Las pruebas de Chi-cuadrado, ANOVA y t-test se usaron para estudiar las diferencias en los puntajes del EQ-VAS entre los sujetos edéntulos y sanos. La significancia estadística se estableció en <0.05. De los 2000 encuestados, 98.3 por ciento fueron edéntulos, 73.0 por ciento reportaron perdida de mas de la mitad de sus dientes, 76.9 por ciento reportaron usar prótesis dentales y 23.7 por ciento problemas relacionados con la alimentación. La edad avanzada, el estrato social bajo y el bajo nivel educativo se relacionaron con mayor pérdida dental. Individuos con pocos dientes y prótesis dentales tuvieron puntajes bajos en el EQ-VAS (p=0.22). La presencia de edentulismo también mostró una correlación negativa con los puntajes del EQ-VAS (rho= -0.102, p<0.01). Se concluye que EQ-VAS es un instrumento de gran utilidad para la medición de calidad de vida en contextos relacionados a salud oral. El edentulismo afecta significativamente la calidad de vida en los adultos mayores y el uso de prótesis dentales no mejora la percepción de la calidad de vida.

The objective of this study was to measure the impact of edentulismand dental prostheses on quality of life (QOL) in older adults inBogotá, Colombia. Edentulism is a frequent condition in olderadults and has great impact on their QOL. No epidemiologicaldata are currently available on edentulism among older adults inColombia. Data were obtained from the SABE-Bogotá study, across-sectional study conducted in 2012, and used to analyze theEQ-VAS (Visual Analog Scale) from the EuroQol instrument tomeasure the perception of quality of life (QOL) in relation toedentulism. The study included 2,000 individuals over 60 yearsold. The Spearman-Rho correlation was used to analyze thecorrelation between EQ-VAS and edentulism. Chi-Square, ANOVAand t-test were used to study the differences in EQ-VAS scoresbetween edentulous and healthy subjects. Statistical significancewas set at p<0.05. Of the 2000 respondents, 98.3% wereedentulous, 73.0% reported half or more missing teeth, 76.9%used dental prostheses and 23.7% had related eating problems.Older age, lower social class and lower education were related toedentulism. Individuals with fewer teeth and dental prostheses hadlower EQ-VAS scores (p<0.05) and dental prosthesis did notimprove EQ-VAS scores (p=0.22). Edentulism also showed asignificant negative correlation with EQ-VAS scores (rho= -0.102,p<0.01). In summary, EQ-VAS is a useful tool for measuring theperception of QOL in dental health scenarios. Edentulismsignificantly affects QOL in older adults and the use of dentalprosthesis does not improve the perception of QOL.

Estudo da carga de doença das condições orais em Minas Gerais, Brasil, 2004-2006 / A study of the overall burden of oral disease in the state of Minas Gerais, Brazil: 2004-2006

Os agravos orais são um problema de saúde pública devido à sua prevalência em praticamente todos os grupos etários. Estudo da Carga Global de Doença para cárie dentária, edentulismo e doença periodontal. Utilizou-se o DALY, que mede simultaneamente o impacto da mortalidade e dos problemas de saúde que afetam a qualidade de vida. A Carga de Doença para condições orais foi analisada em números absolutos e taxas/1.000 habitantes. O número de YLD para cárie foi de 4.489. Estimou-se 33.888 YLD para edentulismo, com taxa de 2,2/1.000 nas mulheres. Na doença periodontal estimou-se 3.217 YLD, resultando em uma taxa de 0,2/1.000 para ambos os sexos. O edentulismo contribuiu mais para a carga de doença orais, sendo mais frequente nas mulheres. Maiores taxas de edentulismo e doença periodontal foram de 45-69 anos, enquanto cárie de 15-49 anos. Os estudos de Carga Global de Doença representam um importante aspecto do diagnóstico de saúde, integrando desfechos fatais e não fatais. Além disso, disponibiliza informações de grande relevância na formulação de políticas de prevenção e tratamento.

