Association of the oral health impact profile with malnutrition risk in Spanish elders

The objective of this study was to determine any relationship between oral health-related quality of life (OHR-QoL) and malnutrition risk in the elderly using the oral health impact profile (OHIP). We studied 250 institutionalized elderly people, 162 females and 88 males, with and without teeth. Data were gathered on: general health; oral health; malnutrition risk, measured with the Mini Nutritional Assessment (MNA); and OHR-QoL, evaluated with the OHIP. A multivariate binary logistic regression model was constructed with malnutrition presence/risk as dependent variable. Mean age was 82.7 ± 8.2 years. Malnutrition or malnutrition risk was shown by 36.8% of the sample. OHIP was associated with malnutrition/risk after adjustment for age, sex, functional status, and mild dementia diagnosis. Malnutrition/risk was 3.43-fold more likely in participants with OHIP-reported "problems" than in those with none. The conclusion of the study was that OHIP-measured OHR-QoL is associated with malnutrition risk.

Sex/Gender differences in tooth loss and edentulism: historical perspectives, biological factors, and sociologic reasons

This review highlights what is known regarding differences in tooth loss by sex/gender, and describes: gender-related tooth ablation (the deliberate removal of anterior teeth during life) found in skulls from history and prehistory; potential mediators of the relationship between sex/gender and tooth loss; the current epidemiology of gender differences in tooth loss (limited to North America); and risk factors for tooth loss in the general population and in women.

Prevalence of oral health problems in U.S. adults, NHANES 1999-2004: exploring differences by age, education, and race/ethnicity

Using the National Health and Nutrition Examination Surveys (NHANES) 1999-2004, the authors examined age patterns in oral health indicators by race/ethnicity and socioeconomic status related to edentulism, presence of root caries, and periodontal disease. Our analysis included subjects who were non-Hispanic White, Mexican American, and African American over the age of 20, and who participated in the NHANES oral health examination. African Americans experienced more oral health problems at younger ages; as age increased, so did racial disparities in oral health problems. Lower educational attainment was strongly associated with more oral health problems at all ages. These results may indicate a faster progression of oral health problems with age among African Americans, thus suggesting that the "earlier aging" of members of racial/ethnic minorities which has been reported in prior research may also be found in oral health.

Multivariate analysis of different factors affecting the patient general satisfaction with complete dentures

The aim of the study was to investigate different factors that affect the level of patient's general satisfaction with maxillary and mandibular complete dentures (CDs) using a multivariate analysis. A total of 100 CD wearers participated in this study. There were 46 men (37-77 years old; mean age 62.6 +/- 9.2) and 54 women (34-77 years old; mean age 60.9 +/- 9.3). In the questionnaire the patients answered the questions regarding gender, age, number of previous CDs worn, the present dentures' age and denture-wearing habits. Participants rated the level of their satisfaction with the esthetics, retention, speech, mastication, sense of taste, comfort and general satisfaction with their CDs. More than 70% of the examined patients claimed all the examined variables to be the best-score category. Of the 9 factors examined, satisfaction with the mastication and esthetics, denture-wearing habits and satisfaction with retention in the maxilla explained the variability of the patients's general satisfaction with their CDs by 72%. Satisfaction with the mastication, denture-wearing habits and satisfaction with speech and comfort in mandible explained the variability of the patients's general satisfaction with their CDs by 79%. These findings suggest that the general patient satisfaction with maxillary CDs is related more to the mastication and retention abilities, as well as with esthetics and denture-wearing habits, while in the mandible CDs is related to mastication and speaking abilities, denture-wearing habits and comfort of wearing.

Tooth loss and dental caries in community-dwelling older adults in northern Manhattan

OBJECTIVE

To examine tooth loss and dental caries by sociodemographic characteristics from community-based oral health examinations conducted by dentists in northern Manhattan.

BACKGROUND

The ElderSmile programme of the Columbia University College of Dental Medicine serves older adults with varying functional capacities across settings. This report is focused on relatively mobile, socially engaged participants who live in the impoverished communities of Harlem and Washington Heights/Inwood in northern Manhattan, New York City.

