Complete dentures associated with frailty among edentulous older Japanese people: A prospective analysis.

OBJECTIVE: This study aimed to explore the cross-sectional and prospective associations between self-reported functionality of complete dentures (FCD), satisfaction with complete dentures (SCD) and the ability to chew hard food (ACHF) on the one hand and the frailty index (FI) on the other hand among edentulous community-dwelling older Japanese people. METHODS: The study examined 770 edentulous participants of the Nihon University Japanese Longitudinal Study of Aging. The self-reported FCD, SCD and ability to chew six groups of food (from hardest to softest) with complete dentures were the independent variables at the baseline. The FI was computed including 40 deficits as the dependent variable at the baseline and 4 years later. Cross-sectional and prospective generalized linear regression models were fitted controlling for age, gender, marital status, education, working status and area of residence. RESULTS: The use of non-functional complete dentures and dissatisfaction with complete dentures were both associated with a higher FI cross-sectionally (3.9% [95% CI 2.2-5.6] and 3.2% [95% CI 1.5-4.9], respectively) and prospectively (3.9% [95% CI 2.0-6.0] and 3.3% [95% CI 1.3-5.3], respectively). Regarding the ability to chew, a higher FI at baseline was observed among those able to chew food of Group 2 (1.9%, [95% CI 0.1-3.7]) and Groups 4-6 (1.9%, [95% CI 0.1-3.7]), and a progressive increment in the FI, as the participants reported being able to chew softer groups of food at the follow-up (Group 2: 2.2% [95% CI 0.05-4.3]; Group 3: 3.6% [95% CI 1.2-6.0]; and Groups 4-6: 3.4 [95% CI 0.7-6.1]). CONCLUSION: Self-reported use of non-functional complete dentures, dissatisfaction with dentures and a reduced ACHF with complete dentures were associated with a higher FI both cross-sectionally and prospectively.

Green composites based on thermoplastic starch reinforced with micro- and nano-cellulose by melt blending - A review.

Starch is a biodegradable biopolymer, a sustainable material that can replace conventional petrochemical-based plastics. However, starch has some limitations, as it must be processed by heating and treated mechanically with a plasticizer to become thermoplastic starch (TPS). Different variables such as mixing speeds, amount, and kind of plasticizers play a vital role in preparing TPS by melting. Despite this, the properties of the TPS are not comparable with those of traditional plastics. To overcome this limitation, microcellulose or nanocellulose is added to TPS by melt mixing, including the extrusion and internal mixing process, which enables large-scale production. This review aims to compile several studies that evaluate the effect of plasticizers, as well as the relevance of incorporating different cellulosic fillers of different dimensions on the properties of TPS obtained by melt mixing. Potential applications of these materials in food packaging, biomedical applications, and other opportunities are also described.

Social determinants of health for moderate and severe periodontal disease in rural and urban populations.

OBJECTIVE: We assessed the prevalence of moderate and severe periodontitis and its association with social determinants of health in rural and urban population from the State of Chiapas, in Southern Mexico. MATERIAL AND METHODS: A cross-sectional population-based study was conducted in 2013 comprising people 20 years and older. The determinants were categorized as proximal (age, sex, indigenous origin, diabetes, smoking, diet), intermediate (level of schooling, occupation, medical and dental care), and structural (type of institution of health care provision, residence area). Periodontal status was assessed using the Periodontal Screening and Recording (PSR) Index. RESULTS: In total, 467 persons (72.4% women; mean age 43.0 years [s.d 14.7]) participated. Of them, 76.5% lived in rural areas and 56.7% were of indigenous origin. Participants with moderate and severe periodontitis had a significantly lower toothbrushing frequency (44.1% and 44.8%, respectively), and poorer oral hygiene (90% and 90.3%, respectively) compared with people without periodontitis (29.4% for toothbrushing frequency and 74.5% for oral hygiene). Moderate periodontitis was associated with poor oral hygiene (OR=2.63) and no schooling (OR=1.86). Severe periodontitis was associated with age (OR=1.05), poor oral hygiene (OR=3.99), no schooling (OR=2.08), and the interaction term of rural area and indigenous origin (RM=5.23). CONCLUSIONS: Social determinants of health play an important role in the development of periodontitis. Preventive oral health programs should thus focus on the specific social, economic, and geographical context of the population.

Tooth Loss and Associated Factors in Mexican Older Adults in Nursing Homes: A Multicenter Cross-Sectional Study.

