The prevalence of edentulism and their related factors in Indonesia, 2014/15

Chewing difficulties mediated association between edentulism and depressive symptoms among middle aged and older population

BACKGROUND

Depression is a major health condition among the aging population. Previous studies indicated that edentulism was a risk factor for depression. The link between edentulism and depression has not been fully clarified.

OBJECTIVES

This study aimed to estimate whether chewing difficulties play a mediating role in the association between edentulism and depression among middle-aged and older populations with national cross-sectional data.

METHODS

Data were obtained from the latest fourth wave of the China Health and Retirement Longitudinal Study (CHARLS). The outcome variable was set as depression, which was measured by the Center for Epidemiologic Studies Depression Scale (CES-D-10). Independent and mediated variables were separately set as self-assessed edentulism and chewing difficulties. The nearest neighbour propensity score matching (PSM) method was used to construct a matching group to balance the basic characteristics of individuals with and without edentulism with minimised bias in the estimation. Causal mediation analysis was performed to estimate the degree of contribution of chewing difficulties to the association between edentulism and depression. Several sensitivity analyses were performed to evaluate the robustness of the primary result.

RESULTS

A total of 15 853 individuals remained for analysis. After PSM, 809 individuals with edentulism and 2628 without edentulism remained for analysis. Among the matched individuals, the mean age was 66.3 ± 9.2 years, 58.5% were female, 78.8% lived in rural areas, 23.5% had edentulism, 51.1% had depressive symptoms, and 50.1% had chewing difficulties. Logistic regression results showed that a higher incidence of edentulism was associated with a higher rate of depression (OR: 1.39, 95% CI: 1.19-1.63) in the matching group. Causal mediation analysis results indicated that the average mediation effect of chewing difficulties on the association between edentulism and depression was 0.010 (95% CI: 0.005-0.015), and the average direct effect was 0.072 (95% CI: 0.036-0.11). The mediation proportion of chewing difficulties was 11.7% (95% CI: 0.079-0.21).

CONCLUSION

A higher prevalence of edentulism was associated with a higher rate of depression among middle-aged and elderly populations. Chewing difficulties moderately mediated the association between edentulism and depression. Fundamental oral function should not be neglected to improve mental health among the aging population.

Patterns of Tooth Extraction at a Student Dental Clinic in Palestine

INTRODUCTION

While the ideal approach in dentistry is to preserve teeth and restore their functionality within the oral cavity, there are circumstances where tooth extraction becomes a necessary and routine dental procedure. In cases where preserving the tooth is not feasible due to unavoidable reasons, extraction may be the preferred choice to ensure the attainment of stable oral health. So, the present study aims to elaborate on the trends in extraction in student dental clinics in Palestine.

MATERIALS AND METHODS

The present study is a cross-sectional study. Informed consent was obtained from the participants before enrolling in the study. Patients from all the departments undergoing extraction procedures were included in the present study. Patient information such as age, sex, and main reason for tooth extraction was collected. A dental record was noted for the number of teeth extracted, the type of the teeth, and the condition of the teeth extracted. All the data collected was entered in the spreadsheet, and frequency was calculated for each variable.

RESULTS

The present study showed that third molars were the most extracted teeth, and dental caries was the primary cause of extraction. In the "clearance cases," lower canines were the most commonly extracted teeth. In the "non-clearance cases," lower incisors and lower first molars were the most commonly extracted teeth.  Conclusion: The present study gives an overview of tooth extraction patterns in student dental clinics in Palestine. Further studies are required to evaluate and compare the prevalence and causes of tooth loss in different settings.

Edentulous disparities among geriatric population according to the sexual difference in South Korea: a nationwide population-based study

The proportion aged 60 years or older in the world's population is expected to double by 2050. In general, they have many complex diseases and poor oral health status. Oral health is one of the important health indicators of elderly people and it is affected by diverse factors, such as socioeconomic status. In this study, sexual difference was considered as an associated factor that is closely related to edentulism. The sexual difference might be more influential within the geriatric population because of lower economic and educational backgrounds at this stage. Edentulism was significantly higher among elderly females than males when combined with the education level. The lower the level of education, the higher the prevalence of edentulism as much as 24 ~ 28 times, especially in females (P = 0.002). These findings suggest a more complex relationship between oral health, socioeconomic status, and sexual difference.