MATERIALS AND METHODS

Self-reported sociodemographic characteristics and health and health care information were provided by community-dwelling ElderSmile participants aged 65 years and older who took part in community-based oral health education and completed a screening questionnaire. Oral health examinations were conducted by trained dentists in partnering prevention centres among ElderSmile participants who agreed to be clinically screened (90.8%).

RESULTS

The dental caries experience of ElderSmile participants varied significantly by sociodemographic predictors and smoking history. After adjustment in a multivariable logistic regression model, older age, non-Hispanic Black and Hispanic race/ethnicity, and a history of current or former smoking were important predictors of edentulism.

CONCLUSION

Provision of oral health screenings in community-based settings may result in opportunities to intervene before oral disease is severe, leading to improved oral health for older adults.

Edentulism trends among middle-aged and older adults in the United States: comparison of five racial/ethnic groups

OBJECTIVES

This study examined edentulism trends among adults aged 50 and above in five ethnic groups in the United States: Asians, African Americans, Hispanics, Native Americans, and non-Hispanic Caucasians.

METHODS

Data came from the National Health Interview Surveys between 1999 and 2008. Respondents included 616 Native Americans, 2,666 Asians, 15,295 African Americans, 13,068 Hispanics, and 86,755 Caucasians.

RESULTS

In 2008, Native Americans had the highest predicated rate of edentulism (23.98%), followed by African Americans (19.39%), Caucasians (16.90%), Asians (14.22%), and Hispanics (14.18%). Overall, there was a significant downward trend in edentulism rates between 1999 and 2008 (OR = 0.97, 95% CI: 0.96, 0.98). However, compared with Caucasians, Native Americans showed a significantly less decline of edentulism during this period (OR = 1.10, 95% CI: 1.02, 1.19).

CONCLUSIONS

While there was a downward trend in edentulism between 1999 and 2008, significant variations existed across racial/ethnic groups. Innovative public health programs and services are essential to prevent oral health diseases and conditions for minority populations who lack access to adequate dental care. Additionally, given the increasing numbers of adults retaining their natural teeth, interventions designed to assist individuals in maintaining healthy teeth becomes more critical.

Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai

OBJECTIVES

This study was to analyze the association of hyposalivation with oral function, nutritional status and oral health in community-dwelling elderly Thai.

METHOD

The subjects were 612 elderly people (mean age = 68.8, SD 5.9 years). Oral function (tasting, speaking, swallowing and chewing) and Mini Nutritional Assessment (MNA) were evaluated. Oral examination investigated teeth and periodontal status. Both unstimulated and stimulated whole saliva were collected for 5 minutes.

RESULTS

Among all subjects, 14.4 % were classified within the hyposalivation. Hyposalivation was associated with gender, systemic disease, medication, and smoking. Subjects within the hyposalivation group had a higher number of decayed teeth and a higher prevalence of periodontitis than the normal salivation group (p < 0.05). The hyposalivation group also had a lower number of teeth present and a lower mean MNA score than the normal salivation group (p < 0.05). Logistic regression analysis showed that hyposalivation in both dentate and edentulous subjects was significantly associated with tasting, speaking, swallowing and chewing.

CONCLUSION

This study suggested that hyposalivation is a risk factor not only for dental caries and periodontal disease but also for taste disturbances, speaking problems, swallowing problems, poor chewing ability and malnutrition. Monitoring salivary flow is an important measure in the care of older people.

Tooth loss and oral rehabilitation in Greek middle-aged adults and senior citizens

PURPOSE

The aims of this study were to investigate the prevalence of tooth loss in Greek individuals aged 35 to 44 and 65 to 74 years in relation to sociodemographic parameters and to describe their prosthetic status and needs.

MATERIALS AND METHODS

A stratified cluster sample of 1,188 middle-aged adults and 1,093 senior citizens was selected according to World Health Organization (WHO) guidelines for national pathfinder surveys. Tooth loss and prosthetic status and needs were recorded according to WHO criteria. Sociodemographic data were collected through face-to-face interviews.

