Prevalence of tooth loss and associated factors in institutionalized adolescents: a cross-sectional study / Prevalência de perda dentária e fatores associados em adolescentes institucionalizados: um estudo transversal

Abstract This study aimed to assess the prevalence of tooth loss and associated factors in institutionalized adolescents. This cross-sectional study included 68 male adolescents incarcerated from Socio-Educational Assistance Center (CASE) aged between 15 and 19 years. Questionnaires were applied individually to assess sociodemographical, economical, medical, behavioral and oral health self-perception variables. All present teeth were evaluated by Decay, Missing, Filling (DMF) Index. The prevalence of tooth loss was analyzed in individuals with ≥1 tooth loss. Associations between tooth loss and exposure variables studied were analyzed by Poisson Regression with robust variance estimation. The prevalence of tooth loss was 47.06%. First molars in the mandible and maxilla and central incisor in the maxilla were the most absent teeth. In the multivariate model, number of decayed teeth, and those that reported daily use of medication were associated with higher tooth loss. Besides, tooth loss was associated with decayed tooth and daily use of medication. Oral health promotion and treatment should be implemented in these institutions to reduce the prevalence of dental loss in these adolescents.

Resumo Esse estudo objetivou avaliar a prevalência de perda dentária e fatores associados em adolescentes institucionalizados. Esse estudo transversal incluiu 68 adolescentes do sexo masculino de um Centro de Atendimento Socioeducativo (CASE) com idades entre 15 e 19 anos. Questionários estruturados foram aplicados individualmente para acessar variáveis sociodemográficas, econômicas, médicas, comportamentais e autopercepção de saúde bucal. Todos os dentes presentes foram avaliados pelo Índice de dentes Cariados, Perdidos e Obturados (CPOD). A prevalência de perda dentária foi analisada em indivíduos com ≥1 dente perdido. Associações entre perda dentária e variáveis de exposição foram analisadas por regressão de Poisson com estimativa de variância robusta. A prevalência de perda dentária foi 47,06%. Primeiros molares na mandíbula e maxila e incisivos centrais na maxila foram os dentes mais ausentes. No modelo multivariado, número de dentes cariados esteve associado com perda dentária, e aqueles que faziam uso diário de medicações foram associados a maior perda dentária. Além disso, perda dentária foi associada com cárie dentária e uso diário de medicação. Promoção de saúde bucal e seu tratamento devem ser implementados nessas instituições para reduzir a prevalência de perda dentária nesses adolescentes.

Diabetes y enfermedad periodontal / Diabetes and periodontal disease

El objetivo de este trabajo fue establecer la relación entre el grado de enfermedad periodontal y el control metabólico de la glucemia en pacientes que padecen diabetes tipo 2. Es un estudio de tipo observacional, descriptivo, transversal. Se seleccionaron 42 pacientes con diagnóstico de diabetes mellitus tipo 2 de ambos sexos, entre 25 y 75. Se realizó odontograma y se evaluó el grado de enfermedad periodontal para determinar el grado de compensación metabólica de los pacientes se tomaron muestras de sangre venosa y se midieron los valores de hemoglobina glicosilada. Un 23,55% de los pacientes no presentaron enfermedad periodontal y el resto se dividió en leve, moderada y severa presentándose la enfermedad leve en primer orden. Los pacientes con mayor grado de enfermedad periodontal presentaron mayor número de piezas dentarias perdidas (p 0,0334). La enfermedad periodontal se distribuye de la misma manera en ambos grupos de control glucémico (p=0,1211). En el grupo estudiado, el grado de enfermedad periodontal es independiente del control glucémico de los pacientes (AU)

The objective of this work was to establish the relationship between the degree of periodontal disease and the metabolic control of glycemia in patients with type 2 diabetes. It is an observational, descriptive, cross-sectional study. 42 patients with a diagnosis of type 2 diabetes mellitus of both sexes, between 25 and 75, were selected. An odontogram was performed and the degree of periodontal disease was evaluated; venous blood samples were taken and glycosylated hemoglobin values were measured to determine the degree of metabolic compensation of the patients. 23.55% of the patients did not present periodontal disease and the rest were divided into mild, moderate, and severe, with mild disease presenting in the first order. The patients with a higher degree of periodontal disease had a higher number of missing teeth (p 0.0334). Periodontal disease is distributed in the same way in both glycemic control groups (p = 0.1211). In the group studied, the degree of periodontal disease is independent of the glycemic control of the patients (AU)

The role of health literacy as a factor associated with tooth loss / O papel da literacia em saúde como fator associado às perdas dentárias

ABSTRACT OBJECTIVE The objective was to analyze the role of health literacy (HL) as a factor associated with tooth loss among users of the Brazilian Health System with chronic non-communicable diseases. METHODS The cross-sectional analytical study was conducted with adult and elderly users chosen at ten Family Health Clinics in a draw in the town of Piracicaba, São Paulo State, Brazil. A questionnaire was applied with sociodemographic data (sex, age, skin color and education), behavioral data (brushing and flossing), determinants in health (type of dental health services and how often) and clinical data (pain). Mouth conditions were collected by intraoral examination of visible dental biofilm and community Pediodontal Index. The systemic clinical conditions (blood glucose, glycated hemoglobin and blood pressure) were extracted from the medical records. The explanatory variable was HL (low, medium and high), measured with the Health Literacy Scale (HLS-14). RESULTS The outcome was tooth loss measured by the index of decayed, missing and filled teeth. Logistic regression was performed using a conceptual model for HL (p < 0.05). For the 238 subjects, the mean age was 62.7 years (± 10.55). Tooth loss was associated with HL in regression models adjusted by type of dental service, dental frequency, and dental floss. In the final model, the factors associated with tooth loss are older age (OR = 1,12; 95%CI: 1,07-1,17), a lower education (OR = 3,43; 95%CI: 1,17-10,10), irregular use of dental floss (OR = 4,58; 95%CI: 1.75 in-7,31), irregular use of dental services (n = 2,60; 95% 1,32-5,12), periodontal pocket (> 4 mm) (n = 0,31; 95%CI: 0,01-0,08), having visible dental biofilm (OR = 7,23; 95%CI: 3,19-16,41) and a higher level of blood sugar (glucose) (n = 1,98; 95%CI: 1.00-3,92). CONCLUSIONS tooth loss was associated with HL when adjusted by health behaviors; when sociodemographic variables and clinical conditions were included, it was less significant. In the final model, behaviors, determinants in health and clinical conditions were risk indicators of tooth loss, showing the multifactorial nature of this phenomenon.