Oral disease is a major public health problem due to its prevalence in practically all age groups. This is a study of the overall burden of dental caries, edentulism and periodontal disease. The Disability-Adjusted Life Year (DALY) indicator was used as it simultaneously measures the impact of mortality and of health problems that affect the quality of life. The overall burden of oral diseases was analyzed in absolute terms and in rates per 1000 inhabitants. The number of Years Lived with Disability (YLD) due to dental caries was 4,489. An estimated 33,888 YLD were lost due to edentulism, with a rate of 1.8/1000 (2.2/1000 among women). An estimated 3217 YLD were lost due to periodontal disease, with a rate of 0.2/1000 for both sexes. Edentulism was the condition that contributed most to the overall burden of oral diseases and is more frequent among women. Higher rates of edentulism and periodontal disease were found in persons aged 45-69 years, while dental caries was more frequent from 15-49 years. The overall burden of oral disease studies represent an important aspect of health diagnosis, integrating both fatal and non-fatal outcomes. Furthermore, these studies provide highly relevant information for preventive and therapeutic policy making.

Satisfação com saúde bucal de idosos brasileiros: um estudo de gênero com modelo hierárquico / Oral health satisfaction among Brazilian elderly: a gender study using a hierarchical model / Satisfacción con la salud bucal en adultos mayores brasileños: un estudio de género con el modelo jerárquico

Os objetivos do presente estudo foram identificar as diferenças de gênero em relação aos fatores associados à satisfação com saúde bucal de idosos e estimar a prevalência de edentulismo por gênero e faixa etária. Foram incluídos 2.052 idosos com 60 anos e mais de idade, residentes em Sete Lagoas, Minas Gerais, Brasil. A regressão de Poisson foi utilizada para estimar a prevalência de edentulismo. A associação entre satisfação bucal e as variáveis independentes foi realizada por meio da regressão ordinal com modelo hierárquico multidimensional. A prevalência de edentulismo nos gêneros masculino e feminino foi de 63% e 68,8%, respectivamente. A maioria dos idosos do gênero masculino (63%) e feminino (57%) estava satisfeita com a saúde bucal. O modelo final ajustado, para ambos os gêneros, foi formado por variáveis referentes ao ambiente externo, comportamentos de saúde e condições de saúde bucal. Conclui-se que a satisfação com a saúde bucal é influenciada fortemente pelas condições de saúde bucal e por comportamentos de saúde, e que os fatores associados são diferentes para cada gênero.

The objectives of this study were to identify gender differences in relation to factors associated with oral health satisfaction among the elderly and to estimate the prevalence of edentulism by gender and age. The study included 2,052 elderly (≥ 60 years) residing in Sete Lagoas, Minas Gerais State, Brazil. Poisson regression was used to estimate prevalence of edentulism. The association between oral health satisfaction and independent variables was estimated using ordinal regression with a hierarchical multidimensional model. Prevalence rates for edentulism in males and females were 63% and 68.8%, respectively. Most elderly males (63%) and females (57%) were satisfied with their oral health. The final adjusted model for both genders consisted of variables related to environmental characteristics, health behaviors, and oral health conditions. The study concludes that oral satisfaction is heavily influenced by oral health status and health behaviors, while the associated factors differ by gender.

Los objetivos de este estudio fueron identificar las diferencias de género, en relación con factores asociados a la satisfacción con la salud bucal de ancianos, con el fin de estimar la prevalencia de edentulismo por género y edad. Se incluyó a 2.052 personas mayores de 60 años y más que residen en Sete Lagoas, Minas Gerais, Brasil. La regresión de Poisson se utilizó para estimar la prevalencia de edentulismo. La asociación entre la satisfacción bucal y las variables independientes se realizó mediante el modelo de regresión ordinal multidimensional jerárquico. La prevalencia de edentulismo en hombres y mujeres era de un 63% y un 68,8%, respectivamente. La mayoría de los hombres de edad avanzada (63%) y mujeres (57%) estaban satisfechos con su salud bucal. El modelo ajustado final, para ambos sexos, fue desarrollado por variables relacionadas con el ambiente externo, las conductas de salud y las condiciones de salud bucal. Se concluye que la satisfacción con la salud bucal está fuertemente influenciada por el estado de salud oral y las conductas de salud, asimismo, los factores asociados son diferentes para cada género.

