Four-year incidence and predictors of tooth loss among older adults in a southern Brazilian city

Use of dental implants among older adults of two southern Brazilian cities: A population-based cross-sectional study

AIM

To assess the prevalence and associated factors with use of dental implants among older adults.

METHODS

This cross-sectional study was performed with home dwelling older adults from the cities Cruz Alta and Veranópolis, Brazil. The main outcome was obtained by a clinical oral examination, considering those with at least one dental implant. Independent variables were collected by a structured questionnaire. Crude and adjusted analysis was performed by Poisson regression with robust variance estimation; results are presented in prevalence ratio (PR) and 95% confidence interval.

RESULTS

It was included 569 participants. The overall prevalence of using at least one dental implant was 16.7%. Higher PR for the use of dental implants was observed in white individuals (PR:5.147; 95% CI:2.033-3.034), in those with at least medium income (PR:3.202; 95% CI:1.196-5.572) and in those with access to dental care in the last 12 months (RP:1.595; 95% CI:1.087-2.340). Older adults with a medium level of education (RP:0.484; 95% CI:0.240-0.978) and those that did not use dental floss (RP:0.627; 95% CI:0.240-0.978) demonstrated a significantly lower PR for use of dental implants.

CONCLUSION

A substantial prevalence of use of dental implants was observed among older adults. In addition, white ones, those with a better financial situation and users of dental floss presented higher use of dental implants.

Health Behaviors and Self-Reported Oral Health among Centenarians in Nanjing, China: A Cross-Sectional Study

The role of health behaviors in oral health conditions in individuals of extremely old age remains understudied. This study included 185 participants aged 100 years or older from the Nanjing Centenarians Study (NCS) to examine the associations between health behaviors and oral health and investigate the potential moderating role of education and living arrangements in such relationships. The oral health status as an outcome included the self-reported oral health status and edentulous status. Health behavior variables included smoking, eating fruits, eating vegetables, participating in leisure activities, and practicing oral hygiene behaviors. Sociodemographic characteristics and health status were considered as confounders. Descriptive statistics, ordinal regression, and logistic regression models were used to address the research questions. Results showed that better oral health was reported by centenarians who were non-smokers, participated in more leisure activities, and practiced higher frequency of oral hygiene behaviors. Those who ate fruits daily and practiced more frequently oral hygiene behaviors were more likely to be dentate. The positive association of oral hygiene behaviors was stronger for centenarians who were formally educated and co-resided with family members. The results suggest that effective interventions should consider health behaviors and living arrangements in this growing population to improve their oral health status.

Salutogenic factors for oral health among older people: an integrative review connecting the theoretical frameworks of Antonovsky and Lalonde

OBJECTIVE

The aim of this integrative review was to describe salutogenic factors associated with oral health outcomes in older people, from the theoretical perspectives of Antonovsky and Lalonde.

MATERIAL AND METHODS

This study was based on a primary selection of 10,016 articles. To organize reported salutogenic factors, the Lalonde health field concept and Antonovsky's salutogenic theory were cross tabulated.

RESULTS

The final analysis was based on 58 studies. The following oral health outcome variables were reported: remaining teeth, caries, periodontal disease, oral function and oral health related quality of life (OHRQoL). We could identify 77 salutogenic factors for oral health and OHRQoL. Salutogenic factors were identified primarily within the fields of Human Biology (such as 'higher saliva flow', 'BMI < 30 kg/m²' and 'higher cognitive ability at age 11'), Lifestyle (such as 'higher education level', 'social network diversity' and 'optimal oral health behaviour') and Environment (such as 'lower income inequality', 'public water fluoridation' and 'higher neighbourhood education level'). In the age group 60 years and over, there was a lack of studies with specific reference to salutogenic factors.

CONCLUSIONS

The results provide an overview of salutogenic factors for oral health from two theoretical perspectives. The method allowed concomitant disclosure of both theoretical perspectives and examination of their congruence. Further hypothesis-driven research is needed to understand how elderly people can best maintain good oral health.