Updating The General Practitioner on The Association Between Teeth Loss and Temporomandibular Disorders: A Systematic Review

The belief about a possible association between the absence of one or more teeth and the presence of temporomandibular disorders (TMD), although old, is still present among the dental class. Although evidence points to a lack of association between loss of posterior support and the presence of TMD, we do not have critical studies on the extent, quantity, or location of these losses. In this sense, this systematic review aims to investigate the association between tooth loss and the presence of TMD signs or diagnostic subgroups. Search strategies using a combination of keywords tooth loss and TMDs were performed in six databases (PubMed, Embase, Web of Science, Livivo, Lilacs, and Scopus) and gray literature from August to September 2020. Observational studies that investigated the association between tooth loss in TMD were considered. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Assessment Checklist for cross-sectional analytical studies, case-control, and cohort studies. Finally, the level of certainty measured by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was assessed. Six articles were included in the review according to the eligibility criteria. Of these, five had a high risk of bias and one had a moderate risk. Only one study showed an association between the loss of posterior teeth and the presence of joint sounds and joint pain, the others found no significant association with sign or TMD subgroups diagnostic.There is no scientific evidence to support the association between one or more tooth loss and the presence of TMD signs and symptoms or diagnostic subgroups.

Prevalence of Total Edentulism and Panoramic Radiographic Findings of Totally Edentulous Patients in a Dental School in Jeddah, Saudi Arabia

Background The prevalence of total edentulism differs significantly between countries and between cities/regions within the same country. It can be affected by various factors, such as age, sex, and socioeconomic factors along with lifestyle and health behavior. Positive findings on panoramic radiographs are frequently observed in totally edentulous patients (TEP) during routine screening. Objectives This study aimed to retrospectively determine the prevalence of total edentulism and to evaluate the distribution and location of positive findings on panoramic radiographs of TEP at a dental school in Jeddah, Saudi Arabia. Methods A total of 12,428 digital panoramic radiographs of patients aged ≥35 years seeking treatment at a dental school from January 2018 to December 2021 were evaluated to determine the prevalence of total edentulism. Retained root stumps, impacted teeth, radiolucent, and radiopaque lesions were detected on the panoramic radiographs of the TEP. Data were analyzed using descriptive statistics. Results Among the 12,428 patients, 521 (4.2%) showed total edentulism on their panoramic radiographs. The prevalence of edentulism was the highest among patients aged >65 years (n=305, 4.5%), men (n=246, 4.2%), and non-Saudi citizens (n=300, 4.4%). A total of 198 radiographic findings were identified in 150 patients. The frequency rates of retained root stumps and impacted teeth were 19.2% (n=100) and 4.6% (n=24), respectively. Radiolucent and radiopaque lesions each accounted for 2.5% (n=13) of the lesions. Conclusions The prevalence of edentulism was higher in patients aged >65 years, male patients, and non-Saudi citizens. Retained root stumps were most often encountered among the four positive findings on panoramic radiographs. Considering the high frequency of positive radiographic findings in TEP, panoramic radiographs must be routinely obtained for TEP, but caution must be exercised to reduce the effects of radiation.

Spatiotemporal trends of disease burden of edentulism from 1990 to 2019: A global, regional, and national analysis

Background

Understanding the spatiotemporal trends in disease burden of edentulism is critical to reducing disease burden of edentulism and deploying medical resources. We assessed the changing patterns of disease burden of edentulism at global, regional, and national levels from 1990 to 2019.

Methods

Data on incident cases, prevalent cases, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of edentulism were extracted from the Global Burden of Disease 2019 Study. We calculated the estimated annual percentage change (EAPC) to quantify spatiotemporal trends in the ASRs of edentulism.