RESUMO OBJETIVO O objetivo foi analisar o papel da Literacia em Saúde (LS) como fator associado às perdas dentárias entre usuários do Sistema Único de Saúde com doenças crônicas não transmissíveis. MÉTODOS O estudo transversal e analítico foi conduzido com usuários adultos e idosos selecionados em dez Unidades de Saúde da Família sorteadas, em Piracicaba - SP, Brasil. Foi aplicado um questionário com dados sociodemográficos (sexo, idade, cor da pele e escolaridade), comportamentais (escovação e uso de fio dental), determinantes em saúde (tipo e frequência de uso de serviço de saúde médico e odontológico) e clínica (dor). As condições bucais foram coletadas por exame intrabucal do biofilme dental visível e Índice Pediodontal Comunitário. As condições clínicas sistêmicas (glicemia, hemoglobina glicada e pressóricas) foram extraídas dos prontuários. A variável explanatória foi a LS (baixa, média e alta), medida pelo Health Literacy Scale (HLS-14). RESULTADOS O desfecho foi à perda dentária medida pelo Índice de dentes permanentes cariados, perdidos e obturados. Foi realizada regressão logística com uso de um modelo conceitual para a LS (p < 0,05). Para os 238 indivíduos, a média de idade foi 62,7 anos (± 10,55). A perda dentária esteve associada à LS nos modelos de regressão ajustados por tipo de serviço odontológico, frequência odontológica e uso de fio dental. No modelo final, a perda dentária teve como fatores associados a maior idade (OR = 1,12; IC95% 1,07-1,17), menor escolaridade (OR = 3,43; IC95% 1,17-10,10), ao uso irregular de fio dental (OR = 4,58; IC95% 1,75-7,31), uso irregular do serviço odontológico (OR = 2,60; IC95% 1,32-5,12), bolsa periodontal (> 4mm) (OR = 0,31; IC95% 0,01-0,08), ter biofilme dental visível (OR = 7,23; IC95% 3,19-16,41) e maior índice de glicemia (OR = 1,98; IC95% 1,00-3,92). CONCLUSÕES A perda dentária esteve associada à LS quando ajustada por comportamentos em saúde, a partir da inclusão das variáveis sociodemográficas e condições clínicas ela perdeu a significância. No modelo final, comportamentos, determinantes em saúde e condições clínicas foram indicadores de risco da perda dentária, demonstrando a multifatorialidade envolvida neste fenômeno.

Acúmulo de risco decorrente da pobreza e perda dentária aos 31 anos, coorte de nascidos vivos de 1982, Pelotas, Rio Grande do Sul, Brasil / Accumulated risk from poverty and tooth loss at 31 years of age: the 1982 live birth cohort in Pelotas, Rio Grande do Sul State, Brazil / Acumulación de riesgo derivado de la pobreza y pérdida dental a los 31 años: cohorte de nacidos vivos de 1982 en Pelotas, Rio Grande do Sul, Brasil

Resumo: O objetivo foi estimar o efeito do acúmulo de risco decorrente da pobreza na perda dentária aos 31 anos. Foram utilizados dados longitudinais da coorte de nascidos vivos de 1982, na cidade de Pelotas, Rio Grande do Sul, Brasil. Para a construção das variáveis de trajetória de renda, foram utilizados quatro pontos do tempo: nascimento, 15, 24 e 30 anos. Os fatores de confusão avaliados foram sexo, escolaridade materna, cor da pele da mãe e fumo aos 24 anos. Como potenciais mediadores, foram utilizados a trajetória de serviço odontológico e a cárie dentária baseada no Significant Index Caries (SIC). Para criação da variável de trajetória do modelo de acúmulo de risco, utilizou-se abordagem analítica de group-based trajectory modeling. O desfecho estudado foi o número de dentes perdidos aos 31 anos. A média de dentes perdidos aos 31 anos foi de 1,25 dente. No modelo de acúmulo de risco, após o ajuste para os confusores e mediadores, os indivíduos que estiveram pobres em um ou dois pontos do tempo apresentaram razão de risco - RR = 1,92 (IC95%: 1,40-2,63), e os que apresentaram três ou quatro episódios de pobreza apresentaram RR = 1,97 (IC95%: 1,24-3,13) para a perda dentária. Os resultados evidenciam o efeito do acúmulo de pobreza ao longo da vida na perda dentária. O efeito é ampliado entre os indivíduos que permaneceram mais tempo expostos à pobreza. As políticas públicas que visem a melhorar as condições de renda atuarão também na redução da perda dentária.

Abstract: The objective was to estimate the effect of accumulated risk from poverty and tooth loss at 31 years, using longitudinal data from the 1982 live birth cohort in Pelotas, Rio Grande do Sul State, Brazil. The income trajectory variables were built with four time points: birth and 15, 24, and 30 years of age. Potential confounding factors were sex, maternal schooling, maternal skin color, and smoking at 24 years. Potential mediators used the history of dentistry services use and caries based on the Significant Index Caries (SIC). The trajectory variable in the accumulated risk model was created with group-based trajectory modeling. The target outcome was the number of missing teeth at 31 years. Mean number of missing teeth at 31 years was 1.25. In the accumulated risk model after adjusting for confounders and mediators, individuals that were poor at one or two time points showed risk ratio - RR = 1.92 (95%CI: 1.40-2.63), and those with three or four episodes of poverty showed RR = 1.97 (95%CI: 1.24-3.13) for tooth loss. The results highlight the effect of lifetime poverty on tooth loss. The effect was expanded in individuals that were exposed to poverty longer. Public policies aimed at improving income conditions also help reduce tooth loss.