Perdas dentarias no Brasil: analise da Pesquisa Nacional de Saude Bucal 2010 / Perdidas dentarias en Brasil: analisis de la Investigacion Nacional de Salud Bucal 2010 / Tooth loss in Brazil: analysis of the 2010 Brazilian Oral Health Survey

OBJETIVO: Analisar a perda dentária com base em estimativas do número médio de dentes perdidos, prevalência de ausência de dentição funcional e edentulismo em adolescentes, adultos e idosos brasileiros, comparando-a com resultados de 2003. MÉTODOS: Os dados referem-se à Pesquisa Nacional de Saúde Bucal (SBBrasil 2010): adolescentes de 15 a 19 anos (n = 5.445), adultos entre 35 e 44 anos (n = 9.779) e idosos entre 65 e 74 anos (n = 7.619). O número de dentes perdidos, a prevalência de indivíduos sem dentição funcional (< 21 dentes naturais) e de edentulismo (perda total dos dentes) foram estimados para cada grupo etário, capitais e macrorregiões brasileiras. Foram realizadas análises de regressão logística (perdas dentárias) e de Poisson (ausência de dentição funcional e edentulismo) multivariáveis para identificar fatores socioeconômicos e demográficos associados a cada desfecho. RESULTADOS: A prevalência de perdas dentárias entre adolescentes foi de 17,4% (38,9% em 2002-3), variando de 8,1% entre os estratos de maior renda a quase 30% entre os menos escolarizados. Entre adolescentes, as mulheres, pardos e pretos, os de menor renda e escolaridade apresentaram maiores prevalências de perdas. Ausência de dentição funcional ocorreu em aproximadamente » dos adultos, sendo superior nas mulheres, nos pretos e pardos, nos de menor renda e escolaridade. A média de dentes perdidos em adultos declinou de 13,5 em 2002-3 para 7,4 em 2010. Mais da metade da população idosa é edêntula (similar em 2002-3); maiores prevalências de edentulismo em idosos foram observadas em mulheres, nos de menores renda e escolaridade. A média de dentes perdidos em adolescentes variou de 0,1 (Curitiba e Vitória) a 1,2 (interior da região Norte). Entre ...

OBJETIVO: Analizar la pérdida dentaria con base en estimaciones del número promedio de dientes perdidos, prevalencia de ausencia de dentición funcional y edentulismo en adolescentes, adultos y ancianos brasileños, comparándola con resultados de 2003. MÉTODOS: Los datos se refieren a la Investigación Nacional de Salud Bucal (SBBrasil): adolescentes de 15 a 19 años (n=5.445), adultos entre 35 y 44 años (n=9.779) y ancianos entre 65 y 74 años (n=7.619). El número de dientes perdidos, la prevalencia de individuos sin dentición funcional (< 21 dientes naturales) y de edentulismo (pérdida total de los dientes), fueron estimados para cada grupo etario, capitales y macro regiones brasileñas. Se realizaron análisis de regresión logística (pérdidas dentarias) y de Poisson (ausencia de dentición funcional y edentulismo) multivariables para identificar factores socioeconómicos y demográficos asociados a cada aspecto. RESULTADOS: La prevalencia de pérdidas dentarias entre adolescentes fue de 17,4% (38,9% en 2002-3) variando de 8,1% entre los estratos de mayor renta a casi 30% entre los menos escolarizados. Entre adolescentes, las mujeres, pardos y negros, los de menor renta y escolaridad presentaron mayores prevalencias de pérdidas. La ausencia de dentición funcional ocurrió en aproximadamente » de los adultos, siendo superior en las mujeres, en los negros y pardos, en los de menor renta y escolaridad. El promedio de dientes perdidos en adultos declinó de 13,5 en 2002-3 a 7,4 en 2010. Más de la mitad de la población anciana es edéntula (similar en 2002-3); mayores prevalencias de edentulismo en ancianos fueron observadas en mujeres, en los de menor renta y escolaridad. El promedio de dientes perdidos en adolescentes varió de 0,1 (Curitiba y Vitória) a 1,2 (interior de la región ...

