The effect of prosthetic rehabilitation with or without dietary advice on nutritional status in elderly patients: a systematic review

BACKGROUND

Elderly people frequently report tooth loss, affecting their nutritional status. There is a gap in the scientific evidence about the influence of prosthodontic rehabilitation on nutritional status.

OBJECTIVE

To investigate the influence of prosthodontic rehabilitation combinates or not with dietary advice on nutritional status in elderly patients.

METHODS

A systematic literature search was conducted in three electronic databases to identify randomized clinical trials that evaluated the effect of prosthetic rehabilitation on nutritional status in subjects aged 60 years or older, with a follow-up of at least 1 month after prosthesis rehabilitation.

RESULTS

Of the 1517 articles identified in the initial search, 12 were selected for the final review. No significant difference between the types of prosthesis were found regarding the chewing by the elderly population. Although patients who received prosthetic treatment had significant improvement in chewing ability, a consistent pattern of improvement in nutritional status was not observed when they did not receive dietary advice. In addition, the association between the condition of the dentition, the masticatory performance and nutritional change of elderly patients has been found. Studies that evaluated simultaneous complete denture treatment and simple dietary advice showed an improvement of nutrient intake in elderly patients.

CONCLUSIONS

Isolated prosthetic rehabilitation may not have the effect of exerting a change in nutritional status of edentulous elderly patients. In general, simultaneous dietary consulting and prosthetic treatment in combination may improve dietary habits, since masticatory capacity and efficiency are not the only factors that influence the nutritional status of a patient.

Clinical evaluation of complete denture fabricated using two different final impression techniques on masticatory efficiency and oral health-related quality of life

Aim

To compare the effect of complete denture fabricated using selective pressure impression and functional impression technique on masticatory efficiency and oral health-related quality of life (OHRQoL) in patients with resorbed ridges.

Settings and Design

A randomized two arm, parallel group study.

Materials and Methods

Forty-eight participants with set inclusion and exclusion criteria were randomly allocated into two groups. Complete denture was fabricated in Group A and Group B using selective pressure and functional impression technique, respectively. The follow-up was done at 3 months. Masticatory efficiency was measured by color-changing chewing gum, and OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI) Hindi Version.

Statistical Analysis Used

The Wilcoxon signed-rank test was applied to check the intergroup analysis for the GOHAI scores of both impression techniques. The Mann-Whitney U test was applied to compare intragroup analysis for masticatory efficiency and the GOHAI scores of both the techniques.

Results

A total of 45 participants completed the follow-up. The mean age of the total participants was 62.7 ± 3.8. No statistically significant difference (P > 0.05) was observed between the masticatory efficiency and post-GOHAI scores of both the impression techniques.

Conclusion

Selective pressure and functional impression techniques may be successfully used to fabricate complete dentures for patients with resorbed ridges.

Patient-reported outcomes with immediate-loaded two-implant-supported mandibular overdentures: Results of a 5-year prospective study

Background/purpose

Few studies have comprehensively assessed long-term patient-reported outcomes for overdentures supported by two immediate implants. The purpose of the study was to evaluate patient-reported outcomes of immediately loaded two-implant-supported overdentures retained by ball attachments over a 5-year evaluation period.

Material and methods

Nineteen participants with edentulous mandibles were provided with immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments. The participants completed the Japanese version of the Oral Health Impact Profile (OHIP)-EDENT-19 and the Patient's Denture Assessment (PDA). Additionally, patient satisfaction was measured by a 100-mm visual analog scale (VAS). Measurements were performed at baseline, and at 1 and 5 years following implant surgery.

Results

Seventeen participants and 14 participants were evaluated at the 1-year and 5-year assessment, respectively. Considering the OHIP-EDENT-19, there was a significant decrease in the total (p = 0.046), “functional limitation” (p = 0.021), and “physical disability” (p = 0.034) scores at 1 year and the total (p = 0.045) and “physical disability” (p = 0.024) scores at 5 years following surgery, compared to the baseline scores. Considering the PDA, there was a significant increase in the “function” (p = 0.038) and “lower denture” (p = 0.003) scores at 1 year and the “function” (p = 0.032), “lower denture” (p = 0.008), and “esthetic and speech” (p = 0.043) scores at 5 years following surgery, compared to the baseline scores. Patient satisfaction at 1 year following surgery was significantly greater than that at baseline (p = 0.005).