Oral health profile of participants of an elderly cohabitation program in the state of Santa Catarina, Brazil

Abstract Introduction Cohabitation and social interaction programs have been shown to enhance several aspects of the quality of life of the elderly. Objective This observational study assessed the oral health and oral health perception of participants of an elderly cohabitation program in the state of Santa Catarina, Brazil. Material and method Calibrated dental students examined/interviewed 235 participants of the program. The oral examination considered Decayed, Missing, and Filled Teeth (DMFT) index, Community Periodontal Index (CPI), Periodontal Attachment Loss (PAL), use and need of prostheses, and presence of oral mucosal lesions. Oral health perception was verified with the Geriatric Oral Health Assessment Index (GOHAI) questionnaire. Data were analyzed with descriptive statistics and chi-square test (α=0.05). Result The mean DMFT index was 24.3 teeth, with emphasis on the ‘Missing’ category. Upper and lower prosthetic needs were 53.6 and 71.1%, respectively. Fifty-five per cent of participants presented oral mucosal lesions. Moderate oral health perception prevailed (43%), with mean GOHAI score of 29.9. The negative perception on physical and pain/discomfort dimensions was statistically associated with lower prosthetic need (p<0.05). Conclusion The participants of the cohabitation program presented poor oral health and prevalence of moderate oral health perception. Lower prosthetic need was associated with negative perception.

Tooth loss in middle-aged adults with diabetes and hypertension: Social determinants, health perceptions, oral impact on daily performance (OIDP) and treatment need

BACKGROUND

This study aimed to explore the association between tooth loss and social determinants, health self-perceptions, OIDP and self-concept of dental treatment need in middle-aged adults with diabetes and hypertension.

MATERIAL AND METHODS

A cross-sectional study was developed with 212 hypertensive and diabetic middle-aged adults (50-65 years). Data were collected from clinical examinations (DMFT) and a questionnaire regarding socioeconomic status, dental health assistance, self-perceptions of oral and general health, OIDP, and the self-concept of dental treatment need. Tooth loss was dichotomized considering the cutoff point of 12 (Model I) or 24 missing teeth (Model II). Data were analyzed using Chi-square, Fisher's exact test and logistic regression (p≤0.05).

RESULTS

Tooth loss was significantly associated with variables such as last dental visit, reason for dental visit, OIDP, perception of dental treatment need, and general self-perception (Model I). Schooling, last dental visit, oral health self-perception and perception of dental treatment need were significantly associated with tooth loss in the Model II. When Model 1 and 2 were adjusted, they demonstrated that last dental visit and perception of dental treatment need were predictor variables.

CONCLUSIONS

The annual dental visit and the self-concept of dental treatment need were associated with tooth loss, demonstrating that these variables reduce the tooth loss prevalence.

Oral Health-Related Quality of Life and Associated Factors in Brazilian Adolescents

This study aimed to assess the impact of oral health on the quality of life of adolescents. A cross-sectional study was performed with students from public and private schools from Passo Fundo, Brazil. All students were aged between 15 and 19 years old. The proportional random sample consisted of 736 adolescents from 20 schools. A structured questionnaire was applied, and an oral examination was performed, counting the number of teeth. Oral health-related quality of life was assessed by OHIP-14. Associations between quality of life and associated factors were analyzed. The mean OHIP-14 score was 7.25. Age, ethnicity and studying in a public school were associated to the OHIP-14 score. Tooth loss (p=0.79) was not associated with quality of life. Additionally, questions related to appearance, such as whether teeth appearance bothers the adolescent (p=0.68) were not associated with quality of life. Attending a public school (OR=1.63; CI95%: 0.98-2.70) and self-reported halitosis (OR=1.48; CI95%: 1.01-2.16) were strongly associated to higher impact on quality of life. It was concluded that socioeconomic conditions and halitosis were associated to higher impact on quality of life of adolescents.

Normative prosthodontic care need: does it impact the daily life of young Saudis with high level of oral diseases? A cross sectional study

BACKGROUND

Assessing the need for prosthodontic care previously included older age groups. There is less information about younger populations who may need this care because of high disease levels. The aim of this study was to assess the normative need for prosthodontic care in a young Saudi population with high oral disease levels, the associated factors and its impact on daily life.

METHODS

A cross sectional study included Saudi adults in the Eastern Province in 2016. A questionnaire was used to assess personal background (confounders), risk factors affecting oral diseases (exposures) and the impact of oral problems on daily life. A clinical examination assessed tooth loss, the presence of prosthodontic appliances, the presence of untreated decay and need for periodontal care. Directed acyclic graphs identified the confounders to be included in regression models with separate outcomes: normative need for prosthodontic care (binary logistic model) and impact on 6 daily life aspects (ordinal regression models).

