Use and need of dental prosthesis among community dwelling elderly: a cross-sectional population-based study / Uso e necessidade de próteses dentárias em idosos domiciliados: um estudo transversal de base populacional

Abstract Background By the use of complete or partial dental prosthesis, function, esthetics, and phonetics are reestablished. Few population-based studies are available in the literature using an older adult population. Objective Evaluate the use of and need for dental prostheses and their associated factors. Method This study included a random sample of 287 elderly, in the city of Cruz Alta, Brazil. Use of and need for dental prostheses were the main outcomes, and two analytical models were constructed. Subgroup analyses were performed for individuals using fixed partial denture (FPD) and removable (partial and/or complete) dental prosthesis (RDP). Results Use of and need for dental prosthesis were identified in 83.6% (n=240) and 42.5% (n=122) of the elderly, respectively. Women presented a significantly higher prevalence ratio (PR) for use of dental prostheses (PR=1.15; 95%IC:1.02-1.28) and lower need (PR=0.70; 95%IC:0.54-0.91). No statistically significant difference was demonstrated for the use of FPD regarding the sex. Higher education level was associated with lower use of prostheses (PR=0.73; 95%IC:0.58-0.91) when compared to lower level of education. Medium level of education showed a significantly lower need for dental prostheses (PR=0.61 - 95%IC:0.39-0.94). Those that did not consume alcohol presented with a significantly lower use of FPD and RDP (PR=0.46; 95%IC:0.23-0.93 and 0.90;0.81-0.99, respectively). Conclusion The use of and need for dental prostheses were associated with sex, level of education, and behavioral factors.

Resumo Introdução Pelo uso de próteses dentárias completas ou parciais, função, estética e fonética são reestabelecidas. Poucos estudos de base população estão disponíveis na literatura utilizando a população idosa. Objetivo Avaliar o uso e a necessidade de prótese dentária, bem como seus fatores associados. Método Esse estudo incluiu uma amostra randômica de 287 idosos da cidade de Cruz Alta, no Brasil. Uso e necessidade de prótese dentária foram os desfechos primários, e dois modelos analíticos foram construídos. No uso de prótese dentária, análises de subgrupos foram realizadas para Prótese Parcial Fixa (PPF) e Prótese Removível (parcial e/ou completa) (PR). Resultados Uso e necessidade de prótese dentária foram detectados em 83,6% (n=240) e 42,5% (n=122) dos idosos, respectivamente. Mulheres apresentaram significativa maior Razão de Prevalência (RP) para o uso de prótese dentária (RP:1,15; IC95%:1,02-1,28) e menor necessidade (RP:0,70; IC95%:0,54-0,91). Nenhuma associação significativa foi encontrada para o uso de PPF em relação aos gêneros. Alto nível educacional esteve associado ao menor uso de prótese (RP:0,73; IC95%:0,58-0,91), quando comparado com escolaridade baixa. Escolaridade média mostrou significativa menor necessidade de prótese dentária (RP:0,61 - IC95%:0,39-0,94). Aqueles que não utilizam álcool apresentaram um menor uso de PPF e PR (RP:0,46; IC95%:0,23-0,93 e 0,90;0,81-0,99, respectivamente). Conclusão Uso e necessidade de prótese dentária estão associados ao gênero, nível educacional e fatores comportamentais.

Oral health-related quality of life and associated factors in the elderly: a population-based cross-sectional study / Qualidade de vida relacionada à saúde bucal e fatores associados em idosos: um estudo transversal com amostra representativa

Abstract This study aimed to evaluate the oral health-related quality of life (OHRQoL) and associated factors in the elderly. A cross-sectional study was conducted with 287 elderly of Cruz Alta, Brazil. The following variables were collected: age, sex, ethnicity, level of education, marital status, retirement, medical/dental history, smoking/alcohol exposure, oral hygiene habits, use and need of dental prosthesis, missing teeth, temporomandibular disorder symptoms (TMD), nutritional status, and halitosis. OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14). The sample was categorized into low impact (sum scores ≤6) and high impact (sum scores ≥7). Associations were analyzed by Poisson regression with robust variation. Mean scores of OHIP-14 was 5.92±8.54. Divorced individuals and those who did not use dental floss presented 77% and 54%, respectively, higher prevalence ratio (PR) of having higher OHRQoL impact. Elderly that did not need dental prosthesis demonstrated a lower impact on OHRQoL (P<0.01). Elderly with TMD presented a higher PR of having higher OHRQoL impact (P<0.01). It was concluded that higher impact on OHRQoL was associated with marital status, non-users of dental floss and those with TMD. No need dental prosthesis were associated with lower impact on OHRQoL.

Resumo O estudo avaliou a qualidade de vida relacionada à saúde bucal (QVRSB) e fatores associados em idosos. Estudo transversal foi realizado em 287 idosos de Cruz Alta, Brasil. As seguintes variáveis foram coletadas: idade, sexo, etnia, nível educacional, estado civil, aposentadoria, histórico médico/odontológico, exposição ao fumo/álcool, hábitos de higiene oral, uso e necessidade de prótese, dentes ausentes, sintomas de desordem temporomandibular (DTM), estado nutricional e halitose. QVRSB foi avaliada pelo OHIP-14 (Perfil de Impacto de Saúde Bucal) e categorizado em baixo impacto (soma dos escores ≤6) e alto impacto (soma dos escores ≥7). Associações foram avaliadas por regressão de Poisson com variância robusta. A média OHIP-14 foi 5,92±8.54. Indivíduos divorciados e aqueles que reportaram não usar fio dental apresentaram 77% e 54%, respectivamente, maior razão de prevalência (RP) de terem maior impacto na QVRSB. Idosos que não necessitam próteses dentárias demonstraram menor impacto na QVRSB (P<0,01). Além disso, idosos com DTM apresentaram maior RP de terem maiores escores de OHIP-14 (P<0,01). Foi concluído que maiores impactos na QVRSB estão associados com estado civil, não uso de fio dental e DTM. Não necessitar de prótese dentária esteve associado com menores impactos na QVRSB.

Oral health-related quality of life and associated factors in the elderly: a population-based cross-sectional study.

This study aimed to evaluate the oral health-related quality of life (OHRQoL) and associated factors in the elderly. A cross-sectional study was conducted with 287 elderly of Cruz Alta, Brazil. The following variables were collected: age, sex, ethnicity, level of education, marital status, retirement, medical/dental history, smoking/alcohol exposure, oral hygiene habits, use and need of dental prosthesis, missing teeth, temporomandibular disorder symptoms (TMD), nutritional status, and halitosis. OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14). The sample was categorized into low impact (sum scores ≤6) and high impact (sum scores ≥7). Associations were analyzed by Poisson regression with robust variation. Mean scores of OHIP-14 was 5.92±8.54. Divorced individuals and those who did not use dental floss presented 77% and 54%, respectively, higher prevalence ratio (PR) of having higher OHRQoL impact. Elderly that did not need dental prosthesis demonstrated a lower impact on OHRQoL (P<0.01). Elderly with TMD presented a higher PR of having higher OHRQoL impact (P<0.01). It was concluded that higher impact on OHRQoL was associated with marital status, non-users of dental floss and those with TMD. No need dental prosthesis were associated with lower impact on OHRQoL.

Tooth loss and associated factors in the elderly in Cruz Alta, Brazil: a crosssectional study.

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.

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.