Resumen: El objetivo fue estimar el efecto de la acumulación de riesgo, derivado de la pobreza, en la pérdida dental a los 31 años. Se utilizaron datos longitudinales de la cohorte de nacidos vivos de 1982, en la ciudad de Pelotas, Rio Grande do Sul, Brasil. Para la construcción de las variables de trayectoria de renta se utilizaron cuatro puntos del tiempo: nacimiento, 15, 24 y 30 años. Los factores de confusión evaluados fueron: sexo, escolaridad materna, color de la piel de la madre y consumo de tabaco a los 24 años. Como potenciales mediadores se utilizó la trayectoria de servicios odontológicos y caries dental, basada en el Significant Index Caries (SIC). Para la creación de la variable de trayectoria del modelo de acumulación de riesgo se utilizó el abordaje analítico de group-based trajectory modeling. El resultado estudiado fue el número de dientes perdidos a los 31 años. La media de dientes perdidos a los 31 años fue 1,25 dientes. En el modelo de acumulación de riesgo, tras el ajuste para confusores y mediadores, los individuos que eran pobres en uno o dos puntos del tiempo presentaron razón de riesgo - RR = 1,92 (IC95%: 1,40-2,63) y quienes presentaron tres o cuatro episodios de pobreza presentaron RR = 1,97 (IC95%: 1,24-3,13) respecto a la pérdida dental. Los resultados evidencian el efecto de la acumulación de pobreza a lo largo de la vida en la pérdida dental. El efecto se amplía entre los individuos que permanecieron más tiempo expuestos a la pobreza. Las políticas públicas que tengan por objetivo mejorar las condiciones de renta actuarán también en la reducción de la pérdida dental.

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.

Is obesity associated with tooth loss due to caries? A Cross-sectional study

Aim: To investigate the association between obesity, overweight, and tooth loss due to caries among university students of (Federal University of Pelotas) in southern Brazil. Methods: A cross-sectional study with all first-year students who regularly enrolled in the first semester of 2016 who were invited to respond to a self-administered questionnaire contain socioeconomic and demographic; psychosocial; oral health; behavioral questions. The body mass index (BMI) was calculated through the self-reported data of weight and height. The main outcome of the present study was determined by the person's that answer having had at least one tooth extracted due to caries. A Poisson regression using a backward stepwise procedure was performed. Two models were tested: i) including socioeconomic and behavioral variables; ii) without behavioral variables. Results: From 3,237 eligible students, 2,089 (64.5%) participated in the present study. Almost 23% of students presented overweight and 8.4% obesity, whereas 362 individuals (17.5%) reported having had at least one tooth extracted due to caries. Regarding the final model adjusted by behavioral variables, it was observed that obese university students presented a 32.0% higher prevalence of tooth loss (PR=0.32,CI95%[1.17­1.49]). However, overweight was not associated with tooth loss in the present sample. When the model was not associated with behavioral variables, overweight was associated with tooth loss (PR=1.44; CI95%[1.15­1.81]), just as obesity (PR=2.13; CI95%[1.63 ­ 2.78]). Conclusions: Obesity and overweight were associated with tooth loss due to caries in the present sample of university students

Tooth loss and associated factors in the elderly in Cruz Alta, Brazil: a cross-sectional study / Perda dentária e fatores associados em idosos em Cruz Alta, Brazil: um estudo transversal

ABSTRACT The aim of this study was to evaluate severe tooth loss and associated factors among the elderly. A homebased crosssectional study, using random probabilistic sampling, was conducted with elderly persons from Cruz Alta, Rio Grande do Sul, Brazil. Oral health was examined and a structured questionnaire was answered. Associations between severe tooth loss and independent variables were determined using Poisson regression with robust variance. The level of significance adopted was 5%. Overall, 287 elderly persons were included. Among the elderly, 86 (29.9%) were edentulous, and 282 (98.3%) had lost at least one tooth. In this sample, median tooth loss was 21 (mean±standard deviation: 19.69±8.21). The sample was dichotomized into two groups according to the definition of severe tooth loss: less than nine remaining teeth or ≥9 remaining teeth. The prevalence of severe tooth loss was 60.3% (n=173). Females were associated with higher prevalence ratio (PR) of severe tooth loss (PR; 95% CI: 1.77; 1.39 - 2.24). Higher level of education was associated with lower PR of severe tooth loss (PR; 95% CI: 0.48; 0.30 - 0.77). The lack of access to dental care was associated with severe tooth loss (PR; 95% CI: 1.38; 1.13 - 1.67). Conversely, frequency of toothbrushing was not significantly associated with severe tooth loss (PR; 95% CI: 0.88; 0.73 - 1.06). High prevalence of severe tooth loss among the elderly was observed and found to be associated with sex, level of education, and access to dental care.

RESUMO Esse estudo objetivou avaliar a perda dentária severa e seus fatores associadas em idosos. Um estudo transversal, de base populacional, usando uma amostra probabilística, foi condu zido com os idosos de Cruz Alta, Rio Grande do Sul, Brasil. Exames de saúde bucal e um questionário estruturado foram realizados. Associações entre perda dentária severa e as variáveis independentes foram feitas, utilizando regressão de Poisson com variância robusta. O nível de significância adotado foi de 5%. No total, 287 idosos foram incluídos. Entre os idosos, 86 (29,9%) eram edêntulos, e 282 (98,3%) apresen tavam pelo menos uma perda dentária. Nessa amostra, a mediana de perda dentária foi 21 (média ± desvio padrão: 19,69±8,21). A amostra foi dividida em dois grupos de acordo com a definição de perda dentária severa: menos de nove dentes remanescentes ou ≥9 dentes presentes. A prevalência de perda dentária severa foi de 60,3% (n=173). As mulheres estiveram associadas com maior razão de prevalência (RP) de terem perda dentária severa (RP; IC95%: 1,77; 1,39 - 2,24). Alto nível educacional esteve associados com menor RP de ter perda dentária severa (RP; IC95% 0,48; 0,30 -0,77). A falta de acesso ao dentista esteve associada com maiores taxas de perda de dentária severa (RP; IC95%: 1,38; 1,13 -1,67). Por outro lado, frequência de escovação não esteve significati vamente associada perda dentária severa (RP; IC95%: 0,88; 0,73 - 1,06). Alta prevalência de perda dentária severa foi detectada entre os idosos e ela foi associada com sexo, nível educacional, e acesso ao dentista.

Prevalência de dificuldade na mastigação e fatores associados em adultos / Prevalence of chewing difficulty among adults and associated factors

Resumo O objetivo deste estudo foi estimar a prevalência de dificuldade na mastigação e fatores associados em adultos de 20 a 59 anos em Patos, PB, Nordeste, Brasil. Foi realizado um estudo transversal com uma amostra aleatória de 532 indivíduos. A dificuldade na mastigação foi avaliada por meio de pergunta sobre dificuldade causada por problemas com dentes ou dentadura. Foram realizadas análises descritiva, bivariada e multivariada por meio de regressão de Poisson. A prevalência de dificuldade na mastigação foi de 30,5%. Na análise multivariada, os fatores associados à dificuldade na mastigação foram: faixa etária, escolaridade, tempo desde a última consulta, perda dentária severa, ausência de dentição funcional, uso e necessidade de prótese dentária, dor de origem dental e sinais e sintomas de alterações na ATM. A magnitude das associações entre as variáveis, com destaque para perda dentária e necessidade de prótese dentária, reforça a importância deste indicador subjetivo na avaliação da condição de saúde bucal dos indivíduos adultos e mostra que a dificuldade na mastigação está associada a uma estrutura multidimensional de fatores.