Conclusion

Immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments improved the oral health-related quality of life and self-assessment of dentures by the patients up to 5 years following implant surgery.

A randomised crossover clinical trial of masticatory function in complete denture wearers with conventional and lingualised balanced occlusion

OBJECTIVES

The purposes of the present study were as follows: (1) to conduct a randomised crossover clinical trial to evaluate masticatory performance in wearers of conventional complete dentures in both arcs with conventional balanced occlusion (CBO) and lingualised balanced occlusion (LBO), using almonds as natural test food chewed for (a) 30 chewing cycles, (b) 40 chewing cycles and (c) until the subject felt ready to swallow and (2) to perform a randomised crossover clinical trial of oral health self-perception through the Geriatric Oral Health Assessment Index (GOHAI) questionnaire.

BACKGROUND

During rehabilitation with full dentures, achieving stability and retention is essential for masticatory performance. A factor that can act is the appropriate occlusal scheme to be used, although the literature is full of discussions as to the most suitable occlusal scheme to be used, being CBO and LBO the most used in complete dentures.

MATERIALS AND METHODS

The clinical trial was conducted with 30 participants (14 males and 16 females; average age 65.8 years). A base of interchangeable posterior teeth in the lower dentures was used, thereby changing the occlusal schemes without needing to make another complete denture. The masticatory tests and GOHAI application were conducted in two sessions: first with each occlusal scheme, and second only after participants did not report discomfort with dentures. The analysis of variance for the mixed repeated-measures test (ANOVA) was used to verify the results (α = 0.05).

RESULTS

The results showed no difference in masticatory performance according to the occlusal scheme (P = .519). The masticatory performance increased with the number of cycles (P < .001) tested, regardless of the type of occlusion scheme, and oral health self-perception was higher after the second masticatory evaluation session (P = .027).

CONCLUSION

The masticatory performance was similar between the two occlusal schemes, increasing according to the number of chewing cycles. The adaptive period is relevant, regardless of the occlusion scheme, because the time factor was decisive for the improvements noted in the oral health self-perception of the participants (according to the GOHAI results).

Impact of rehabilitation versus edentulism on systemic health and quality of life in patients affected by periodontitis: A systematic review and meta-analysis

AIM

To investigate the effect of rehabilitation in fully/partially edentulous patients with stage IV periodontitis on oral-health-related quality of life (OHRQoL) and systemic health.

MATERIALS AND METHODS

A systematic electronic and manual search was conducted. Three authors independently reviewed, selected, and extracted the data. Outcomes were OHRQoL (Oral Health Impact Profile 14 [OHIP-14] and OHIP-49, General Oral Health Assessment Index [GOHAI], visual analogue scale, symptoms registration) and systemic health-related outcomes (incidence and prevalence of systemic diseases, values of systemic disease indicators). Qualitative data were synthesized for OHRQoL and systemic health-related outcomes. Meta-analysis was conducted on available quantitative data.

RESULTS

The search identified 59 articles (6724 subjects in total). OHRQoL improved across all the studies, irrespective of the number of missing teeth, their location, or treatment modality. Meta-analysis showed significant improvement of OHIP-49 (36.86, p < .01) in manuscripts including subjects affected by periodontitis, consistently with the remaining literature (reduction of score points post rehabilitation: OHIP-14 = 10.52, OHIP-49 = 56.02, GOHAI = 5.40, p < .01 for all). Non-rehabilitated subjects exhibited inferior cognitive status, higher medication intake, and frailty. However, our data are limited and should be interpreted with caution.

CONCLUSIONS

Oral rehabilitation improves OHRQoL and, potentially, systemic health in edentulous patients. It is unclear whether these findings may be extrapolated to patients with stage IV periodontitis.