Results

In 2019, the number of prevalent cases and DALYs of edentulism were 35.2 and 9.6 million, and the ASPR and ASDR were 43.12/1,000 and 1.18/1,000, with EAPCs of -0.18 [95% confidence interval (CI): -0.28, -0.09] and -0.16[95% CI: -0.26, -0.07] from 1990 to 2019, respectively. Females and the elderly had a higher burden of edentulism. Although the ASPR, ASDR, and ASIR in the high SDI, high-middle SDI, and middle SDI regions showed a decreasing or stable trend, the absolute disease burdens of edentulism in these regions were still high. Although the absolute disease burdens of low SDI and low-middle SDI were low, their ASPR and ASDR showed an upward trend. In countries with high initial disease burden or high SDI, ASPR, ASDR, and ASIR showed stable or declining trends.

Conclusion

The absolute disease burden due to edentulism was increasing in many countries and regions. Countries should reduce the disease burden caused by edentulism by adopting measures including the prevention and treatment of dental caries and periodontal disease.

Perception of Edentulous Patients and Dental Professionals towards Care and Maintenance of Complete Denture Prostheses

Methods

A descriptive qualitative study was conducted among 30 EDPs attending dental prosthetic clinics (DPCs) at the four centres in Fiji and 28 DPs at the four DPCs under purposive sampling. Semi-structured questionnaire with open-ended questions was used for in-depth interview (IDI) with EDPs via telephone and focus group discussion (FGD) with DPs virtually via Zoom. Participant responses were recorded and thematic analysis was used to manually analyze the verbatim transcripts.

Results

Five themes were identified as perceptions of EDPs towards care and maintenance of CDP in Fiji: patient perceptions towards CDP, CDP care and maintenance, communication between DPs and EDPs, challenges faced in CDP, and management strategies to CDP care and maintenance. Seven themes were identified as perceptions of DPs: CDP guidelines, post-denture insertion advice, care and maintenance, challenges while treating EDPs, management strategies to challenges faced, communication and teamwork, and recommendations to improving quality of CDP delivery in Fiji.

Conclusion

Patients' perception towards care and maintenance of CDP was low. It is highly recommended for EDPs to adhere to CDP advice given by DPs whilst for DPs, it had been recommended to provide written, oral, and visual forms of CDP care and maintenance advice to EDPs for effectiveness.

Association between tooth loss and hypertension: A systematic review and meta-analysis

OBJECTIVES

Poor oral health status may increase the risk of cardiovascular disease. However, whether a specific association exists between tooth loss and hypertension is inconclusive. Accordingly, a quantitative systematic review was conducted to investigate the relationship between tooth loss and hypertension.

METHODS

Systematic search, data analysis and quality assessment were conducted on relevant literature published in PubMed, Embase, Web of Science and Cochrane Libraries until October 2021. Odds ratio (OR) with 95% confidence interval (CI) was used as effect size to evaluate the association between tooth loss and hypertension. Meta-regression and subgroup analyses were performed to identify whether difference was associated with study-level factors.

RESULTS

Of the 56 studies selected, 28 studies in 16 different countries involving 1,224,821 individuals were eligible for the systematic review. After adjustment for confounding factors, individuals with tooth loss had a higher risk for hypertension (OR 1.20; 95%CI 1.10-1.30, I² = 40.02%). With respect to the risk of hypertension on tooth loss, individuals with hypertension still had a higher risk for tooth loss (OR 1.35; 95%CI 1.07-1.62, I² = 51.10%). Age limitation of the included population is the major source of heterogeneity. However, studies in which the population was limited to the elderly did not report an increase in association between tooth loss and hypertension compared with studies without age limitation.

CONCLUSIONS

The results suggest a bidirectional association between tooth loss and hypertension. Future longitudinal prospective studies are required to establish causality between tooth loss and hypertension.

CLINICAL SIGNIFICANCE

Subjects with severe tooth loss should be carefully monitored for the manifestation of hypertension. The oral health status of hypertensive patients should also be meticulous maintained to prevent unwarranted tooth loss.

Comparison of biological and mechanical properties of different paranasal sinus mucosa in goat

OBJECTIVE

The present study was designed to explore endurable pressure intensity of different paranasal sinus mucosa in goats.