Abstract The aim of this study was to estimate the prevalence of chewing difficulty and associated factors in adults aged 20 to 59 years in Patos, in the State of Paraiba in the Northeast Region of Brazil. A cross-sectional study was conducted with a random sample of 532 participants. The outcome chewing impairment was assessed using the question "How often do you have difficulty eating due to problems with your teeth or dentures?". Crude and adjusted prevalence ratios were estimated using Poisson regression. The prevalence of chewing difficulty was 30.5%. An association remained between the following variables and chewing difficulty in the final multivariate models: age group, schooling, being a smoker/non-smoker, length of time since last visit to the dentist, severe tooth loss, absence of functional dentitions, dental prosthesis use, need for a dental prosthesis, oral pain, and signs and symptoms of TMJ dysfunction. The magnitude of the associations between the variables and chewing difficulty, notably tooth loss and the need for a dental prosthesis, emphasize the importance of subjective indicators for assessing the oral health status of adults and shows that chewing difficulty is associated with a range of multi-dimensional factors.

Impacto da perda dentária na qualidade de vida de idosos com transtornos psiquiátricos / Impact of dental loss on the quality of life of elderly patients with psychiatric disorders

Objetivo: Avaliar a perda dentária, uso e necessidade de prótese em idosos com transtornos psiquiátricos e seu impacto na qualidade de vida. Métodos: Foi realizado um estudo epidemiológico transversal e descritivo. Os participantes foram idosos atendidos no Centro de Atendimento Psicossocial (CAPS) de um município mineiro. A coleta de dados foi realizada por meio de exame clínico bucal que avaliou a perda dentária, o uso e a necessidade de prótese, sendo que também foi aplicado um questionário, o Geriatric Oral Health Assessment Index (GOHAI). Para verificar a associação entre o GOHAI e as variáveis estudadas foram realizados os testes de Mann-Whitney e de Kruskal-Wallis, com nível de significância de 5,0% (p < 0,05). Resultados: Participaram 28 idosos, com alta prevalência de edentulismo total (75,0%), entre os quais 64,3% utilizam prótese dental superior e 32,1% prótese inferior. Quanto à necessidade de prótese 60,7% necessitavam de prótese superior enquanto 85,7% necessitavam de prótese inferior. A média do GOHAI foi de 29,1, considerada baixa. Conclusão: A maioria dos idosos desse estudo apresentou elevada perda dentária, que refletiu na percepção da saúde bucal ruim encontrada, sinalizando para a necessidade de tratamentos reabilitadores e de políticas públicas mais efetivas para promoção de saúde bucal. (AU)

Aim: To evaluate the dental loss, the use of and need for prostheses in elderly patients with psychiatric disorders, and their impact on quality of life. Methods: A cross - sectional and descriptive epidemiological study was carried out. The participants were elderly patients who received dental care at the Psychosocial Care Center (CAPS) of a municipality in the state of Minas Gerais. Data collection was performed through oral clinical examination that evaluated the dental loss, and the use of and the need for prostheses, together with a questionnaire, the Geriatric Oral Health Assessment Index (GOHAI), which was also applied. The Mann-Whitney and Kruskal-Wallis tests, with a significance level of 5.0% (p < 0.05), were used to verify the association between GOHAI and the studied variables. Results: A total of 28 elderly patients, with a high prevalence of total edentulism (75.0%), participated, among which 64.3% used maxillary dental prostheses and 32.1% used mandibular dental prostheses. Regarding the need for prostheses, 60.7% needed maxillary prostheses, while 85.7% required mandibular prostheses. The GOHAI average was 29.1, which is considered low. Conclusion: Most of the elderly from this study presented high dental loss, which reflected the perception of poor oral health, signaling the need for rehabilitation treatments and more effective public polices for the promotion of oral health. (AU)

Experiências de perda dentária em usuários adultos e idosos da Atenção Primária à Saúde / Tooth loss experiences in adult and elderly users of Primary Health Care

Resumo Partindo da perspectiva teórica da fenomenologia, este artigo propôs-se a compreender as experiências de perda dentária em usuários da Atenção Primária à Saúde de Porto Alegre, Rio Grande do Sul. A perda dentária foi identificada pela análise de prontuários odontológicos dos usuários adultos e idosos que acessaram o serviço de saúde bucal na Unidade de Saúde estudada. A partir desta identificação, entrevistas domiciliares individuais foram realizadas. A amostra foi intencional. Os dados foram interpretados pela análise de conteúdo, com apoio do software ATLAS.ti (Visual Qualitative Data Analysis). O estudo teve aprovação ética. Perder dentes foi uma experiência que expressou subjetividades, mostrando narrativas plurais, com destaque para a função social da boca. Para além do número de dentes perdidos, o entendimento do modo como as pessoas se percebiam sem esses dentes determinou o quanto a perda dentária afetou suas vidas. O uso de próteses agregou valor ao corpo, permitindo o restabelecimento do seu equilíbrio com o mundo. Estudos de abordagem qualitativa nos serviços de saúde devem ser considerados para o planejamento de ações que priorizem as necessidades percebidas pelas pessoas em seus territórios, buscando reduzir estigmas e desigualdades sociais.

Abstract From the theoretical perspective of phenomenology, this article seeks to understand the experiences of tooth loss in adult and elderly users of Primary Health Care in Porto Alegre, Rio Grande do Sul. Tooth loss was identified by the analysis of dental records of users that attended the oral health service at the Health Unit under study. Following this identification, individual household interviews were carried out. The sample was intentional. Data were interpreted by content analysis using the software ATLAS.ti (Visual Qualitative Data Analysis). The study had ethical approval. Losing teeth was an experience that expresses subjectivities, showing plural narratives and highlighting the social function of the mouth. Besides the number of missing teeth, the understanding of how people perceived themselves without their teeth determined how much tooth loss affected their lives. Wearing prostheses adds significance to individuals' perceptions of their body, restoring the balance between their body and the world. Qualitative approach studies in health services should be considered in order to plan interventions which prioritize people's individual needs in their own territories, thus reducing stigmas and social inequalities.