Evaluation of patients' perception of gingival recession, its impact on oral health-related quality of life, and acceptance of treatment plan

Objective: Gingival recessions (GR) may cause aesthetic and hypersensitivity complaints which might affect oral health-related quality of life (OHRQoL). The aim of this study was to evaluate the patients' awareness of their own GR, the impact of GR on OHRQoL and the acceptance of suggested treatment modalities.Materials and Methods: This cross-sectional study was conducted with 205 patients. The demographic variables were recorded and patients' perception of GR was questioned. Full-mouth examination was carried out and clinical parameters were recorded. Gingival recessions, GR related complaints were evaluated and GR treatments were suggested and acceptance were also recorded by the examiner. The patients filled out OHRQoL-United Kingdom (OHRQoL-UK) questionnaire regarding to their GR and were asked if GR have/would have impact on oral health and if the GR will/would get worsen. Data was analysed with independent t test and Mann-Whitney U test.Results: 4819 teeth were evaluated and 733 GR examined in 147 patients. Fifty-seven patients were unaware of their GR. A strong belief that GR have impact on oral health (88.78%) and GR will progress (86.34%) was detected. Acceptance of treatment was increased and non-invasive modalities were preferred if patients had complaints. The awareness of GR status increases and the misperception decreases the OHRQoL-UK scores. The results revealed that hypersensitivity decreases the OHRQoL-UK scores and aesthetic concerns and hypersensitivity decreases the OHRQoL-UK physical scores significantly (p < .05).Conclusions: The results indicated that the patients might be unaware of their GR and the GR related factors may lead to poorer OHRQoL.

Assessment of the Effect of Oral Health on Quality of Life and Oral-Health Indicators among ESRD Patients in Southwest Florida: A Pilot Study

Purpose

To determine and compare OHRQoL (oral-health-related quality of life) using the Geriatric Oral Health Assessment Index (GOHAI-12) and Oral Health Impact Profile (OHIP-14) among patients receiving hemodialysis (HD).

Methods

Face-to-face interviews and intraoral examinations were conducted among 70 patients. Mann-Whitney U test and Kruskal-Wallis test were used to compare each item score with demographics and dental and overall health status.

Results

The mean number of years on dialysis was 4.7 ± 7.5 yrs; the mean number of teeth present was 19.7 ± 11.04; median values of OHRQoL using GOHAI-12 and OHIP-14 were 52 and 64. Within GOHAI-12, limiting food (p 0.043), uncomfortable eating in front of people (p 0.045), limiting contact with people (p 0.046), and eating without discomfort (p 0.011) were significantly associated with females. Being worried (p 0.040) and self-conscious (p 0.048) were significant for age groups ≤65 years. Prevented from speaking was associated with >20 teeth (p 0.016). Being worried about oral health was associated with number of years on dialysis (p 0.042). Within OHIP-14, speech was associated with number of teeth present (p 0.024). Total inability to function was significantly associated with race (p 0.018), number of teeth (p 0.028), and edentulousness (p 0.031).

Conclusions

GOHAI-12 was more effective than OHIP-14 in assessing OHRQoL. However, most subjective experiences did not correlate with clinical findings. Systemic health issue like end-stage renal disease affecting QoL might have taken precedence over dental problems. Clinical assessments should be inherent in oral-health evaluation and there should be cooperation between nephrologists and dentists in promoting oral health and treating systemic conditions among HD patients.

The effect of some missing teeth on a subjects' oral health related quality of life

Objectives:

To determine the impact of missing teeth on the level of Oral Health Related Quality of Life (OHRQoL)in subjects reporting at a teaching dental hospital.

Method:

Using a structured Performa incorporating the 12-item General Oral Health Assessment Index (GOHAI) Questionnaire, and a consecutive (non-probability) sampling technique, data relating to 182 subjects fulfilling the study inclusion and exclusion criteria were collected using the method of interview and examination. Subjects responses to each of the 12 items of the GOHAI questionnaire were recorded to determine the impact of missing teeth on OHRQoL. Each of the GOHAI item had a maximum score of 5 thus giving a total of 60 as the maximum score. A high score of GOHAI indicated better ORHRQoL. The ORHRQol of subject was taken as good when the GOHAI score ranged 57-60, average when 51-56 and poor when ≤50.

Results:

Subjects had a mean age of 35.6 ± 5.8 (S. Dev) with males as 50.5% compared to females (49.5%). The mean GOHAI score for all the subjects was 48.4 ± 8.2 as compared to the mean GOHAI score of 48.4 ± 8.2 for males and 47.6 ± 8.3 for females. The ORHRQoL was good in only 27%. A high proportion of subjects (53%) had poor OHRQoL. The number and the frontal location of the missing teeth adversely impacted OHRQoL. Missing maxillary anterior teeth had the most negative effect on OHRQoL. Missing mandibular first molar was the most common missing tooth either alone or in combination with other missing teeth among the subjects studied. The most important GOHAI items contributing to the adverse impact on the OHRQoL of the majority of subjects with some missing teeth were;often worried/concerned about dental problems and never having been pleased or happy with the look of their teeth and gum

Conclusion:

The adverse effect of missing teeth on OHRQoL was substantial necessitating the importance of preventing the condition of missing teeth or restoring when missing and maintaining the oral health of subjects.