The objective of this study was to determine the experience of tooth loss and associated factors in older adults and elderly residing in nursing homes. A cross-sectional study was conducted in Mexican older adults and elderly aged ≥60 years living in four nursing homes (two in Mexico City, Mexico: one in Cuernavaca, Morelos, and one in Oaxaca, Oaxaca). The data were collected at the facility (home nursing) by two dentists in 2019. To determine the number of tooth loss and DMFT, a clinical oral examination was performed. In addition, a questionnaire was applied to determine diverse independent variables (demographic, socioeconomic, and behavioral). The analysis was performed using nonparametric tests and negative binomial regression (p < 0.05). 257 subjects were included. The mean age was 81.25 ± 9.02 years, and 60.7% were women. The mean number of lost teeth was 18.78 ± 9.05 (women = 19.43 ± 8.59 and men = 17.77 ± 9.68; p > 0.05). In the multivariate negative binomial regression model, it was found that, for each one-year increase in age, the mean tooth loss increased 0.92% (p < 0.05). In current smokers (p < 0.01) and in those who brush their teeth < 2 times a day (p < 0.01), the average of tooth loss increased 22.04% and 61.46%, respectively. The experience of tooth loss in Mexican older adults and elderly was high. Demographic (age) and habit of behavior (tobacco use and less frequent tooth brushing) were associated with increased tooth loss. It is important to promote oral health programs for institutionalized older adults.

Frailty index and ten oral conditions in the Coyoacan cohort study: A cross-sectional analysis.

OBJECTIVES: To analyse the relationship between the Frailty Index and 10 oral conditions controlling for nutritional status among Mexican community-dwelling older people. BACKGROUND: Studies suggest that the association between frailty and oral conditions are mediated by nutrition. MATERIALS AND METHODS: This cross-sectional analysis includes 487 community-dwelling men and women aged ≥70 years old. Interview and clinical examinations were performed at participants' homes. Objective (number of natural teeth, root remnants, dental condition, utilisation and functionality of removable dental prostheses and periodontitis) and subjective (utilisation of dental services, self-rated oral health, chewing difficulties and xerostomia) oral variables were collected by trained personnel. The Frailty Index was calculated considering 35 deficits. Nutritional status measured with the Mini-Nutritional assessment (MNA), age, sex, education, and marital status were included as covariates. We fitted 11 multivariate generalised linear models (one for each oral condition), assuming gamma distribution for Frailty Index as the outcome. RESULTS: Participants average age was 78.1 years, 52.1% were women. We observed a higher Frailty Index among those rating their oral health as worse than others their age (5.1%), reporting chewing difficulties often (4.9%) and fairly and very often (7.0%), and xerostomia (4.8%). Age, gender and MNA were consistently associated with the Frailty Index. CONCLUSION: Subjective oral conditions are compatible with the Frailty Index after controlling for older people's nutritional status and covariates.

Validity of the dental operating microscope and selective dentin removal with ultrasonic tips for locating the second mesiobuccal canal (MB2) in maxillary first molars: An in vivo study.

Background: Several investigations have determined whether the use of a dental operating microscope (DOM) in combination with selective dentine removal with ultrasonic tips increases the percentage of location of the Mesiobuccal 2 (MB2) root canal in maxillary first molars (MFM). However, these studies did not report the performance of in vivo measurements with the comparison with a gold standard. The aim of this study was to determine the validity of the DOM and selective dentin removal with ultrasonic tips to locate the MB2 root canal in MFM using Cone Beam Computed Tomography (CBCT) as the gold standard. Material and Methods: The initial sample size was 91 patients, but 7 were excluded, so the sample size was 84 patients who signed the informed consent. Inclusion criteria: MFM indicated for root canal treatment. An expert blinded observer identified the MB2 in the CBCT. Two standardized examiners (Kappa=91%) performed the clinical assessment in three stages: Stage 1, canal location with an endodontic explorer and a mirror; Stage 2, use of DOM and Stage 3, use of DOM plus selective dentine removal with ultrasonic tips. The validity of each stage was calculated. Results: The prevalence of MB2 using CBCT was 79%, by clinical location was 68%. Sensitivity was 79%, 82%, 86% for stage 1, 2 and 3, respectively. Specificity and Positive Predictive Values were 100% for all methods. Negative Predictive Value was 56%, 60%, 67%, respectively. Positive Likelihood Ratio tends to infinity for all methods, Negative Likelihood Ratio= 0.21, 0.18 and 0.14 and Accuracy= 83%, 86% and 89%, respectively. Conclusions: The use of DOM with selective dentine removal with ultrasonic tips is the most valid method for locating MB2 canal in MFM. There was an increase in the location of the MB2 root canal with the DOM and ultrasonic tips, which definitely help the clinician. Key words:Cone beam computed tomography, microscopy, second mesiobuccal canal, sensitivity and specificity, validity.