A falta de dentição funcional está associada ao comprometimento das funções bucais entre adultos brasileiros / The absence of functional dentition is associated with the lack of commitment to oral functions among Brazilian adults

Resumo Objetivou-se identificar se a falta de dentição funcional (DF) está associada com o comprometimento das funções bucais/atividades diárias entre adultos brasileiros. Para isto, foram utilizados dados da Pesquisa Nacional de Saúde Bucal - SB Brasil 2010. A DF foi avaliada pelo critério proposto pela Organização Mundial de Saúde (pelo menos 20 dentes na boca). O instrumento Impactos Odontológicos nos Desempenhos Diários (IODD) foi utilizado para avaliar as atividades diárias/funções bucais. Análises descritivas, bivariadas (Qui-quadrado) e múltiplas (Regressão Logística) foram realizadas, sendo estimado o odds ratio e o intervalo de confiança 95% (OR/IC95%). Foram incluídos e avaliados 9564 adultos. Foram considerados sem DF 2200 adultos (20,5%). Tiveram impacto em pelo menos uma das atividades diárias/funções bucais avaliadas, 55,0% dos adultos. A falta de DF entre adultos foi associada (p ≤ 0,05) com o impacto na fala (1,88/1,33-2,64) e vergonha ao sorrir ou falar (1,35/1,00-1,83). Uma prevalência considerável de falta de DF foi identificada, esta ausência foi associada às atividades diárias/funções bucais (fala e vergonha ao sorrir e falar). A reabilitação dentária de pacientes sem DF deve considerar a devolução destas funções bucais perdidas (fala e vergonha ao sorrir ou falar).

Abstract The scope of this study was to identify if the absence of functional dentition (FD) is associated with a lack of commitment to oral functions/daily activities among Brazilian adults. For this purpose, data from the National Survey of Oral Health (referred to as SB Brasil 2010) was used. FD was evaluated by the criterion proposed by the WHO (at least 20 teeth in the mouth). The Oral Impacts on Daily Performance (OIDP) questionnaire was used to evaluate daily activities/oral functions. Descriptive, bivariate (chi-squared) and multiple (logistic regression) analysis was conducted, and the odds ratio estimated with a 95% confidence interval (OR/CI95%). The research evaluated 9,564 adults, of which 2,200 adults (20.5%) were considered to have poor FD, and at least one of the daily activities/oral functions evaluated had an impact among 55% of adults. The lack of FD between adults was associated (p ≤ 0.05) with the impact on speech (1.88/1.33-2.64) and being ashamed to smile or talk (1.35/1.00-1.83). A considerable prevalence of lack of FD was identified, this absence being associated with the lack of commitment to the daily activities/oral functions. Dental rehabilitation of patients with a lack of FD should consider the restoration of these lost oral functions (speech and being ashamed to smile or talk).

A Saúde bucal está associada à presença de sintomas depressivos em idosos? / Is oral health associated with the presence of depressive symptoms among the elderly?

Resumo O objetivo do estudo foi descrever a prevalência de sintomas depressivos medidos por meio da Escala de Depressão Geriátrica-EDG - 15 e testar a associação de variáveis de saúde bucal com sintomas depressivos em uma população de idosos vinculados a onze unidades de saúde da família do Sul do Brasil. Estudo transversal com 439 idosos. Foi utilizado questionário padronizado para a obtenção das variáveis socioeconômicas e de saúde bucal. As variáveis clínicas de saúde bucal foram obtidas por um dentista treinado. Os sintomas depressivos desfecho do estudo foram obtidos por meio da Escala de Depressão Geriátrica-EDG - 15. A prevalência dos sintomas depressivos foi de 18,3% (IC95% 14,6-21,8). Analisando as variáveis de exposição e os sintomas depressivos, por meio da análise regressão de Poisson ajustada, os indivíduos com 1 a 9 dentes (RP = 1,68; IC95%1,06-2,64, p = 0,012), com percepção de boca seca (RP = 2,23; IC95%1,52-3,28, p < 0,001) e de dor na boca (RP = 2,11; IC95% 1,10-4,07, p = 0,036) tiveram maiores prevalências de sintomas depressivos. O estudo identificou uma prevalência importante de sintomas depressivos e que as variáveis de saúde bucal estão associadas à presença dos mesmos na população idosa.

Abstract The scope of this study was to describe the prevalence of depressive symptoms measured by the Geriatric Depression Scale-EDG - 15 and test the association of oral health variables and depressive symptoms in a population of the elderly linked to eleven Family Health Units in the south of Brazil. It involved a cross-sectional study with 439 elderly individuals. A standardized questionnaire was used to obtain socio-economic and oral health variables of the study. The clinical variables of oral health were obtained by a qualified dentist. The symptoms of depression, which was the scope of the study, were obtained by the Geriatric Depression Scale-EDG −15. The prevalence of depressive symptoms was 18.3% (CI95% 14.6-21.8). Analyzing the exposure variables and depressive symptoms through adjusted Poisson regression analysis, individuals with 1 to 9 teeth (PR = 1.68; CI95% 1.06-2.64, p = 0.012), with a perception of dry mouth (PR = 2.23; CI95% 1.52-3.28, p < 0.001) and perception of pain in the mouth (PR = 2.11; CI95% 1.10-4.07, p = 0.036) have a higher prevalence of depressive symptoms. The study identified a significant prevalence of depressive symptoms and that oral health variables are associated with the presence of depressive symptoms in the elderly population.

Lack of association between dietary inflammatory index and low impact fractures in the Brazilian population: the Brazilian Osteoporosis Study (BRAZOS)

Abstract Introduction: Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. Evidence suggests that a deficiency in micronutrients may contribute to bone loss during aging and exert generalized effects on chronic inflammation. Recently, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures. Methods: Individuals from The Brazilian Osteoporosis Study (BRAZOS) database had their DII calculated. BRAZOS is an important cross-sectional epidemiological study carried out with a representative sample of men and women ≥40 years old. The research was conducted through in-home interviews administered by a trained team. Nutrition Database System for Research (NDSR) software was used to analyze data on the intake of nutrients, which were employed to calculate the DII using Statistical Analysis Software (SAS®) and Statistical Package for the Social Sciences (SPSS®) to assess its association with low-impact fractures. Results: A total of 2269 subjects had their DII score calculated using information from 24-h recall data. Males had lower DII than females (DII = 1.12 ± 1.04 vs DII = 1.24 ± 0.99, p = 0.012). Women taking statins had lower DII (DII = 0.65 ±1.14 vs DII + 1.26 ± 0.98, p = 0.002), indicating a greater potential for diet-related anti-inflammatory effects. Conclusion: Our findings suggest that women might have a pro-inflammatory diet pattern compared to men. However, we did not find any association between DII scores and low-impact fractures.