RESULTS

Complete data were available for 574/ 700 = 82% and 46.7% needed prosthodontic care with 2 lost teeth on average among adults of mean age = 33.2 years. The confounders controlled for the need for prosthodontic care included socioeconomic status (SES), dental visits last year and health insurance. The confounders for the impact on daily life included age and SES. In adjusted models, normative need for prosthodontic care was significantly associated with untreated decay (OR = 2.09, 95% C.I. = 1.37, 3.19). The impact on daily life was not significantly associated with prosthodontic care need but with untreated decay, especially sleeplessness (regression coefficient = 0.53, 95% C.I. = 0.02, 1.04) and dropping daily activities (regression coefficient = 0.79, 95% C.I. = 0.13, 1.46). In addition, the need for periodontal care was associated with food avoidance (regression coefficient = 0.73, 95% C.I. = 0.28, 1.18).

CONCLUSIONS

In Saudi adults in the Eastern Province, there was a considerable normative need for prosthodontic care due to untreated decay. The impact on daily life was related to the underlying oral diseases rather than the need for prosthodontic care itself.

Missing Teeth and Prosthetic Treatment in Patients Treated at College of Dentistry, University of Dammam

The percentage of completely and partially edentulous patients and their prosthetic treatment at the Department of Substitutive Dental Sciences (SDS), College of Dentistry, University of Dammam, were investigated. Panoramic radiographs and medical records of adult patients (n = 479, mean age 45.9 years, and range 25-96 years) treated in 2011-2014 were examined. 6% of the patients were completely edentulous, 8% had single jaw edentulousness, and 74% were partially edentulous. Edentulousness was significantly correlated with age and the number of missing teeth was significantly higher among males (p < 0.026). Diabetes was significantly associated with complete edentulousness, single edentulous jaw (p value 0.015), and partial edentulousness (p value 0.023). Kennedy class III was the most frequent class of partial edentulousness in single and/or both jaws (p = 0.000). Patients having class I and/or class II were treated most often with removable partial dentures (RPD) (p = 0.000), while patients having class III were treated with fixed partial dentures (FPD). It was found that complete edentulousness increases in older age and the number of missing teeth was significantly higher among males. Kennedy class III was most common in both upper and lower jaw and was treated more often with FPD than with RPD.

Incidence of Tooth Loss in Adults: A 4-Year Population-Based Prospective Cohort Study

Objective

To verify the incidence of tooth loss in extended age group of adults in 4 years.

Materials and Methods

The prospective cohort study assessed adults (20–64 years old) between 2011 and 2015, from Piracicaba, São Paulo, Brazil. The dependent variable was cumulative incidence of tooth loss, assessed by difference between missing teeth (M) of decayed, missing, and filled tooth index (DMFT) in 2011 and 2015. Participants were stratified into young (20–44 years old) and older (45–64 years old) adults. Mann–Whitney U test (p < 0.05) was used to compare the means of incidence of tooth loss between age groups.

Results

After four years, 57.7% (n = 143) of adults were followed up and the mean incidence of tooth loss was 0.91 (SD = 1.65); among these, 51 adults (35.7%) who lost their teeth showed mean tooth loss of 2.55 (SD = 1.86). In older adults, incidence of tooth loss was higher (p = 0.008), but no difference between age groups was found when only adults with incidence of tooth loss were assessed (p = 0.844).

Conclusion

There was higher incidence of tooth loss in older adults after four years, however, without difference between age groups when only those who lost teeth were evaluated.

Characterization of Oral Microbiota in Removable Dental Prosthesis Users: Influence of Arterial Hypertension

INTRODUCTION

Studies have described the possible relation between oral infections and atherosclerotic events.

OBJECTIVE

To characterize the oral microbiota of normotensive and hypertensive users of dental prostheses.

METHODS

The sample consisted of 41 complete dental prosthesis users, divided into groups: 21 participants with systemic arterial hypertension and 20 normotensive participants. The data collection included the characteristics of the sociodemographic variables and the determination of the microbial load in the saliva. For the descriptive analyses, Statistical Package for the Social Sciences was used. The description of the proportional differences between the groups was based on the application of Mann-Whitney's statistical test. Statistical significance was set at 5% (p < 0.05).