Relationship between gerotranscendence and oral health-related quality of life

OBJECTIVES

The purpose of our cross-sectional study was to investigate the relationship between gerotranscendence and oral health-related quality of life (OHR-QOL). To our knowledge, this is the first study to investigate the relationship between gerotranscendence and OHR-QOL.

METHODS

Participants (total n = 1969; 70-year-old group, n = 999; 80-year-old group, n = 970) were drawn from resident lists in four areas of Japan: one urban area and one rural area in each of two geographical regions. OHR-QOL was measured using the Geriatric Oral Health Assessment Index (GOHAI). Measurement of occlusal force was performed using pressure-sensitive sheets. Gerotranscendence was assessed with the Japanese Gerotranscendence Scale Revised (JGS-R). We used multiple linear regression analysis to examine the relationships among OHR-QOL and other variables.

RESULTS

Geriatric Oral Health Assessment Index score was significantly correlated with occlusal force, number of teeth, financial status and JGS-R score on linear regression analysis.

CONCLUSION

Degree of gerotranscendence was significantly and independently correlated with degree of OHR-QOL in our sample.

Consumption of green tea but not coffee is associated with the oral health-related quality of life among an older Japanese population: Kyoto-Kameoka cross-sectional study

BACKGROUND/OBJECTIVES

The consumption of both green tea and coffee is known to induce positive health effects; however, it remains unclear whether there is an association between the consumption of these beverages and oral health-related quality of life (OHRQoL). Thus, the present study investigated the relationship between the consumption of green tea and coffee and OHRQoL.

SUBJECTS/METHODS

We analyzed cross-sectional baseline data in 2012. The subjects were 7514 Japanese participants (3563 men, 3951 women; ≥65 years of age). Each subject completed a validated self-administered questionnaire that included items on the frequency of the consumption of green tea and coffee. OHRQoL was evaluated using the self-reported General Oral Health Assessment Index (GOHAI), which assesses oral health problems in older adults. A GOHAI score <50 points was defined as a poor OHRQoL.

RESULTS

Following adjustment for age, body mass index, total energy intake, alcohol, smoking, medication use, coffee, and fruit and vegetable consumption, increased consumption of green tea showed a strong positive association with the GOHAI score in both men and women (P_trend < 0.001 in both). In contrast, after adjusting for all factors, no statistically significant association was observed between coffee consumption and the GOHAI score in men (P_trend = 0.538) or women (P_trend = 0.607). The respective multivariate-odds ratios (95% confidence intervals) for a poor OHRQoL associated with green tea consumption frequencies of none, <1 cup/day, 1-2 cups/day, and ≥3 cups/day were 1.00, 1.01 (0.80-1.27), 0.95 (0.74-1.21), and 0.78 (0.61-0.99) (P_trend = 0.024) in men, and 1.00, 1.19 (0.90-1.57), 0.98 (0.74-1.29), and 0.86 (0.67-1.12) (P_trend = 0.014) in women.

CONCLUSIONS

Regardless of sex, green tea consumption was positively associated with the GOHAI score. Therefore, ≥3 cups/day of green tea may reduce the risk of a poor OHRQoL, especially in men.

Oral Health-related Quality of Life among Patients after Complete Denture Rehabilitation: A 12-month Follow-up Study

Introduction:

Complete edentulism is an eventual oral health outcome and results from the combined pathology of dental caries, periodontal disease, or faulty method of rehabilitation due to reduced cost. Complete edentulism has a significant concern and leads to reduced quality of life (QoL) along with impact on general health. However, it has been observed that due to wider and better oral health services globally, edentulism rate is decreasing every decade. Edentulism is directly related to masticatory and nutritional problems, and some authors regard it as a good mortality indicator.