Psychosocial evaluation for liver transplantation: A brief guide for gastroenterologists. / Evaluación psicosocial para trasplante hepático: una guía breve para gastroenterólogos.

Liver transplantation is a lifesaving treatment that improves survival and quality of life. The procedure requires adequate transplant candidate selection carried out by a multidisciplinary team. Psychosocial evaluation is a necessary part of recipient selection and its primary aims are to identify problems and psychosocial needs of the patient and his/her family, to improve transplantation outcomes. Different psychosocial conditions are considered risk factors for morbidity and mortality after transplantation. The presence of those factors per se is not an absolute contraindication, thus adequate evaluation promotes equal access to healthcare, improves results, and optimizes resources. The present review provides an overview of and guidelines for the most important psychosocial issues during the pretransplantation phase.

Effect of supercritical incorporation of cinnamaldehyde on physical-chemical properties, disintegration and toxicity studies of PLA/lignin nanocomposites.

Poly (lactic acid)/lignin nanocomposites (PLA/Lig-Np) containing cinnamaldehyde (Ci) were obtained by a combination of melt extrusion and supercritical impregnation process. In this work, Ci impregnation tests were carried out in a high-pressure cell at 40 °C for 3 h using 12 MPa and 1 MPa min-1 of depressurization rate, obtaining impregnation yields ranging from 5.7 to 10.8% w/w. Thermal, mechanical and colorimetric properties of the developed films were affected by the incorporation of lignin nanoparticles and the active compound, obtaining biodegradable plastic materials with a strong UV-light barrier property compared to PLA films. In addition, disintegrability tests under composting conditions confirmed the biodegradable character of nanocomposites developed. On day 23, a disintegration percentage greater than 90% was determined for all bionanocomposites. Finally, to establish the possible toxicity effect of the nanocomposites obtained, studies in vivo were performed in normal rats. Toxicity studies showed normal blood parameters after a single dose of nanocomposites. PLA/Ci/Lig-Np bionanocomposite films could be potentially applied to design biodegradable UV-light barrier materials for food packaging and biomedical applications.

Classification of radiologically isolated syndrome and clinically isolated syndrome with machine-learning techniques.

BACKGROUND AND PURPOSE: The unanticipated detection by magnetic resonance imaging (MRI) in the brain of asymptomatic subjects of white matter lesions suggestive of multiple sclerosis (MS) has been named radiologically isolated syndrome (RIS). As the difference between early MS [i.e. clinically isolated syndrome (CIS)] and RIS is the occurrence of a clinical event, it is logical to improve detection of the subclinical form without interfering with MRI as there are radiological diagnostic criteria for that. Our objective was to use machine-learning classification methods to identify morphometric measures that help to discriminate patients with RIS from those with CIS. METHODS: We used a multimodal 3-T MRI approach by combining MRI biomarkers (cortical thickness, cortical and subcortical grey matter volume, and white matter integrity) of a cohort of 17 patients with RIS and 17 patients with CIS for single-subject level classification. RESULTS: The best proposed models to predict the diagnosis of CIS and RIS were based on the Naive Bayes, Bagging and Multilayer Perceptron classifiers using only three features: the left rostral middle frontal gyrus volume and the fractional anisotropy values in the right amygdala and right lingual gyrus. The Naive Bayes obtained the highest accuracy [overall classification, 0.765; area under the receiver operating characteristic (AUROC), 0.782]. CONCLUSIONS: A machine-learning approach applied to multimodal MRI data may differentiate between the earliest clinical expressions of MS (CIS and RIS) with an accuracy of 78%.

Effect of a School-Based Supervised Tooth Brushing Program In Mexico City: A Cluster Randomized Intervention.