RESULTS

The analysis of the oral microbiota showed the vast growth of aerobic microorganisms in all samples from both groups. The microbial load of streptococci and staphylococci was significantly higher among hypertensive participants. Candida yeasts were detected in the saliva culture of most samples. The hypertensive participants rank in the category of very high colonization index/high risk of infection related to this microorganism.

CONCLUSIONS

The mouth of dental prosthesis users, especially when hypertensive, can constitute an important reservoir of pathogens, indicating an established inflammatory or infectious condition or risk for developing this condition.

Racial differences in periodontal disease and 10-year self-reported tooth loss among late middle-aged and older adults: the dental ARIC study

OBJECTIVE

To investigate racial differences in the associations between periodontitis and 10-year self-reported incident tooth loss in a biracial, community-based cohort of US late middle-aged and older adults.

METHODS

Subjects were 3,466 dentate men and women aged 53-74 who underwent dental examinations from 1996 to1998. In 2012-2013, telephone interviewers asked participants about tooth loss in the preceding 10 years. Separate multivariable ordinal logistic regression models were used to calculate proportional odds ratios (OR) and 95% confidence intervals (CI) as estimates of association between periodontitis and tooth loss for Whites and African-Americans (AAs).

RESULTS

The majority of participants were White (85 percent) and female (57 percent) with 23 teeth on average at enrollment. Approximately half the Whites (56 percent) and AAs (49 percent) had periodontitis. At follow-up, approximately 44 percent of AAs and 38 percent of Whites reported having lost ≥1 tooth. In multivariable models, severe periodontitis (OR = 3.03; 95% CI = 2.42-3.80) and moderate periodontitis (OR = 1.64; 95% CI= 1.39-1.94) were significant risk factors of incident tooth loss among Whites. For AAs, severe but not moderate periodontitis increased the odds of incident tooth loss (OR = 2.22; 95% CI = 1.37-3.59). In the final model, education was inversely associated with incident tooth loss among AAs, while lower income was associated with greater odds of tooth loss among Whites.

CONCLUSIONS

In this population-based cohort, there is racial heterogeneity in the association between periodontitis and tooth loss. Interventions to reduce the impact of periodontitis on tooth loss need to consider these differences.

[Prospective study on tooth loss in a cohort of dentate elderly]

The aim of this study was to assess factors associated with tooth loss in elderly 60 years or older during a four-year observation period. A representative cohort of dentate elderly from the city of São Paulo, Brazil, participated in the study. The outcome was teeth loss incidence from 2006 to 2010. Demographic and socioeconomic characteristics, health services access and use, behavior, reported diseases, cognitive status, functional status, state of dentition, and use of dental prosthesis were recorded as independent variables in 2006 and the outcome was measured in 2010. Negative binomial regression models were used. Participation included 440 dentate elderly. Increased likelihood of tooth loss was associated with use of two removable prostheses (RR = 1.57; 95%CI: 1.02-2.41), fair self-rated oral health (RR = 1.62; 95%CI: 1.11-2.36), bad/very bad self-rated oral health (RR = 1.87; 95%CI: 1.11-3.17), male gender (RR = 1.74; 95%CI: 1.28-2.37), and living alone (RR = 2.03; 95%CI: 1.11-3.72).

[Primary healthcare geared to the needs of the elderly: from theory to practice]

This article seeks to establish a confrontation between theory and practice with respect to healthcare for the elderly. The theory was evaluated by a study of documents that comprise the legal and theoretical framework related to the health of the elderly, which generated a matrix to assess universal access, equity, comprehensiveness and quality of care. However, the practice of healthcare was evaluated by a population-based study conducted on 862 elderly individuals and a census that assessed primary healthcare (PHC) units in two districts of Porto Alegre in the state of Rio Grande do Sul, Brazil. The variables chosen to verify the categories were type of care accessed, first contact attribute, wheelchair accessibility and availability of priority access. Other variables include comprehensive care and the presence of dental root remains, basic PHC score, the adequacy of health facilities and ongoing professional training, as well as cross-sectional categories, elderly groups and home care. A mismatch was found between recommendation and practice in some factors and advances were observed in the equity and quality of care regarding the ongoing training of professionals.