OBJECTIVE: To estimate the mean number of missing teeth, lack of functional dentition and total tooth loss (edentulism) among adolescents, adults and the elderly in Brazil, comparing the results with those of 2003. METHODS: Data from 5,445 adolescents aged 15-19, 9,779 adults aged 35-44 and 7,619 elderly individuals aged 65-74, participants in the Brazilian Oral Health Survey (SBBrasil) 2010, were analyzed. The mean missing teeth, proportion of lack of functional dentition (< 21 natural teeth) and proportion of edentulism (total tooth loss) were estimated for each age group, each state Capital and each macro region. Multivariable logistic regression (tooth loss) and Poisson (absence of functional dentition and edentulism) analyses were performed in order to identify socioeconomic factors and demographic characteristics associated with each outcome. RESULTS: The prevalence of tooth loss among adolescents was 17.4% (38.9% in 2002-03) ranging from 8.1% among those earning higher income to almost 30% among those with less schooling. Among adolescents, females, those with black or brown skin and those with the lowest levels of income and schooling had a higher prevalence of tooth loss. Lack of functional dentition affected nearly » of adults, it was higher among women, among those with black and brown skin and among those with the lowest levels of income and schooling. Mean missing teeth in adults decreased from 13.5 in 2002-03 to 7.4 in 2010. More than half of elderly is edentulous (similar to the 2002-03 findings); higher prevalence of edentulism was found among women and those with the lowest levels of income and schooling. Among adolescents the mean missing teeth ranged from 0.1 (in Curitiba, South Brazil and Vitória, Southeast Brazil) to 1.2 (in the North countryside). Among adults the lowest mean missing teeth was found in Vitória (4.2) and the highest in Rio Branco, North Brazil (13.6). CONCLUSIONS: A remarkable ...

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.

Edentulousness, denture wear and denture needs of the elderly in rural South India

The objectives of this study were to evaluate the prevalence of edentulousness, patient's perception on dietary changes resulting from tooth loss and to identify the disparity between actual and patient perceived need to replace missing teeth in an elderly rural population in south India. A cross sectional study using the systematic cluster sampling method was used to select the study sample of 150 elderly men and women. Data were collected using questionnaires and oral examination. The data were statistically analyzed using chi square test and pearson correlation. 15.6% of the rural elderly were completely edentulous and 54.7% were partially edentulous. Observed differences in distribution between the sampled elderly age groups were found to be statistically significant. Although 70.3% of the evaluated elderly actually required prosthodontic treatment, only 14.4% perceived the need to replace missing teeth. A small percentage of the elderly [18%] perceived a severe change in their diets due to tooth loss. Thirty three percent of them perceived a moderate change and 28% felt that there were no dietary changes because of tooth loss. It is essential to identify feasible strategies to provide primary dental health education and treatment to all rural elderly in the future. We suggest community dental health services as a general health need of the elderly rather than a special health need of the community

Prevalence of permanent tooth loss among children and adults in a suburban area of Chennai.

Aim: To determine the prevalence of permanent tooth loss among children and adults in a suburban area of Chennai. Design: Cross sectional descriptive study. Study setting: The study was conducted in Tiruverkadu, a suburban area of Chennai. Materials and Methods: A house-to-house survey was done in Tiruverkadu. The study population consisted of 6, 12, 15 years children, 35-44 years, and 65-74 years adults. Type III dental examination was carried out. Cross tabulations and Chi-square statistics were computed. The level of significance was chosen as P<0.05. Results: Out of the total 679 subjects, 309 subjects had tooth loss. Females (47.9%) had greater tooth loss compared to males (42.9%). Tooth loss increased as age progressed. Subjects in the lower socio-economic status had greatest tooth loss. The mean tooth loss among the subjects was 2.7. Conclusion: This study indicates that tooth loss increases with age and differs for gender and socio-economic status. The prevalence of tooth loss among the subjects was found to be high in children as well as in adults. Therefore, dental professionals should utilize various measures available in preventive dentistry to minimize tooth loss.

Assessment of oral health status and treatment needs of elders associated with elders' homes of Ambala division, Haryana, India.

Objective: To determine the oral health status and treatment needs of subjects aged 60 years and above. Background: The average life span in most parts of the world continues to increase. In the coming decades, dental practitioners will face the challenge of providing dental care for a growing number of elders who retain more natural teeth. Materials and Methods: The study was conducted in 10 elders' homes of Ambala division on subjects 60 years or older. Modified WHO format (1997) was used. All the subjects present in the elders' home on the day of examination were included. One hundred and fifty-two subjects were examined. Results: Around half (47.4 %) of the subjects had no functional teeth. Among the rest of the subjects, 26.9% subjects did not use any oral hygiene measure. 19.1% subjects reported wearing a denture. 36.8% subjects had not visited a dentist ever in their life. 28.7% subjects were suffering from pain. The mean number of decayed teeth per subject was 3.66. Maximum subjects had a Community Periodontal Index score of 2. Conclusion: Education regarding maintenance of oral hygiene and regular dental check up should be stressed for the elders. Dental care, especially prosthetic care, should be focused upon.