Large-scale school-based programs effectively provide health education and preventive strategies. SaludARTE is a school-based program, including supervised tooth brushing, implemented in 51 elementary schools in Mexico City. OBJECTIVES: To assess the three-month efficacy of supervised tooth brushing in reducing dental plaque, gingival inflammation, and bleeding on probing in schoolchildren participating in SaludARTE. STUDY DESIGN: This was a pragmatic cluster randomized intervention, with two parallel branches. Four randomly selected schools participating in SaludARTE (n=200) and one control school, which did not participate in the program (CG) (n=50), were assessed. Clusters were not randomly allocated to intervention. The main outcomes were as follows: mean percentage gingival units with no inflammation, dental surfaces with no dental plaque, and gingival margins with no bleeding. The independent variable was supervised tooth brushing at school once a day after a meal. Guardians and children responded to a questionnaire on sociodemographic and oral hygiene practices, and children were examined dentally. Mean percentage differences were compared (baseline and follow-up). RESULTS: A total of 75% of guardians from the intervention group (IG) and 77% from the CG answered the questionnaire. Of these, 89.3% were women, with a mean age of 36.9±8.5 years. No differences in sociodemographic variables were observed between groups, and 151 children from the IG and 35 from the CG were examined at baseline and follow-up. Mean percentage differences for plaque-free surfaces (8.8±28.5%) and healthy gingival units (23.3%±23.2%) were significantly higher in the IG. CONCLUSION: The school-supervised tooth brushing program is effective in improving oral hygiene and had a greater impact on plaque and gingivitis than on gingival bleeding. It is necessary to reinforce the oral health education component of the program.

Impact of caries and dental fluorosis on oral health-related quality of life: a cross-sectional study in schoolchildren receiving water naturally fluoridated at above-optimal levels.

PURPOSE: The purpose of this study was to evaluate the impact of caries and fluorosis on oral health-related quality of life (OHRQoL) among schoolchildren living in areas with high concentrations of fluoride in water. METHODS: Five hundred and twenty-four schoolchildren (8-12 year olds) residing in rural communities in central Mexico were examined for oral hygiene, caries (International Caries Detection and Assessment System, ICDAS II), and fluorosis (Thylstrup and Fejerskov Index, TFI). OHRQoL was evaluated with the Child Perceptions Questionnaire for two age groups (CPQ8-10 and CPQ11-14). Generalized structural equation models were constructed for data analysis. RESULTS: Overall prevalence of caries was 88.5% and fluorosis 46.9%. In the group of 8-10 year olds, 48% of the children had advanced carious lesions in primary or permanent teeth (ICDAS ≥4), 22.6% had moderate/severe fluorosis, and 59.9% of children had an impact on OHRQoL. Schoolchildren with ICDAS ≥4 were more likely [OR = 1.75, (95% CI 1.34-2.28)] to suffer a negative impact on OHRQoL. In the group of 11-12 year olds, 19.9% of children had advanced carious lesions and 23.2% showed moderate/severe fluorosis; 67.3% of children reported had an impact on OHRQoL. Children 11-12 year olds with fluorosis (TFI ≥4) [OR = 2.39 (95% CI 2.12-2.69)], caries (ICDAS ≥4) [OR = 2.18 (95% CI 2.13-2.24)], and low brushing frequency [OR = 2.04 (95% CI 1.21-3.44)] were more likely to have deterioration on OHRQoL. CONCLUSION: A negative impact on OHRQoL was observed in children with caries and fluorosis. CLINICAL RELEVANCE: Deterioration on OHRQoL found in children as a sequel of caries and fluorosis should be considered when designing health policies leading to prevention and effective health promotion programs and incorporated to clinical guidelines for timely dental treatment.

Oral Disease and 3-Year Incidence of Frailty in Mexican Older Adults.

BACKGROUND: Poor oral health has been associated with some components of frailty. The objective of this study was to identify the association between clinical measures of oral health and the incidence of frailty among community-dwelling older adults aged 70 or older in Mexico City. METHODS: A 3-year cohort study with a probabilistic representative sample of home-dwelling elders of one district of Mexico City was performed. Baseline and follow-up interview and oral clinical evaluations were carried out by standardized examiners in participants' homes. Dependent variable was incident frailty defined according to the frailty phenotype. Independent variables were the utilization of dental services, the presence of xerostomia, the number of natural teeth, use of removable dental prostheses, presence of severe periodontitis, and presence of root remnants. Sociodemographic, behavioral, and health measures were included as confounders. The association between oral health conditions and incident frailty was modeled using Poisson regression models with robust variance estimators. The models were adjusted for confounders and interactions. RESULTS: We identified a 14.8% cumulative incidence of frailty. Each additional tooth was associated with a lower probability of developing frailty by 5.0% (risk ratio = 0.90; 95% CI 1.02-1.10). The 3-year risk ratio of developing frailty was 2.13 times higher (95% CI 1.01-4.50) among participants having severe periodontitis. CONCLUSIONS: The number of teeth and the presence of severe periodontitis are associated with the development of frailty after controlling for confounders. Further studies are needed on this topic.