METHOD

Mucosa commonly involved in maxillary sinus augmentation, including mucosa from maxillary sinus crest, maxillary sinus floor, and frontal sinus, were harvested in a computed tomography-guided manner. The obtained mucosa was then sectioned into square and irregular ones for maximum endurable pressure intensity determination and morphological observation, respectively.

RESULTS

Thickness of paranasal sinus mucosa, as determined under morphological staining by an optical microscope with a graduated eyepiece, were calculated. And the results showed that the average thickness of maxillary sinus crest mucosa, floor mucosa, and frontal sinus mucosa in goats were 410.03 ± 65.97 μm, 461.33 ± 91.37 μm and 216.90 ± 46.47 μm, respectively. Significant differences between maxillary sinus crest and frontal sinus, maxillary sinus floor, and frontal sinus were observed (P < 0.05). Maximum endurable pressure intensity was determined by utilizing a self-made clamp device and the results revealed maximum endurable pressure intensity of maxillary sinus crest mucosa, floor mucosa and frontal sinus mucosa in goats were 260.08 ± 80.12Kpa, 306.90 ± 94.37Kpa and 121.72 ± 31.72Kpa, respectively. Also, a statistically significant difference was observed when comparing the endurable pressure intensity between maxillary sinus crest and frontal sinus, maxillary sinus floor, and frontal sinus (P < 0.05). Further correlation analysis also revealed a positive correlation between the thickness of mucosa of the maxillary sinus and frontal sinus and maximum endurable pressure intensity (P < 0.05).

CONCLUSION

Mucosal thickness and maximum endurable pressure intensity of maxillary sinus crest and floor were larger than that of frontal sinus mucosa and a positive correlation between the thickness of mucosa and endurable pressure intensity was observed. Our results thus might provide an experimental basis and guidance for mucosa-related problems involved maxillary sinus augmentation.

Association between social capital and oral health among adults aged 50 years and over in China: a cross-sectional study

Background

Social capital has a potential effect in protecting oral health among population. However, no study has explored the association between social capital and oral health in the Chinese context. Due to the unique culture, political, social context in China, it is important to understand their association in the Chinese context. The study aims to investigate the association between cognitive and structural dimensions of social capital with edentulism among adults aged 50 years and over in China.

Method

The study used data from the WHO SAGE (Study on Global AGEing and Adult Health) wave 1 China component. Structural social capital was operationalized as social participation. Cognitive social capital was operationalized as perceived community trust and perceived community safety. Community-level social capital was measured by aggregating individual-level social capital into community level. Oral health was measured using a final marker of oral health status, self-reported edentulism. A 2-level multilevel logistic regression was used to evaluate the association between different dimensions of social capital and oral health.

Results

In total, 12,856 individuals were included in the study, the overall prevalence of edentulism was 9.1% (95% CI 8.3–10.0). Multilevel logistic analysis revealed that individual-level social capital and community-level social capital are independently associated with edentulism. Individuals with low structural social capital and living in areas with low structural social capital have, respectively, 1.54 (95% CI 1.18–2.01) and 2.14 (95% CI 1.47–3.12) times higher odds for edentulism, after adjustment for potential confounders (age, sex, marital status, residence locality, wealth, education level, chronic conditions) and a potential mediator(smoking).

Conclusions

Living in a community with lower structural social capital and individual with low structural social capital is associated with higher risk for edentulism among adults aged 50 years and over in China.

Association between diabetes and edentulism and their joint effects on health status in 40 low and middle-income countries

INTRODUCTION

Previous studies on the diabetes-edentulism relationship have yielded conflicting results. Therefore, the goal of this study was to investigate the association between diabetes and edentulism, and their joint effects on health status in adults from 40 low and middle-income countries (LMICs).

RESEARCH DESIGN AND METHODS

Data from the World Health Survey were used for this cross-sectional study (2002-2004). Forty countries (18 low-income and 22 middle-income countries) were included. Edentulism and diabetes were assessed using yes-no questions based on self-report. Health status was assessed in seven different domains (self-care, pain/discomfort, cognition, interpersonal activities, sleep/energy, affect, and perceived stress). The association between diabetes (exposure) and edentulism (outcome) was analyzed using multivariable logistic regression models, while their joint effects on health status were assessed using multivariable linear regression models.