Evaluation de la prévalence de l'édentement dans les cabinets dentaires de la ville de Ouagadougou

La perte des dents entraîne une réduction de l'efficacité masticatoire et un changement des habitudes alimentaires. L'objectif de cette étude était d'évaluer la prévalence de l'édentement dans les cabinets dentaires de la ville de Ouagadougou. Matériels et méthodes. L'étude descriptive transversale portait sur 400 patients âgés de plus de 15 ans, venus en consultation dans les différents cabinets dentaires de la ville de Ouagadougou. L'analyse statistique descriptive des données a été faite à l'aide du logiciel EPI-INFO version 7.1.2. L'étude descriptive des résultats a été réalisée avec un intervalle de confiance de 95 %. L'étude analytique a utilisé le test de Student Fisher et le test du Khi². Résultats. Une prédominance féminine a été notée dans l'échantillon (56,75%). La moyenne d'âge était de 42,03 ans ± 13,4. Le nombre moyen de dents absentes était de 3,6 dents et l'arcade maxillaire présentait 51% des édentements. L'édentement non compensé concernait 79,25% des patients. Conclusion. La forte prévalence de l'édentement peut être associée à un certain nombre de facteurs tels que le statut socioéconomique, le niveau d'instruction et l'accès aux soins. L'amélioration de la politique de santé bucco-dentaire pourra rendre l'accès équitable aux soins prothétiques

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.

Trends in socioeconomic inequalities in the prevalence of functional dentition among older people in Brazil / Tendências em desigualdades na prevalência da dentição funcional em idosos brasileiros / Tendencias en inequidades socioeconómicas, relacionadas con la prevalencia de dentición funcional, entre adultos mayores en Brasil

The objective of this research was to evaluate trends in socioeconomic inequalities in the prevalence of functional dentition among community-dwelling older adults in Brazil. This was a cross-sectional study with data from the last two SBBrasil Project surveys conducted in 2003 and 2010. Functional dentition was defined as the presence of 20 or more natural teeth and was assessed during the clinical examination of dentition status. Schooling was used as the socioeconomic position measure. Socioeconomic inequality was measured using two complex measures; the slope index of inequality (SII) and the relative index of inequality (RII). The prevalence of functional dentition was 10.8% (95%CI: 8.1-14.2) in 2003 and 13.6% (95%CI: 11.1-16.5) in 2010. The prevalence of functional dentition increased significantly over the educational rank in both years. Absolute inequalities were significant for both years and remained unaltered between 2003 and 2010. Significant relative inequality in the prevalence of functional dentition was found in both years of the survey. Socioeconomic inequalities in the prevalence of functional dentition among older adults in Brazil persisted significantly between both national oral health surveys.

O estudo teve como objetivo avaliar as tendências nas desigualdades socioeconômicas na prevalência da dentição funcional entre idosos não institucionalizados no Brasil. O estudo usou dados das duas últimas pesquisas do Projeto SBBrasil, realizadas em 2003 e 2010. A dentição funcional foi definida como a presença de 20 ou mais dentes naturais, avaliada durante o exame clínico odontológico. A escolaridade foi usada como medida de nível socioeconômico. A desigualdade socioeconômica foi estimada com duas medidas complexas: o índice absoluto de desigualdade ou slope index of inequality (SII) e o relative index of inequality (RII). A prevalência da dentição funcional foi 10,8% (IC95%: 8,1-14,2) em 2003 e 13,6% (IC95%: 11,1-16,5) em 2010. A prevalência da dentição funcional aumentou significativamente com o aumento do nível de escolaridade em ambos os anos. As desigualdades absolutas foram significativas para ambos os anos e permaneceram inalteradas entre 2003 e 2010. Nos dois anos da pesquisa, foi observada uma desigualdade relativa significativa na prevalência da dentição funcional. As desigualdades socioeconômicas na prevalência da dentição funcional entre idosos brasileiros persistiram significativamente entre as duas pesquisas nacionais de saúde oral.

El objetivo de esta investigación fue evaluar las tendencias en inequidades socioeconómicas, respecto a la prevalencia de una dentición funcional entre adultos mayores, residentes en comunidades de Brasil. Se trata de un estudio transversal con datos de los dos últimos programas de Proyecto SBBrasil, en los que se realizaron encuestas durante los años 2003 y 2010. La dentición funcional se definió como la presencia de 20 o más dientes naturales y se evaluó durante un examen clínico del estatus de la dentadura. Se valoró la escolaridad como medida de clasificación socioeconómica. La inequidad socioeconómica se midió usando dos medidas complejas; slope index of inequality (SII) y el relative index of inequality (RII). La prevalencia de la dentición funcional fue 10,8% (IC95%: 8,1-14,2) en 2003 y 13,6% (IC95%: 11,1-16,5) en 2010. La prevalencia de la dentición funcional se incrementó significativamente con el aumento del nivel de escolaridad en ambos años. Las inequidades absolutas fueron significativas para ambos años y permanecieron inalteradas entre 2003 y 2010. Se halló una inequidad relativa significativa en la prevalencia de la dentición funcional durante ambos años de la encuesta. Las inequidades socioeconómicas en la prevalencia de la dentición funcional entre adultos mayores en Brasil persistieron significativamente en ambas encuestas de salud bucal nacionales.