RESULTS

Complete edentulism affected 0.3% of individuals aged 35 to 44 years and 31.5% of those aged 65 to 74 years. Most middle-aged adults (92.1%) had ≥ 21 natural teeth, while the corresponding percentage for the senior citizens was 23.1%. The mean number of missing teeth was 5.2 in middle-aged adults and 21.6 in senior citizens. The multivariate analysis showed that education level was the only predictor of tooth loss in both age groups. Approximately 38% of those aged 35 to 44 years and 80% of those aged 65 to 74 years had dental prostheses, while 47.6% of middle-aged adults and 66.3% of senior citizens did not need any prosthetic treatment. The need for complete dentures was relatively low in both age groups. Comparisons of the present results with those of 1985 indicate that the dentate status of Greek adults aged 35 to 44 years has not improved. Furthermore, the prevalence of tooth loss in the elderly population was high compared with internationally reported findings.

CONCLUSION

The replacement of missing teeth with fixed or removable prostheses will continue to be common in Greece for the foreseeable future.

Total tooth loss and systemic correlates of inflammation: role of obesity

Obesity and edentulism are both associated with multiple systemic disorders with an inflammatory background including periodontal diseases. This study aimed to evaluate the different impact of obesity on inflammation in dentate and toothless subjects. The data came from the population-based, cross-sectional study SHIP (Study of Health in Pomerania). We determined anthropometric measures including BMI, waist-to-hip ratio (WHR), diagnostic periodontal parameters, and systemic metabolites. It was shown that measures of systemic markers of inflammation and lipid or glucose metabolism (P < 0.001) were increased with higher WHR. When adjusted for age, sex, smoking, diabetes, education, physical activity, and last dentist's appointment, C-reactive protein (CRP), fibrinogen, and leukocyte count were significantly related to WHR increasing from the first to the fourth WHR quartile (P < 0.001) as well as to the BMI. In both dentate and edentulous subjects higher WHR contributes significantly to increasing systemic CRP and fibrinogen with sex differences. In toothless subjects, while still dependent on increasing WHR, the inflammatory markers CRP and fibrinogen were higher than in dentate subjects, thereby revealing effect modification between sex and edentulism (P < 0.010). In conclusion, subjects with total tooth loss, although devoid of periodontal inflammation, may exhibit increased levels of systemic inflammatory mediators. Possible implications are discussed with respect to obesity and its relationship to inflammation.

Needs for prosthetic treatment in Vilnius population at the age over 45 years old

AIM OF THE STUDY. The aims of the study was to evaluate needs for prosthetic treatment among middle-aged and elderly population in Vilnius, to find out rates of edentulism among Vilnius inhabitants and to ask them about their approach to personal oral hygiene. MATERIALS AND METHODS. This cross-sectional study was approved by Lithuanian Bioethics Committee and carried out by one investigator. Our study was performed in period from 2008 to 2012. We have examined and interviewed 634 patients in the principle of free choice (randomized selection). Quantity of remaining teeth and previous prosthetic treatment was assessed. RESULTS. According to questionnaire previous prosthetic treatment was attached for 204 (43.8%) male and 262 (56.8%) female patients, total 466 (73.5%) of all subjects involved into our research, 168 (26.5%) never had a prosthetic treatment. During examination we found, that 219 (34.5%) of all examined persons were treated with removable prosthesis, 180 (28.4%) treated with fixed prosthesis and for 67 (10.6%) both: fixed and removable kinds of prosthesis were attached. Toothless jaws were found in 26.5% (n = 168) of population. We found 179 (28.2%) edentulous maxillas and 168 (26.5%) mandibles. CONCLUSIONS. The intensity of tooth loss in the middle-aged and eldery population of Vilnius city significantly increases with age. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Consolidation in oral health perceptions starts before age 50, suggesting early intervention before that age.

Oral health among white, black, and Mexican-American elders: an examination of edentulism and dental caries

OBJECTIVES

To examine racial/ethnic disparities in oral health among older Americans.