RESULTS

There were 175 814 adults aged ≥18 years included in this study (mean (SD) age 38.4 (16.0) years; 49.3% men). Overall, the prevalence of edentulism was 6.0% and diabetes was 2.9%. There was a positive and significant association between diabetes and edentulism in the overall sample (OR=1.40, 95% CI 1.18 to 1.66), in low-income countries (OR=1.78, 95% CI 1.21 to 2.62) and in middle-income countries (OR=1.24, 95% CI 1.04 to 1.47). In addition, people with comorbid diabetes and edentulism had worse health status in the domains of cognition, sleep/energy, and perceived stress, compared with those with diabetes only.

CONCLUSIONS

Diabetes was positively associated with edentulism in this sample of more than 175 000 individuals living in LMICs. Providing oral care to individuals with diabetes may potentially lead to a reduction in their risk of edentulism.

Edentulism and select chronic diseases among adults aged ≥45 years in China, 2011-2018: A longitudinal study

OBJECTIVES

Information on the association between edentulism and chronic medical conditions in developing countries is lacking. We investigated such information among adults aged ≥45 years in China.

METHODS

A national longitudinal data set from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2018 was analysed. A multilevel logistic regression model was applied to analyse the association between edentulism and select chronic diseases.

RESULTS

There were 74 240 Chinese adults aged ≥45 years in this study. The prevalence of self-reported edentulism was 8.8% in 2011 and had increased to 16.4% by 2018.

CONCLUSION

Edentulism was a factor associated with a higher risk of various self-reported chronic diseases among adults aged ≥45 years in China. Edentulism is one of the comorbidities among ageing people with chronic conditions. Preventive public health policy should consider controlling shared risk factors at an earlier age.

Dependence in instrumental activities of daily living and its implications for older adults' oral health

We aimed to assess the association between dependence in instrumental activities of daily living (IADL) and oral health in older adults. We conducted a cross-sectional study of 280 people aged ≥60 years served at public primary health care centers in Northeastern Brazil. Sociodemographic, oral discomfort and general health data were collected. The Lawton and Brody scale were used to assess IADL. This research adheres to the STROBE checklist. Most participants were married (n = 139; 49.6%), women (n = 182; 65.0%) and retired (n = 212; 75.7%). A total of 37 (13.2%) older adults had some degree of dependence in IADL. Dependence in IADL was associated with: retirement (p<0.040), poor general health (p = 0.002), speech problems (p = 0.014), use of medications (p = 0.021), difficulty chewing and swallowing food (p = 0.011), voice changes (p = 0.044), edentulism (p = 0.011), use of toothbrush (p<0.001), use of toothpaste (p<0.001), and visit to the dentist in the previous year (p = 0.020). Functional disability was associated with older age, cardiovascular diseases, speech problems, chewing and swallowing difficulties, use of medication and brushing deficiency. The functional dependence in IADL can be considered an indicator of oral health status in older adults.

The epidemiology of edentulism and the associated factors: A literature Review

Considering the advancement of curative and preventive dentistry, edentulism is still a challenging problem for healthcare providers all over the world. Dental caries and periodontal diseases are the main causative factors to teeth loss and eventually, if untreated, lead to edentulism. The socioeconomical factors also contribute to the edentulism as it has an association with education and income status. This literature review will put some highlights in the epidemiology and etiology of edentulism, its prevalence, and the association with the social-economical factors.

The prevalence of partial edentulism and complete edentulism among adults and above population of Riyadh city in Saudi Arabia

OBJECTIVES

The present study was conducted to investigate the prevalence of complete edentulism and partial edentulism among adults and above population in Riyadh city, in relation to gender, age, and education level. Baseline information related to edentulism will help us take action to promote oral health.

METHODS

A cross-sectional stratified cluster study was carried out in 2018-2019 in several dental care centers across Riyadh city. A total of 618 subjects aged 35-74 years were selected through convenient sampling and information related to edentulism was gathered followed by clinical examination.