Comparación de la Salud Oral de Embarazadas y Puérperas Hospitalizadas según uso de Programa de Salud Oral Integral de la Embarazada: Estudio Transversal / Oral Health Status of Hospitalized Pregnant Women Users of the Pregnancy Ges Program in Chile Compared to not Users: A Cross Sectional Study

RESUMEN: Dentro de las patologías orales, la caries, enfermedad periodontal y pérdida de dientes, son las enfermedades más frecuentes en la población adulta, sin embargo, su prevalencia en pacientes embarazadas del tercer trimestre y puérperas hospitalizadas es un área poco investigada. Comparar la condición de salud oral de embarazadas del tercer trimestre y puérperas hospitalizadas en el Hospital Parroquial de San Bernardo entre los años 2015-2016, que utilizaron el programa de salud oral integral de la embarazada GES versus aquellas que no lo utilizaron. Se realizó un estudio de tipo transversal donde se evaluó a 321 pacientes, las cuales se encontraban hospitalizadas en el servicio de Ginecología y Obstetricia del Hospital Parroquial de San Bernardo. Se analizó la prevalencia de caries, enfermedad periodontal, piezas ausentes y COPD, utilizando el programa estadístico Stata 14.0 y Test chi-cuadrado, Mann Whitney, exacto de Fisher. La muestra quedó constituida por 293 pacientes, 236 (80,55 %) correspondían a pacientes que utilizaron el programa GES de la embarazada. El promedio de edad de las pacientes fue de 26 años, el nivel socio económico y el nivel educacional más prevalente fue el nivel C3 en el 42,3 % y media completa en un 37,8 %, respectivamente. Las embarazadas que utilizaron el programa GES, presentaron un componente C menor y un componente O mayor, cuya diferencia fue estadísticamente significativa, para el componente C y O del COPD (p=0,0001 y p=0,0089) respectivamente. El ser beneficiario GES es un factor protector de caries, con un OR de 0,33 valor p < 0,001 y un intervalo de confianza al 95 % de 0,18 - 0,61. Las pacientes evaluadas no presentaban diferencias en los parámetros periodontales estudiados, en cambio las pacientes GES si tenían un factor C menor que las no GES, en el COPD.

ABSTRACT: Dental caries, periodontitis and tooth loss are considered the most frequent oral conditions in the adult population. This is not an exception during pregnancy, where efforts have been made in Chile to improve women's oral health through the GES program initiative, developed in 2010. However, prevalence of these conditions is unknown for the Chilean pregnant and puerperal population. The aim of this study was to compare differences in the oral health condition of third trimester pregnant and puerperal women hospitalized in San Bernardo's Parochial Hospital during 2015-2016 with regards to the use of the GES program. A cross-sectional study was conducted in the Gynecology and Obstetrics Service of San Bernardo's Parochial Hospital, where 321 hospitalized third trimester pregnant and puerperal women received a thorough oral examination with a selfadministered questionnaire collecting data on sociodemographics, oral hygiene habits and frequency of dental visits. The prevalence of dental caries, periodontal disease and tooth loss were studied. Chi-square, Mann Whitney and Fisher's exact tests were conducted using the Stata 14.0 software. Two hundred and ninety three patients agreed to participate, with a mean age of 26, and 236 (80.55 %) were GES program users. A C3 socio-economic and educational level of (42.3 %) and a completed high school level (37.8 %) were the most frequent. Pregnant and puerperal women using the GES program presented statistically lower (p = 0.0001) and a higher restoration records (p = 0.0089) in the COPD index. The evaluated patients had a high COPD index and a high prevalence of periodontal disease. Being a GES user had an OR of 0.33 p value <0.001 and a 95 % confidence interval of 0.18 - 0.61. The evaluated patients did not present differences in periodontal parameters studied, whereas GES patients had a C factor lower than non-GES patients, in the COPD. The GES program could be a caries protective factor for third trimester pregnant and puerperal women hospitalized in San Bernardo's Parochial Hospital during2015-2016.

Qualidade de vida e condições de saúde bucal de hipertensos e diabéticos em um município do Sudeste Brasileiro / Quality of life and oral health among hypertensive and diabetic people in a Brazilian Southeastern city

Resumo O objetivo deste estudo foi avaliar a qualidade de vida relacionada às condições clínicas de saúde bucal entre hipertensos e diabéticos de Alfenas, MG, Brasil. Estudo domiciliar, descritivo-analítico, transversal, com amostra randomizada, sistemática, estratificada por Equipe Saúde da Família, composta por 218 sujeitos. Aplicou-se os índices CPOD, T-Health, FS-T, SiC index, uso e necessidade de próteses e OHIP-14. A maioria dos sujeitos (56,42%) apresenta apenas Hipertensão Arterial, é do sexo feminino (67,43%), com idade média de 64,83 (± 11,99), variando entre 35 e 93 anos. Não se observou diferenças significativas para as variáveis entre hipertensos, diabéticos e hipertensos-diabéticos. Registrou-se CPOD = 27,16 (± 6,15), com 22,94 (± 10,46) dentes perdidos; T-Health = 5,23 (± 6,52); FS-T = 8,53 (± 10,12) e SiC = 32 (± 0,00). Dos sujeitos, 85,78% usavam próteses (58,72% Prótese Total) e 61,01% necessitavam das mesmas (58,26% no arco inferior). As correlações entre OHIP-14 (5,37 [± 4,95]) e condições clínicas evidenciaram a presença de dentes afetando dimensões psicológicas, além de uso e necessidade de próteses associadas a impactos físicos e sociais (p < 0,05). Concluiu-se que edentulismo, uso e necessidade de próteses afetaram a qualidade de vida de hipertensos e diabéticos em aspectos psicológicos, físicos e sociais.

Abstract This research aimed to assess the oral health related to quality of life among hypertensive and diabetic patients in the city of Alfenas, Brazil. This was a domiciliary-based, descriptive-analytical, cross-sectional research with a random, systematic sample stratified by the Family Health Team, consisting of 218 individuals. The following indexes were applied: DMFT, T-Health, FS-T, SiC index, use and need of prosthesis and OHIP-14. Most of the patients (56.42%) had only high blood pressure, were females (67.43%), with an average age of 64.83 (±11.99) years old, varying between 35 and 93 years old. No significant differences on the variables between hypertensives, diabetics and hypertensive-diabetics were noticed. The following data was registered: DMFT=27.16 (± 6.15), with 22.94 (± 10.46) of missing teeth; T-Health=5.23 (± 6.52); FS-T=8.53 (± 10.12) and SiC=32 (± 0.00). 85.78% of the individuals were using prosthesis (58.72% Dentures) and 61.01% needed prostheses (58.26% in the jaw).The correlations between OHIP-14 (5.37 [± 4.95]) and oral health evidenced the increase in the number of teeth affecting psychological dimensions, besides the use and need of prostheses were associated to physical and social impacts (p < 0.05). We concluded that edentulism, use and need of prostheses affected quality of life in hypertensive and diabetic patients concerning psychological, physical and social aspects.