Negative impact of oral health conditions on oral health related quality of life of community dwelling elders in Mexico city, a population based study.

AIM: Oral health in old persons is frequently poor; non-functional prostheses are common and negatively affect quality of life. The objective of this study was to estimate the impact of oral health problems on oral health related quality of life in a sample of home dwelling Mexican elders. METHODS: Household survey in 655 persons 70 years old and over residing in one county in Mexico City. VARIABLES: Oral Health Related Quality of Life (Short version of the Oral Health Impact Profile validated in Mexico-OHIP-14-sp), self-perception of general and oral health, xerostomia, utilization of dental services, utilization and functionality of removable dental prostheses, dental and periodontal conditions, age, gender, marital status, schooling, depression, cognitive impairment and independence in activities of daily living (ADL). A negative binomial regression model was fitted. RESULTS: Mean age was 79.2 ± 7.1 years; 54.2% were women. Mean OHIP-14-Sp score was 6.8 ± 8.7, median was 4. The final model showed that men (RR = 1.30); persons with xerostomia (RR = 1.41); no utilization of removable prostheses (RR = 1.55); utilization of non-functional removable prostheses (RR = 1.69); fair self-perception of general health (RR = 1.34); equal (RR = 1.43) or worse (RR = 2.32) self-perception of oral health compared with persons of the same age; and being dependent for at least one ADL (RR = 1.71) increased the probability of higher scores of the OHIP-14-sp. Age, schooling, depression, cognitive impairment and periodontal conditions showed no association. CONCLUSIONS: Oral rehabilitation can improve quality of life, health education and health promotion for the elder and their caregivers may reduce the risk of dental problems. Geriatr Gerontol Int 2017; 17: 744-752.

Psychological factors and his influence in the oral health of older people: a narrative review / Factores psicológicos y su influencia en la salud oral en el adulto mayor: una revisión narrativa

Abstract: there has been a significant growth in the elderly population of developing countries. This growth leads health systems in those countries to face an increase in consultations for oral diseases for this age group. Therefore, the biopsychosocial approach is essential for healthy aging in the elderly. The objectives of this review article are to identify the psychological factors that have a relationship with most prevalent oral diseases in elderly people (dental caries and periodontal disease), and then describe how tooth loss, the principal consequence of caries and periodontal disease, impacts the mental health of older people. Finally, some proposals for dental work in the elderly are discussed, considering the psychological factors related to oral health.

Resumen: este último tiempo, ha existido un aumento significativo de los adultos mayores en los países en desarrollo. Este aumento lleva a estas naciones a enfrentar un crecimiento en las consultas dentales para este grupo etáreo. Bajo este contexto, es que la aproximación biopsicosocial es esencial para el envejecimiento saludable en la tercera edad. El objetivo de este artículo de revisión sería, en primer lugar, dentificar los factores psicológicos que tienen relación con las enfermedades más prevalentes en el adulto mayor (caries dental y enfermedad periodontal), para luego describir como la pérdida de dientes, principal consecuencia de la caries y enfermedad periodontal, impacta en la salud mental del adulto mayor. Finalmente, se discuten algunas propuestas para el trabajo dental en el adulto mayor, considerando los factores psicológicos relacionados a la salud oral.

Frailty from an Oral Health Point of View.

Frailty commonly affects older persons, increasing their risk for adverse outcomes. Oral health is affected by those conditions related to the mouth and teeth, including caries, periodontal diseases, dysgeusia, presbyphagia and oral cancer among others. Oral health problems can be classified as development defects and acquired problems. These latter are related to infection or trauma, have a cumulative effect throughout life and their consequences are lifelong. Such acquired problems can be classified as primary or secondary, both interacting in a complex manner. Recovery to a previous state of tissue integrity is often impossible from these conditions. These complex interactions have negative impacts on the individual's general health and quality of life. Oral status is an important contributor to general health, and has been linked to several chronic conditions such as cognitive impairment, diabetes, cardiovascular diseases, strokes, and cancer. An individual's oral health is mostly stable throughout life. Tooth loss may be considered as the final outcome, resulting as a consequence of history of caries and periodontitis, as well as failure of prevention and treatment. The loss of a tooth may thus represent the first step of a vicious cycle. In fact, without intervention, one missing tooth may lead to further teeth loss, thus reducing the capability to chew and consume nutrients (essential for life and adequate physiological function), and finally contributing to the development of age-related chronic diseases.