RESULTS

Of the total sample, 349 (56.5%) were males and 261 (43.5%) were females. In the overall assessment of edentulism, it was found that the majority of the subjects 426 (69%) had one or more teeth missing. Among these subjects, there was (2.6%) who were completely edentulous, which represented (1.8%) of the total sample.

CONCLUSION

A high percentage of adult patients have missing teeth and complete edentulism was found mostly in elderly people. Frequenting a dental center had an inverse relation with edentulism.

Prevalence and Associated Factors of Frailty in Community-Dwelling Older Adults in Indonesia, 2014-2015

Objective: The investigation aims to study the prevalence and correlates of frailty in a national community-dwelling sample of older Indonesians. Methods: Participants were 2630 older adults, 60 years and older (median age 66.0 years, interquartile range = 9.0) who took part in the cross-sectional Indonesia Family Life Survey (IFLS-5) in 2014–2015. They were requested to provide information about sociodemographic and various health variables, including frailty. Multivariable Poisson regression analysis was utilized to estimate the correlates of socio-demographic factors, health variables, and frailty. Results: The overall prevalence of frailty was 8.1%; 61.6% were prefrail. In adjusted Poisson regression analysis, older age, being unmarried, separated, divorced or widowed, residing in Java and major island groups, poor cognitive functioning, loneliness, and functional disability were associated with frailty. Conclusion: Several sociodemographic and health risk factors for frailty were identified that can help in guiding intervention strategies in Indonesia.

Use of traditional medicines and traditional practitioners by children in Indonesia: findings from a national population survey in 2014-2015

Background: Little data are available about traditional and complementary medicine use in children in the general population in Southeast Asia, including Indonesia. The aim of this investigation was to assess the prevalence of the use of traditional medicines and traditional practitioners in children in a national population-based survey in Indonesia.

Methods: The cross-sectional sample included 15,739 children (0–14 years) (median age 7.0 years, inter quartile range =7.0) that took part in the Indonesia Family Life Survey in 2014–2015.

Results: The prevalence of use of traditional medicines as a treatment in the past four weeks was 6.2%, vitamins or supplements 19.9%, and over-the-counter modern medicine 61.1%. The prevalence of traditional practitioner use in the past 4 weeks was 3.4%, and the prevalence of the use of traditional medicines and/or traditional practitioner in the past 4 weeks was 8.8%. The purpose of consulting the traditional practitioner was mainly massage (86.8%) and treatment for illness (14.8%). In the adjusted logistic regression analysis, having a birth certificate (as a proxy for better economic status) and poor self-rated health were associated with traditional medicine use. Younger age and poor self-rated health were associated with traditional practitioners use.

Conclusion: A high prevalence of traditional medicine use in children in Indonesia was found, and several social factors and poor health status of its use were identified.

Hand Grip Strength and Its Sociodemographic and Health Correlates among Older Adult Men and Women (50 Years and Older) in Indonesia

Objective

There is lack of knowledge about the patterns and correlates of hand grip strength (HGS) of older adults in Indonesia. This study aims to assess sociodemographic and health determinants of HGS among older adult men and women in Indonesia.

Methods

Participants were 7097 individuals of 50 years and older (mean age 61.2 years, SD=9.4) that participated in the cross-sectional Indonesia Family Life Survey (IFLS-5) in 2014-15. The assessment measures included a questionnaire on sociodemographic characteristics and health variables and anthropometric and HGS measurements. Linear multivariable regression analysis was conducted to estimate the association of social and health variables and HGS.

Results

The mean HGS was 28.2 kgs for men and 17.2 kgs for women. In adjusted linear regression analysis among both men and women, height, being overweight or obese, and having a good self-rated health status were positively associated with HGS, while age, having underweight, low cognitive functioning, and functional disability were negatively associated with HGS. In addition, among men, higher education and medium economic background were positive and having two or more chronic conditions, having severe depressive symptoms, and having moderate sleep impairment were negatively associated with HGS.

Conclusion

The study contributed to a better understanding of patterns and correlates of HGS among older adults in Indonesia. Gender-specific and health related interventions may be needed so as to improve the physical functioning of the growing older populace in Indonesia.