Perfil de saúde bucal de idosos não institucionalizados e sua associaçãocom autoavaliação da saúde bucal / Oral health profile among community-dwellingelderly and its association with self-rated oral health

RESUMO: Introdução: O uso de prótese e a perda dentária em idosos estão associados a impactos significativos na saúde geral e na qualidade de vida. A avaliação contínua do perfil de saúde bucal dessa população é importante para o planejamento das ações e políticas da área. Objetivo: Foram objetivos deste trabalho avaliar a prevalência de perda dentária e uso de próteses entre idosos em diferentes períodos, verificar as características sociodemográficas associadas à dentição funcional (mais de 20 dentes) e avaliar o impacto do uso de prótese e da perda dentária na autoavaliação da saúde bucal. Métodos: A amostra foi composta por pessoas de 60 anos ou mais, participantes do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). A avaliação da prevalência de perda dental e uso de próteses foi feita a partir da comparação dos dados coletados nos anos de 2000, 2006 e 2010. As análises dos fatores associados à dentição funcional e autoavaliação de saúde bucal foram realizadas com base nos dados coletados no ano de 2010. A comparação do perfil de saúde bucal ao longo dos três períodos foi feita por meio de análises descritivas e comparação de intervalos de confiança. Realizou-se análise de regressão logística múltipla para avaliar os fatores associados à dentição funcional e à autoavaliação da saúde bucal. Resultados: A prevalência de perda dental e uso de próteses se manteve constante ao longo dos três anos analisados. A dentição funcional foi significativamente associada à escolaridade, sexo e cor/gênero. Idosos com necessidade de próteses e bolsa periodontal apresentaram mais chances de autoavaliação ruim. Conclusão: Não houve redução da prevalência de perda dentária e uso de próteses ao longo de dez anos na população estudada. A dentição funcional está associada a desigualdades sociodemográficas. A autoavaliação de saúde bucal está associada à necessidade de próteses.

ABSTRACT: Introduction: The use of dental prosthesis and the tooth loss in elderly people are associated with significant impact on the overall health and quality of life. Continuous assessment of oral health profile in this population is important for planning the actions and policies of the area. Objectives: The aims of this study were to assess the prevalence of tooth loss and use of dental prosthesis among the elderly people in different periods, to evaluate the association between functional dentition (20 teeth or more) and socioeconomic factors, and to evaluate the impact of tooth loss and use of dental prosthesis on self-rated oral health. Methods: Thesample consisted of people aged 60 years and older who participated in the Health, Well-Being, and Aging Study (SABE). Data from the years 2000, 2006, and 2010 were used to assess the prevalence of tooth loss and use of dental prosthesis. Analysis of the factors associated with the functional dentition and self-rated oral health was based on the data collected in 2010. Comparison of oral health profile over the 3 years was done through descriptive analysis and comparison of confidence intervals. Multiple logistic regression models were used to assess the factors associated with functional dentition and self-rated oral health. Results: The prevalence of tooth loss and use of dental prosthesis remained constant over the three periods analyzed. Functional dentition was significantly associated with education, sex, and race/gender. Individuals in need of dental prosthesis and with periodontal pocket were more likely to report poor oral health. Conclusion: There was no reduction in the prevalence of tooth loss and in the use of dental prosthesis over 10 years. Functional dentition is associated with socioeconomic inequalities. Self-rated oral health is associated with the need of dental prosthesis.

Sinking Teeth into Dental Health of Older Adults in Jamaica / Compromiso Entusiasta con la Salud Dental de los Adultos Mayores en Jamaica

ABSTRACT Objectives: To describe the prevalence of tooth loss, denture use and dental care utilization among older persons by age, gender, union, residence, education, chronic illness and health insurance status and to identify independent predictors of dental service use and tooth loss. Methods: A cross-sectional survey utilizing a nationally representative sample of 2943 older persons in Jamaica was conducted. Data related to tooth loss, dental care use and sociodemographic data were obtained. Relationships between variables were assessed in bivariate analyses and logistic regression models subsequently developed to identify predictors of tooth loss and dental care use. Results: Tooth loss (any) prevalence was 94% and among those who reported tooth loss, 61.1% had dentures: the majority of those with dentures reported using them. Non-use was mainly related to damaged denture or discomfort. Only 35% of persons reported a dental visit within the last 12 months. Age, union status and educational level were significant predictors of both tooth loss and dental visit within the past year. Additionally, gender, residence and having health insurance predicted dental care utilization. Conclusion: Dental health issues are important in the care of older persons and assume increasing relevance given rapid ageing of the population. Jamaica must craft strategies to address emergent needs in its response to the challenges of oral healthcare for older persons.

RESUMEN Objetivos: Describir la prevalencia de la pérdida de dientes, el uso de prótesis dentales, y la utilización de la atención dental entre las personas mayores por edad, género, estado civil, residencia, educación, enfermedad crónica, y posesión de seguro médico, e identificar predictores independientes de la utilización de la atención dental, así como de la pérdida de dientes. Métodos: Se realizó una encuesta transversal utilizando una muestra representativa de 2943 personas de edad a nivel nacional en Jamaica. Se obtuvo datos sobre la pérdida de dientes, el uso de los servicios dentales, y la demografía. Las relaciones entre las variables se evaluaron en análisis bivariados y modelos de regresión logística desarrollados posteriormente para identificar los predictores de la pérdida de dientes y la utilización de la atención dental. Resultados: La prevalencia de la pérdida de dientes (cualesquiera) fue 94%, y entre los que informaron pérdida de dientes, un 61.1% utilizaban prótesis dentales: la mayoría de los que utilizaban prótesis dentales reportaron su uso. El no uso se relacionó principalmente con prótesis dentales dañadas o molestias. Sólo el 35% de las personas reportaron una visita dental en los últimos 12 meses. La edad, el estado civil, y el nivel educacional fueron predictores significativos de la pérdida de dientes y la visita dental el año anterior. Además, el género, la residencia y la posesión del seguro médico fueron predictores de la utilización de la atención dental. Conclusión: Los problemas de salud dental son importantes en el cuidado de las personas de edad y adquieren una relevancia creciente dado el rápido envejecimiento de la población. Jamaica debe elaborar estrategias para abordar las necesidades emergentes en su respuesta a los desafíos de la salud oral de las personas mayores.