METHODS

Differences in frequency of edentulism and number of decayed, missing, and filled teeth were assessed in 2,679 non-Hispanic white, 742 non-Hispanic black, and 934 Mexican-American individuals aged 60 and older from the National Health and Nutrition Examination Survey (1999-2004).

RESULTS

Controlling for potential confounding variables, blacks and Mexican-Americans had significantly higher numbers of decayed teeth but fewer numbers of filled teeth than whites. Although blacks had a lower likelihood of being edentulous than whites, dentate blacks had a higher number of missing teeth. Compared with whites, Mexican-Americans were less likely to be edentulous, and dentate Mexican-Americans had fewer missing teeth. Our study also showed that blacks and Mexican-Americans had less frequent dental checkups than whites.

CONCLUSIONS

Oral health disparities are persistent across racial/ethnic groups for older Americans despite the fact that the differences between groups typically diminish when socioeconomic, health-related, and behavioral factors are considered in the models. Our study suggests that reducing racial/ethnic oral health disparities requires multiple clinical approaches.

Edentulism risk indicators among Mexican elders 60-year-old and older

The objective of this study was to determine the prevalence of edentulism in Mexican elders aged 60 years and older, and the associated risk indicators. A cross-sectional study was undertaken in 139 elders living in either of two long-term care (LTC) facilities, or attending an adult day center (ADC) in Pachuca, Mexico. A subject was edentulous when natural teeth were completely absent, determined through a clinical examination. Risk indicators were collected using questionnaires. Analyses were performed using binary logistic regression in STATA 9.0. Mean age was 79.0±9.8 years. Many subjects were women (69.1%). The prevalence of edentulism was 36.7%. In multivariate analysis, after adjusting for age and sex, the variables that were inversely associated (p<0.05) with edentulism were living with a spouse (odds ratio=OR=0.31), and lacking health insurance (OR=0.70). Variables associated with higher risk of being edentate were lower educational attainment (OR=1.61), having received radiation therapy (OR=4.49), being a smoker (OR=4.82), and having diabetes (OR=2.94) or other chronic illnesses (OR=1.82) (with hypertension approaching significance, p=0.067). In this sample of Mexican elders, diverse variables were associated with edentulism, in particular smoking and past radiotherapy. Oral health programs within and outside LTC/ADC should take into account risk factors specific to the older population.

Changes in tooth mortality between 1990 and 2002 among adults in Västerbotten County, Sweden: influence of socioeconomic factors, general health, smoking, and dental care habits on tooth mortality

The objectives of the study were to analyse changes in tooth mortality among adults in Västerbotten County, Sweden, between 1990 and 2002 and determine whether socioeconomic factors, general health, smoking, and dental care habits influenced tooth mortality. The study was based on samples drawn from the adult population in Västerbotten County in 1990 and 2002. The studied age groups were 35-, 50-, and 65-year-olds. In 2002 75-year-olds were included. The surveys comprised a clinical examination and a questionnaire.The latter focused on oro-facial symptoms, socioeconomic factors, general health, smoking, and dental care habits. Complete data were obtained from 715 individuals in 1990 and from 768 individuals in 2002.Variables used to depict tooth mortality were edentulousness, occlusal supporting zones (Eichner index), and number of teeth. The prevalence of edentulousness in Västerbotten County decreased from 12.7% in 1990 to 3.7% in 2002 (P < 0.001). The mean number of teeth increased in all age groups between 1990 and 2002, and so did the number of individuals with tooth contact in all occlusal supporting zones and no gaps between teeth. Low educational level, weak economic status, smoking, and irregular visits to the dental clinic were all significantly related to increased tooth mortality. Between 1990 and 2002 tooth mortality decreased significantly in the adult population of Västerbotten County, Sweden. Cross-sectional analysis identified socioeconomic factors, smoking, and irregular use of dental care services as being related to tooth mortality in both 1990 and 2002.