Edentulism in Brazil: trends, projections and expectations until 2040

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

[Association between tooth root remains and self-reported oral health among the elderly]

The presence of tooth root remains is a common clinical finding among elderly patients and may reflect a need for treatment. The scope of this study sought to explore the association between the presence of tooth root remains and self-reported oral health among the elderly. Secondary data from two sanitary districts of Porto Alegre, State of Rio Grande do Sul, were analyzed. A conceptual theoretical model was used in the analysis to assess factors related to self-perceived oral health: gender, age, education, marital status, smoking habit, alcohol consumption, demand for oral health care, participation in community groups, family economic self-sufficiency, oral health service accessed, number of teeth and the presence of tooth root remains. The statistical data were analyzed using Chi-square and Poisson Regression tests (95% CI analysis; α 5%). The sample consisted of 849 elderly individuals with a mean age of 69.7 years (± 7.2); 14.5% of the elderly had tooth root remains and 60.7% reported good self-perceived oral health. According to the hierarchical analysis, the absence of tooth root remains was associated with good oral health perception. The qualification and expansion of health care provided should be considered in order to allow planning actions to ensure the maintenance of good oral health for the elderly.

Epidemiology of oral health conditions in older people

The main conditions of interest when considering the epidemiology of oral diseases among older people are tooth loss, dental caries, periodontitis, dry mouth and oral pre-cancer/cancer, along with oral-health-related quality of life (OHRQoL). This article presents an overview of what is known about the epidemiology of each of the main conditions of interest among older populations.

Surgical and Non-Surgical Procedures Associated with Recurrence of Periodontitis in Periodontal Maintenance Therapy: 5-Year Prospective Study

BACKGROUND AND OBJECTIVE

Prospective studies that investigated the influence of surgical and nonsurgical procedures in the recurrence of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs have not been previously reported. The objective of this study was to evaluate longitudinally the recurrence of periodontitis in regular compliers (RC) and irregular compliers (IC) individuals undergoing surgical and non-surgical procedures over 5 years in a program of PMT.

MATERIALS AND METHODS

A total of 212 individuals participated in this study. Full-mouth periodontal examination including bleeding on probing, probing depth, and clinical attachment level were determined at all PMT visits over 5 years. The recurrence of periodontitis was evaluated in RC and IC individuals undergoing surgical and non-surgical procedures in PMT. The influences of risk variables of interest were tested through univariate analysis and multivariate logistic regression.

RESULTS

Recurrence of periodontitis was significantly lower among RC when compared to IC. Individuals with recurrence of periodontitis and undergoing surgical procedures showed higher probing depth and clinical attachment loss than those who received non-surgical procedures. Recurrence of periodontitis was higher in individual undergoing surgical procedures and irregular compliance during PMT.

CONCLUSIONS

Irregular compliance and surgical procedures in individuals undergoing PMT presented higher rates of recurrence of periodontitis when compared to regular compliant patients undergoing non-surgical procedures.

Factors contributing to tooth loss among the elderly: A cross sectional study

BACKGROUND

The present study evaluates the influence of several demographic, health, personal, and clinical factors on the number of missing teeth in old age sample.

METHODS

The number of patients included was 259; they received a full mouth examination and answered a questionnaire provided by one examiner. All the variables related to teeth loss based on the literature were included. These variables focused on age, gender, race, marital status, clinical attachment level, pocket depth, year of smoking, number of cigarettes smoked per day, number of medications, root decay, coronal decay, health status, and year of education. Statistical analysis involved stepwise multivariate linear regression.

RESULTS

Teeth loss was statistically associated with clinical attachment level (CAL)(p value 0.0001), pocket depth (PD) (0.0007) and education level (0.0048). When smoking was included in the model, age was significantly associated with teeth loss (0.0037). At least one of these four factors was also related to teeth loss in several specific groups such as diabetes mellitus, male, and White. The multiple linear regressions for all the proposed variables showed that they contributed to teeth loss by about 23%.

CONCLUSIONS

It can be concluded that less education or increased clinical attachment level loss may increase number of missing teeth. Additionally, age may cause teeth loss in the presence of smoking.

Social disparities in dentition status among American adults

OBJECTIVES

To assess the overall dentition status of American adults, to investigate disparities and changes in dentition using the National Health and Nutrition Examination Surveys 2005-2006 and 2007-2008 and to study the effects of family poverty status, education, citizenship and language on dentition after adjusting for other demographics.