Salivary Parameters (Salivary Flow, pH and Buffering Capacity) in Stimulated Saliva of Mexican Elders 60 Years Old and Older.

OBJECTIVE: To compare a limited array of chewing-stimulated saliva features (salivary flow, pH and buffer capacity) in a sample of elderly Mexicans with clinical, sociodemographic and socio-economic variables. SUBJECTS AND METHODS: A cross-sectional study was carried out in 139 adults, 60 years old and older, from two retirement homes and a senior day care centre in the city of Pachuca, Mexico. Sociodemographic, socio-economic and behavioural variables were collected through a questionnaire. A trained and standardized examiner obtained the oral clinical variables. Chewing-stimulated saliva (paraffin method) was collected and the salivary flow rate, pH and buffer capacity were measured. The analysis was performed using non-parametric tests in Stata 9.0. RESULTS: Mean age was 79.1 ± 9.8 years. Most of the subjects included were women (69.1%). Mean chewing-stimulated salivary flow was 0.75 ± 0.80 mL/minute, and the pH and buffer capacity were 7.88 ± 0.83 and 4.20 ± 1.24, respectively. Mean chewing-stimulated salivary flow varied (p < 0.05) across type of retirement home, tooth brushing frequency, number of missing teeth and use of dental prostheses. pH varied across the type of retirement home (p < 0.05) and marginally by age (p = 0.087); buffer capacity (p < 0.05) varied across type of retirement home, tobacco consumption and the number of missing teeth. CONCLUSIONS: These exploratory data add to the body of knowledge with regard to chewing-stimulated salivary features (salivary flow rate, pH and buffer capacity) and outline the variability of those features across selected sociodemographic, socio-economic and behavioural variables in a group of Mexican elders.

The Coyoacán Cohort Study: Design, Methodology, and Participants' Characteristics of a Mexican Study on Nutritional and Psychosocial Markers of Frailty.

BACKGROUND: "Frailty" has emerged as a condition associated with an increased risk of functional decline among the elderly, which may be differentiated from aging, disability, and co-morbidities. OBJECTIVE: The Mexican Study of Nutritional and Psychosocial Markers of Frailty among Community-Dwelling Elderly has emerged to help answer many questions about frailty among the older adults. This report presents the design of the study and baseline data of its participants. DESIGN: The "Coyoacan cohort" is a longitudinal observational study developed in Mexico City. PARTICIPANTS: A representative sample of 1,294 non-institutionalized men and women aged 70 years and older were randomly recruited to undergo a face-to-face interview and a comprehensive geriatric assessment (including clinical evaluations and blood samples) between 2008 and 2009. MEASUREMENTS: Data collected included socio-demographic and economic characteristics, medical history, oral health, drug use, cognitive function and mood, nutritional status, physical performance and functional status, physical activity, quality of life, social networks, and biological data. Frailty was defined as the presence of ≥3 of the following components: slowness, poor muscle strength, low physical activity, exhaustion and unintentional weight loss. RESULTS: A total of 1,124 participants completed the interview. The mean age was 79.5 ± 7.1 years, and 55.9% were female. Nine hundred and forty-five subjects completed the clinical evaluation and 743 blood samples were collected. The baseline prevalence of frailty was 14.1%. CONCLUSIONS: Understanding the medical, biological, and environmental factors that contribute to the phenomenon of frailty is the goal of the current research in the field.

Oral health conditions and frailty in Mexican community-dwelling elderly: a cross sectional analysis.

BACKGROUND: Oral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly. METHODS: Analysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate), utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factors RESULTS: Of the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Those who had a higher probability of being frail included women (OR = 1.9), those who reported myocardial infarction (OR = 3.8), urinary incontinence (OR = 2.7), those who rated their oral health worse than others (OR = 3.2), and those who did not use dental services (OR = 2.1). For each additional year of age and each additional drug consumed, the probability of being frail increased 10% and 30%, respectively. CONCLUSIONS: Utilization of dental services and self-perception of oral health were associated with a higher probability of being frail.