Evaluation of oral health status of retirement-age population in Latvia

INTRODUCTION. Latvian government Health care financing regulations do not envisage free dental care in nursing homes. Consequently, in this situation arises need to carry out comparative evaluation of oral health status and quantity indicators of dental prosthodontics among retirement-age population in Latvia. The aim of the study was to estimate oral health and dental prosthodontics indicators among retirement-age population in Latvia. PATIENTS AND METHODS. We examinated 465 retirement-age inhabitants in Latvia. We assessed dental status, quantity and quality of the existing complete dental prostheses. We also evaluated the DMF-T index. RESULTS. Oral health indicators among Latvian retirement-age population are better than those for nursing homes residents in the same age group. Complete dental prostheses used by nursing homes residents do not meet denture's quality criteria. Retirement-age patients have oral hygiene problems. CONCLUSIONS. DMF-T index among Latvian retirement-age population is lower than among residents of nursing homes. The major component of DMF-T index is the number of lost teeth. The assessment of dental prostheses among residents of nursing homes showed unsatisfactory results. Retirement-age population in Latvia needs treatment of oral mucosal diseases, improvement of oral hygienic measures and increase of amount of dental prosthodontics.

Edentulism associated with obesity: a study of four national surveys of 16 416 Swedes aged 55&#x2013;84 years

OBJECTIVE

To investigate the association between edentulism and obesity in the Swedish population aged 55–84 years over a 22-year period as a result of changes in health and socio-economic factors.

MATERIAL AND METHODS

Subjects aged 55–84 years (n = 16 416) were randomly sampled from the Swedish population by Statistics Sweden on four occasions (1980–81, 1988–89, 1996–97 and 2002). Trained interviewers collected information about dental status and anthropometric, demographic, socio-economic, lifestyle and health-related factors. Statistical analyses were based on logistic regression models.

RESULTS

Edentulism decreased from 43% to 14% in the age group 55–84 years from 1980 to 2002, and the proportion of subjects with removable dentures decreased from 68% to 33%. In the age group 55–74 years, the proportion of subjects with low education decreased from 60% to 28%, and the proportion of obese subjects (body mass index ≥30 kg/m²) increased from 9% to 15%. In women aged 55–74 years, the association between obesity and edentulism, adjusted for health, lifestyle and socioeconomic factors, was significant in all surveys, and the odds ratio for obesity changed from 1.64 (95% confidence interval 1.18–2.27) in 1980 to 3.17 (95% confidence interval 1.69–6.18) in 2002. In men, the association was weaker and was significant only in the sample that combined all surveys and included individuals aged 55–84 years.

CONCLUSION

The study indicated an association between edentulism and obesity, which was most obvious in women aged 55–74 years.

Questionnaire-based study on sleep-disordered breathing among edentulous subjects in a university oral health center

The aim of this study was to evaluate the prevalence of sleep-disordered breathing (SDB) and its relationship with nocturnal denture wear in edentulous subjects. Sixty-two edentulous subjects completed questionnaires to ascertain their risk for SDB; 25 subjects wore dentures during sleep. The prevalence of SDB was 40.3% based on the results of the Berlin Questionnaire. There was no significant difference between high- and low-risk groups with respect to age, Body Mass Index, or denture use, except for a history of self-reported high blood pressure. The prevalence of suspected SDB in edentulous subjects was higher than in the general population.

Complete edentulism and socioeconomic factors in a Jordanian population

This study considered the need and demand for complete dentures in a select group of 600 Jordanian adults and the relationship between complete edentulism and sociodemographic variables by means of a pilot-tested questionnaire. Both maxillary and mandibular dentures were fabricated for 505 subjects, while 95 needed complete dentures in only one arch. Significantly more men than women requested complete dentures. Approximately 80% (28 of 35) of subjects who required replacement dentures for esthetic reasons were women, while over 85% (18 of 21) of subjects who required a spare set of dentures were men. The findings suggest a significant relationship between sociodemographic variables and edentulism, with age, education level, and socioeconomic status playing vital roles in edentulism and denture demand.