Methodology:

The sample population consisted of 100 individuals comprising 63 males and 37 females who fulfilled the inclusion criteria. Geriatric oral health assessment index (GOHAI) was administered by a single investigator at baseline (preinsertion) and also 6 and 12 months postdenture insertion. Sociodemographic data, including age and gender, were also collected.

Results:

It was observed that the overall oral health-related QoL (OHRQoL) scores of the sample improved significantly at 6 and 12 months postinsertion (P < 0.001) when compared to baseline scores. When GOHAI scores were compared individually for males and females (pre- and post-insertion), it was observed that there was statistically significant improvement in OHRQoL (male – pre = 25.02 ± 1.34 and post-12 months = 8.84 ± 1.26, P < 0.001, female – pre = 25.19 ± 0.88 and post-12 months = 9.05 ± 1.20, P < 0.001) postinsertion of denture in both the groups.

Conclusion:

OHRQoL in patients improved after complete denture rehabilitation. There was an upward shift in score for each item in GOHAI from preinsertion to 6 and 12 months postinsertion of dentures, reflecting improvement in OHRQoL of the sample.

Neutral zone or conventional mandibular complete dentures: a randomised crossover trial comparing oral health-related quality of life

There is widespread consensus that the neutral zone (NZ) concept contributes to improved stability for mandibular complete dentures (CDs). However, little is known about its impact on oral health-related quality of life (OHRQoL) of edentulous patients compared to conventionally (CV) manufactured dentures. In this prospective crossover trial, performed at the Oral Health Centre of the University of the Western Cape, CV and NZ mandibular dentures were made for each patient. Scores from the 20-item oral health impact profile (OHIP-20) for both types of dentures were compared with pre-treatment scores using paired t-tests. Treatment effect size (ES) was established. Associations of OHIP-20 scores and several patient variables (age, gender, period of edentulousness, quality of the denture-bearing tissue, denture dimensions, preference) were performed using the generalised linear model. Significance was set at P = 0·05. Records of thirty-five participants were included in the study (mean age of 62·3 years, range 47-85 years). There were highly significant differences between pre-treatment and both post-treatment OHIP-20 scores with t = 6·470 for CV and t = 6·713 for NZ. Treatment ES was large for both types of dentures (>0·8). Difference of ES between NZ and CV dentures was small (ES < 0·2). None of the patient variables showed significant associations with OHIP-20 scores of the two types of dentures, except for preference and NZ OHIP-20 scores. For this group of patients, both treatment methods improved OHRQoL significantly and patient-related factors did not influence impact on OHRQoL differently for both interventions.

Does periodical department audit really works to make things fall in place: A Geriatric/General Oral Health Assessment Index based audit in prosthodontics

Purpose:

The purpose was to assess the outcome of improved staff supervision on the efficiency and quality of complete dentures delivered by clinical students.

Materials and Methods:

The audit was performed in two parts. In the first cycle, retrospective analysis for complete dentures delivered by clinical students was undertaken, and patient's satisfaction was graded using Geriatric/General Oral Health Assessment Index (GOHAI). All the impeding factors encountered in the first cycle were identified, and corrective measures were implemented. Subsequently, a prospective analysis for the dentures delivered under strict staff supervision was undertaken in the second cycle. Patient satisfaction was graded again using GOHAI.

Results:

Improved staff supervision increased the patient satisfaction significantly.

Conclusions:

The quality of care had improved in leaps and bounds compared to the first cycle due to increased level of supervision and strict adherence to the recommendations made at the end of the first cycle.

Comparison of chewing ability, oral health related quality of life and nutritional status before and after insertion of complete denture amongst edentulous patients in a Dental College of Pune

BACKGROUND

The relationship between tooth loss and nutritional intake is important. As people age, their diminished physical capacity and decreased income adversely affect their ability to maintain their teeth. The aim of the study was to assess and compare the chewing ability, oral health related quality of life and nutritional status before and after fabrication and insertion of complete denture amongst edentulous participants in a dental college.

MATERIAL AND METHODS

Non Randomized Intervention study. The study population consisted of 42 participants (16 females and 26 males), aged 50 years and above. Prior to commencement of the study, informed consent was obtained and validation and reliability test of the questionnaire were done. The data for chewing ability, GOHAI and nutritional status assessment was recorded at baseline, 3(rd), 6(th) and 12(th) month after denture fabrication and insertion. The statistical comparisons were performed by repeated measure ANOVA and Chi-square test. P value<0.05 was considered as statistically significant.