METHODS

Descriptive statistics were used to explore and summarise dentition status. The prevalence of dentition markers over two surveys were compared using tests of proportions and a series of regressions were used to estimate the strength of association of family poverty status, education, citizenship and language with the four markers of dentition status.

RESULTS

Overall, dentition status has improved in adults. However, gaps exist in that non-Hispanic Black and Mexican-Americans have a higher prevalence of dental decay and lower restoration rates than other races. After adjusting for selected demographics, adults with less education (<12 years) and lower family income had significantly higher dental decay rates, lower restoration rates and more missing teeth than those with more education (≥12 years) and those with higher family incomes.

CONCLUSION

This study indicates that disparities in dentition associated with race/ethnicity, education and income still exist among adults in the USA. The results also indicate that to improve overall oral health and close the existing gaps in oral health, increased access to dental care would be needed for people who have low incomes and low levels of education.

Tooth loss in individuals under periodontal maintenance therapy: 5-year prospective study

BACKGROUND AND OBJECTIVE

Tooth loss (TL), one of the most visible results of the evolution of periodontitis, causes physiological and psychological impacts on a patient's life. This prospective study aimed to evaluate the incidence, underlying reasons and influence of risk predictors for the occurrence of TL in a program of periodontal maintenance therapy (PMT) over 5 years.

METHODS

The sample comprised 212 individuals diagnosed with chronic moderate-severe periodontitis, who had finished active periodontal treatment, were incorporated in a PMT program. Individuals were divided in to two groups: 96 regular compliers (RC) and 116 irregular compliers (IC). Full-mouth periodontal examination was performed. Social, demographic, behavioral and biological variables of interest were collected at all PMT visits. The effect of risk predictors and confounders for TL, as well as the underlying reasons of TL, were assessed by univariate and multivariate analysis.

RESULTS

TL was significantly lower among RC (0.12 teeth lost/year) in comparison to IC (0.36 teeth lost/year; p < 0.01). Individuals that were > 55 years old, males and smokers lost significantly more teeth in both groups (with IC > RC). The number of teeth lost due to periodontal reasons was significantly higher than TL for other reasons in both groups (p < 0.01). The final linear and logistic model for TL included: male gender, smoking, probing depth 4-6 mm in up to 10% of sites and irregular compliance.

CONCLUSION

IC individuals undergoing PMT presented higher rates of TL when compared to RC individuals. Findings demonstrated the influence of irregular compliance and the importance of monitoring other risk predictors for TL such as smoking, male gender and severity of probing depth during PMT.

Tooth loss and periodontitis in older individuals: results from the Swedish National Study on Aging and Care

BACKGROUND

Due to the increasing number of older people, there is a need for studies focused on this population. The aims of the present study are to assess oral and systemic conditions in individuals aged 60 to 95 years with access to dental insurance.

METHODS

Probing depths (PDs), tooth loss, alveolar bone levels, and systemic health were studied among a representative cohort of older individuals.

RESULTS

A total of 1,147 individuals in young-old (aged 60 or 67 years), old (aged 72 or 78 years), and old-old (aged ≥81 years) age groups were enrolled, including 200 individuals who were edentulous, in this study. Annual dental care was received by 82% of dentate individuals. Systemic diseases were common (diabetes: 5.8%; cardiovascular diseases: 20.7%; obesity: 71.2%; elevated C-reactive protein [CRP]: 98.4%). Serum CRP values were unrelated to periodontal conditions. Rates of periodontitis, defined as ≥30% of sites with a distance from cemento-enamel junction to bone of ≥5 mm, were 11.2% in women in the young-old age group and 44.9% in men in the old-old age group. Individuals in older age groups had a higher likelihood of periodontitis defined by bone loss and cutoff levels of PD ≥5 mm (odds ratio: 1.8; 95% confidence interval: 1.2 to 2.5; P <0.01). A total of 7% of individuals in the old-old age group had ≥20 teeth and no periodontitis. Systemic diseases, dental use, or smoking were not explanatory, whereas age and sex were explanatory for periodontitis.

CONCLUSIONS

The prevalence of periodontitis increased with age. Sex seems to be the dominant explanatory factor for periodontitis in older individuals. Despite frequent dental visits, overall oral health in the oldest age cohort was poor.