Periodontal disease and risk for neuropathic foot ulceration in type 2 diabetes

AIMS

Diabetic neuropathy (DN) has been associated with oral dryness, tooth loss and an increased risk for foot ulceration, but the association between periodontal problems and DN has not been fully elucidated. This study investigated whether the risk for neuropathic foot ulceration (DM-NFUR) was associated with periodontal disease (PD) in patients with type 2 diabetes mellitus.

METHODS

This cross-sectional study examined 122 patients with type 2 diabetes for PD; findings were compared with results for presence of DM-NFUR. PD severity was classified as none/mild (NM-PD), moderate/severe (MS-PD) and edentulous (E).

RESULTS

NM-PD was found in 40.2% patients; MS-PD, in 32.0%; and 27.8% were edentulous. DM-NFUR was detected in 18.4% of the patients in the NM-PD group, in 68.2% in the MS-PD group, and in 61.8% of completely edentulous individuals. PD was significantly correlated with DM-NFUR (p<or=0.001). After adjustment for sex, age, diabetes duration, dental health care and education, PD and edentulism were independently associated with DM-NFUR (odds ratio(adjusted); 6.6; 95% CI 2.3-18.8; p<or=0.001, and odds ratio(adjusted) 4.9; 95% CI 1.6-15.3; p<or=0.01).

CONCLUSIONS

Patients with DM-NFUR have substantially more MS-PD and edentulism. Further studies should evaluate whether diabetic neuropathy is a risk factor for PD.

Periodontal condition of the elderly in Finland

OBJECTIVE

To describe the periodontal condition of the elderly in Finland and its association with sociodemographic factors.

MATERIAL AND METHODS

The study was based on a subpopulation of 1460 persons (748 dentate persons) aged > or =65 years who participated in a nationally representative Health 2000 Survey in Finland. The data for this study were collected by means of an interview and a clinical oral examination.

RESULTS

Seventy-three percent of the participants in this study had gingival bleeding in at least one sextant. The proportion of participants with no teeth with deepened periodontal pockets > or =4 mm deep was 31%. Twenty-eight percent of the participants had one to three teeth with deepened periodontal pockets > or =4 mm deep, 15% had four to six and 26% had > or =7. At the individual level, a high number of teeth with deepened periodontal pockets was associated with sociodemographic factors such as high age, intermediate or higher education, and living in a rural area.

CONCLUSION

At a national level, the greatest need for periodontal treatment presently derives from persons aged 65-74 years and/or those with low education, due to their high representation in the elderly population.

National survey of oral health status of children and adults in Turkey

OBJECTIVES

To estimate the severity of dental caries and the periodontal status of children and adults in Turkey.

BASIC RESEARCH DESIGN

This cross-sectional study was undertaken between September 2004 and February 2005. The Turkish Statistics Institute (TSI) selected a representative sample using the proportional stratified sampling method. The selected ages/age groups were 5, 12, 15, 35-44 and 65-74. At the end of the study, 7,833 individuals had been reached. Dental students were calibrated and examinations were done according to World Health Organization (WHO) guidelines during home visits.

RESULTS

Only 30.2% of the 5-year-old group was caries-free, and the mean dmft was 3.7. Mean DMFT was 1.9 in 12- year-olds, 2.3 in 15-year-olds, 10.8 in 35-44-year-olds, and 25.8 in 65-74-year-olds. In both adolescents and adults, the prevalence of caries was higher among females than in males. In rural areas, the prevalence of caries was high among 5-year-olds, while DMFT was high in the elderly. The prevalence of dental caries was similar for 12- and 15-year-olds in urban and rural areas. Slightly less than half (48.0%) of 65-74 year-olds were edentulous. Healthy periodontal tissue was noted in 56.2% of fifteen-year-olds. In the 35-44 yr-old age group, calculus problems were high (62.6%), and 1.2% had attachment losses of 6 mm or greater. Rural subjects had more severe periodontal problems than their urban counterparts.

CONCLUSION

Community-based oral disease prevention programs are needed urgently for the promotion of oral health in Turkey.