RESULTS

Chewing ability, GOHAI, BMI (Body Mass Index) and data from Food-intake questionnaire showed statistically significant improvement from baseline to 6(th) month but no statistically significant improvement was observed from 6(th) month to 12(th) month. Nutritive value of food (protein, energy and fat) showed no significant difference over a period of 12 months (p<0.05).

CONCLUSION

Thus, it was concluded that the intervention (denture insertion) was effective in increasing the chewing ability, body weight, food-intake, and oral health related quality of life.

Dificuldades diárias associadas às próteses totais

A efetividade de serviços de saúde pode ser avaliada pela ótica da qualidade de vida. Assim, este estudo avaliou o serviço de reabilitação a partir das dificuldades diárias associadas a próteses totais convencionais (PTC), produzidas entre 2007 e 2009, pelos Centros de Especialidades Odontológicas (CEO) de uma mesorregião do Rio Grande do Norte (RN). Realizou-se um estudo seccional com 138 usuários dessas PTC, coletando-se os dados por exame clínico e questionário baseado no indicador Oral Impacts on Daily Performances. Utilizaram-se os testes de Fisher e Qui-quadrado para testar associação das variáveis. Como resultado, 42% da amostra relatou dificuldades, relacionadas à PTC, para executar atividades bucais. Tais dificuldades foram mais frequentes e intensas nas atividades de comer, falar e sorrir. No total, 58,7% da amostra não tinha dentes funcionais. Quanto à avaliação clínica das PTC, 57,2% das superiores e 9,2% das inferiores estavam satisfatórias. Houve associação da presença de dificuldades e a ausência de dentes funcionais, mas não com PTC inadequadas. Assim, os CEO foram efetivos na reabilitação com PTC superior, já que as dificuldades encontradas integram limitações próprias a tal reabilitação. Por outro lado, o custo benefício da reabilitação inferior deve ser reavaliado.

Assessment of Oral Health Related Quality of Life Among Completely Edentulous Patients in Western India by Using GOHAI

BACKGROUND

Quality of life in elderly is a very sensitive issue. It is important to know if the dental problems, general health and dental treatment have an impact on the quality of life in elderly. The elderly population has a typical set of mind regarding their oral health. This study examines the trends in patients' behavioral patterns due to tooth loss, suggestive of some change in quality of life.

AIMS

The purpose of this study was to identify and acknowledge the problems of completely edentulous patients and their relationship to the Quality of Life (QOL). Also, the study was aimed at exploring the changes in global self-rated general health between the pre and post-treatment scores.

SETTINGS AND DESIGN

This is a randomized controlled clinical trial study which is done to evaluate the problems in the elderly and quality of life as long as their oral health is concerned. It is conducted on a group of people representing the elderly population with complete edentulism.

MATERIAL AND METHODS

Sixty three patients with mean age 69.41 who needed dentures were investigated before and after 6 months of their treatment by administration of GOHAI (Geriatric Oral Health Assessment Index) scale. Comparison between Pre & Post-treatment values of various scores were done with McNemar-Bowker Test. Quantitative data was represented using Mean ± SD and Median, IQR (Interquartile range). Analysis of Pre & Post-treatment quantitative data was done using Wilcoxon Signed Rank Test.

RESULTS

The results of the present study showed GOHAI scores increased from 28.90 + 7.28 to 42.19 + 7.60 (p=highly significant). There was a significant change in the quality of life in elderly after their prosthodontic rehabilitation, though the self rated general health did not show any significant improvement.

CONCLUSION

It is the responsibility of the entire dental fraternity to understand the needs of elderly associated to their oral health. It is important to evaluate and assess the psychological effects of tooth loss on their quality of life. A thorough investigation is necessary before and after the dental/prosthodontic care.

[Self-rated oral health: results of the World Health Survey-Primary Care in four municipalities in Rio de Janeiro State, Brazil, 2005]

Self-rated health is a subjective indicator that combines physical and emotional components and individual well-being. It has gained an important role in Public Health, with increasing use in the evaluation of the general population's health status. This study focuses on dental care and oral health status, including self-rated oral health, using data from 1,871 individuals 18 years or older, interviewed in World Health Survey-Primary Care, conducted in four municipalities in the State of Rio de Janeiro, Brazil. Bivariate logistic regression models were used to identify the determinants of 'excellent' or 'good' self-rated oral health. For both men and women, variables significantly associated with self-rated oral health were: per capita family income, frequency of dental visits, tooth loss, and use of dental prostheses. The results showed a socioeconomic gradient in self-rated oral health, precarious oral health among the elderly, and the importance of regular dental visits for maintaining oral health.

Association between self-assessment of complete dentures and oral health-related quality of life

The purpose of this study was to determine which factors related to patient self-assessment of dentures are associated with changes in oral health-related quality of life (OHRQoL) among edentulous patients after replacement of complete dentures, and to determine whether masticatory performance as determined using an objective method affects the changes in OHRQoL among edentulous patients. As a preliminary study, the existing questionnaire regarding self-assessment of dentures consisting of 39 question items, measured with a 100-mm visual analogue scale, was analysed by factor analysis. Then a questionnaire, composed of 22 question items, was developed containing six subscales of 'function', 'lower denture', 'upper denture', 'expectation', 'aesthetic and speech' and 'importance'. Final participants in the present study comprised 93 edentulous patients requiring new conventional complete dentures (44 men, 49 women; mean age, 75·0 years). These patients were asked to complete the Japanese version of the Oral Health Impact Profile (OHIP)-EDENT, comprising 19 question items for assessment of OHRQoL in edentulous patients, along with the developed questionnaire regarding self-assessment of dentures. Moreover, masticatory performance was measured using a colour-changeable chewing gum. The questionnaire and measurement were completed twice; before and after replacement of complete dentures. Stepwise multiple regression analysis identified 'lower denture' and 'aesthetic and speech' as significant independent variables besides OHIP-EDENT scores before replacement. These results suggest that sufficient retention of lower dentures and appropriate appearance may lead to improved OHRQoL in edentulous patients.

Denture quality has a minimal effect on health-related quality of life in patients with removable dentures

The present study examined the association of denture quality and health-related quality of life (HRQoL) in patients with removable dentures. In a study of 171 consecutive patients with removable partial dentures or complete dentures (mean age: 68·0 ± 9·3 years) at a university-based prosthodontic clinic, dentists rated two aspects of denture quality (stability and aesthetics) using a 100-mm visual analog scale (VAS). HRQoL was evaluated using the mental and physical component summary (MCS and PCS) scores of the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36). Oral health-related quality of life (OHRQoL) was evaluated using the Oral Health Impact Profile-Japanese version (OHIP-J). The associations among denture quality, OHRQoL, and HRQoL were examined by linear regression models. Bivariable linear regression analyses revealed that denture stability was significantly associated with the SF-36 MCS [regression coefficient = 0·52 for a 10-unit increase in denture stability on a 0-100 VAS, 95% confidence interval (CI): 0·03-1·00, P = 0·04], but not with the PCS (0·11, 95% CI: -0·49 to 0·70). Denture aesthetics was not related to the PCS or the MCS (0·22, 95% CI: -0·44 to 0·88 or 0·07, 95%CI: -0·47 to 0·62). When OHIP-J was added to the regression model, this variable was substantially and significantly associated with the MCS and PCS summary scores; in addition, the regression coefficient for denture quality decreased in magnitude and was statistically nonsignificant in all analyses. The quality of removable dentures had a minimal effect on HRQoL in patients with removable dentures, and this association was mediated by OHRQoL.

Does prosthodontic rehabilitation change the eating patterns among completely edentulous patients?

OBJECTIVE

 Nutrition is compromised in completely edentulous individuals. As there is limited literature available on the nutritional health of the elderly in the Indian population, the present study was undertaken to assess these changes before and 1 month after placement of complete dentures in a dental hospital in Indore, Madhya Pradesh, India.

MATERIALS AND METHODS

The 10-item closed-ended questionnaire was completed by the investigator who interviewed the subjects (n = 35) before placement of complete dentures and 1 month later.

RESULTS

A statistically significant difference was found for having an illness or condition that led to a change in the type and/or amount of food eaten (p = 0.013); eating few fruits, vegetables, or milk products (p = 0.005) and having oral problems that made it difficult to eat (p = 0.003).

CONCLUSIONS

Prosthodontic rehabilitation improved the eating pattern with increased intake of fruits, vegetables and milk products.