Xerostomia and hyposalivation: a preliminary report of their prevalence and associated factors in Brazilian elderly diabetic patients

PURPOSE

The objective of the present study was to determine the prevalence of xerostomia (dry mouth sensation) and hyposalivation in elderly type-2 diabetic individuals and to establish whether such conditions might be associated with their socioeconomic status and/or medical and oral health conditions.

MATERIALS AND METHODS

The present cross-sectional study included 315 functionally independent elderly individuals, aged 60 years or above, residing in Natal, northeastern Brazil. A total of 52 subjects self-reported to be diabetic. The data on the subjects' health condition were collected using a questionnaire, performing a physical examination and sialometry (unstimulated and stimulated whole saliva flow rates), and the variables were subjected to descriptive statistics, chi-square and Student t test (a = 0.05).

RESULTS

The prevalence of dry mouth was found to be 25%. Hyposalivation was found in 48% and 46% of the subjects in unstimulated and stimulated conditions, respectively. The only factor that was associated with xerostomia among the diabetics was workplace (P = 0.01), suggesting that elderly diabetics working at home might be less likely to have dry mouth than those working outside. No variable assessed was associated with hyposalivation, in either unstimulated or stimulated salivary flow.

CONCLUSIONS

The prevalence of dry mouth and hyposalivation was high in elderly diabetics. Only at-home jobs were observed to be associated with dry mouth. There was no association between hyposalivation and the variables assessed, with regard to either unstimulated or stimulated saliva. Further studies, involving larger samples, are required to confirm the present findings.

Predictors and correlates of edentulism in healthy older people

PURPOSE OF REVIEW

To review peer-reviewed, original research studies published in 2008-2009 that present data relating to the predictors and correlates of edentulism and tooth loss in older adults.

RECENT FINDINGS

Edentulism rates vary markedly between countries and between urban and rural settings within countries. Rates are generally falling over time, but this reduction largely reflects a cohort effect on tooth loss in childhood and young adulthood. Socioeconomic factors, along with accompanying lifestyles and health behaviours remain strong predictors of edentulism, many of these factors relate to peak prior intelligence. Immunological mechanisms of tooth loss are becoming elucidated. Edentulism, itself, predicts mortality and correlates with a wide range of health outcomes, but these, in turn, also correlate with predictors of tooth loss such as peak prior intelligence. Edentulism correlates separately from these lifelong traits with measures of self-esteem and quality of life.

SUMMARY

Edentulism is important as a correlate of self-esteem and quality of life in older adults. It is also a useful marker of socioeconomic status earlier in life.

Adult oral health status in California, 1995-2006: demographic factors associated with tooth loss due to disease

The most recent 2006 estimates indicate that 60 percent of California adults did not experience tooth loss due to disease. However, about 39 percent were missing one or more teeth due to disease, and another 1 percent were edentulous. In an 11-year (1995-2006) pooled multivariate analysis, California adults who were older, less educated, racial/ethnic minorities, current or former smokers, or had lower annual incomes were more likely to be missing teeth.

Oral health problems and needs in nursing home residents in Northern Italy

OBJECTIVE

To describe the oral health status and treatment needs of a sample of elderly people residing in nursing homes in Northern Italy.

RESEARCH DESIGN

a sample of 595 elderly residents (mean age 83.2+/-9.2 yrs), with adequate cognitive skills were examined by six calibrated dentists.

RESULTS

The sample (82% women) was divided into two groups: edentulous (43%) and dentate. In the edentulous group 58% wore dentures in both jaws, 8% in only one jaw and 34% had no dentures. The main problems were dirty or loose dentures and poor oral hygiene. In the dentate group the mean number of teeth was 8.4+/-7.4, 53% wore dentures (removable, fixed or a combination). Poor oral hygiene was found in 86%, root caries in 51% and coronal caries in 46%. Their main needs were professional cleaning (72%), oral hygiene instructions (62%) and tooth/root extractions (56%). While normative needs were noted for 82% of the whole sample, oral treatment needs were accurately perceived by only 20% of residents, poorly by 24%, while 46% indicated that they had no oral treatment needs.