Oral health profile among community-dwellingelderly and its association with self-rated oral health

Self-assessed masticatory function and frailty in Brazilian older adults: the FIBRA Study

OBJETIVE

To investigate the relationship between the masticatory function and the frailty of older people.

METHODS

Exploratory cross-sectional study using secondary data from the FIBRA Project on the frailty conditions of older people living in urban areas of six Brazilian municipalities, from 2008 to 2009. The population consisted of older adults aged 65 and over with no cognitive impairment. A single session identification questionnaire and the Mini-Mental State Examination (MMSE) were applied, followed by collecting sociodemographic data and data on the participants' self-assessment of masticatory function, general health, and oral health.

RESULTS

2,341 older people (164 frail older adults), of whom 63.2% reported not having seen a dentist in the last year, and approximately 26% of them had three or more functional feeding problems. Older participants (OR = 2.88; 95%CI: 2.01-4.13), who are retired (OR = 2.31; 95%CI: 1.18-5.53), those who were depressed (OR = 2.31; 95%CI: 1.58-3.38), and those who self-assessed their general health as worse compared to others of the same age (OR = 3.91; 95%CI: 2.39-6.40) were at higher risk of frailty. Three or more problems related to the functional aspects of mastication were associated with a greater chance of frailty (OR = 2.06; 95%CI: 1.25-3.41).

CONCLUSION

This study found an association between masticatory function and a greater chance of frailty among the studied population.

Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals

Dental caries and periodontal disease represent a health problem and a social cost for the entire population, and in particular for socio-economically disadvantaged individuals who are less resistant to disease. The aim of this review is to estimate the prevalence and severity of the two dental pathologies, caries and periodontal disease, in the different classes of socio-economically disadvantaged subjects and to understand which of them are most affected. A systematic search of the literature was performed in MEDLINE (via PubMed), EMBASE and Web of Science after establishing a suitable search strategy for each database, using keywords related to socio-economically vulnerable classes and health outcomes. Socio-economically disadvantaged individuals are more susceptible to tooth decay and periodontal disease (with relative tooth loss) than non-vulnerable people. Additionally, when multiple vulnerabilities are combined in the same subject, these oral diseases worsen. There is no type of vulnerability more affected by caries and periodontitis than others, since overall they all have severe disease indices. The data from this systematic literature review might be useful for health policy makers looking to allocate more resources and services to socially disadvantaged individuals, resulting in making them more resilient to oral disease due to their social marginalization.

Inter-examiner agreement in the application of an oral health assessment instrument in hospitalized elderly

OBJECTIVES

to analyze the correspondence between nurse and dental surgeon assessments in the application of an Oral Health Assessment in dental screening of elderly hospitalized patients.

METHODS

cross-sectional study with elderly patients (n = 54) admitted to University Hospital from the Federal University of São Paulo. Data were collected through the assessment of oral cavity. Descriptive statistical techniques were used to analyze them, using tables and graphs.

RESULTS

there was correlation and agreement between nurse and dental surgeon assessments referring to application of an Oral Health Assessment in dental screening of hospitalized elderly.

CONCLUSIONS

oral Health Assessment in dental screening for hospitalized elderly by nurses demonstrated excellent reproducibility and may be a resource to identify buccal alteration, helping the planning and execution of nurse care associated to oral health.

The relationship of aging, complete tooth loss, and having a dental visit in the last 12 months

OBJECTIVES

To evaluate the extent to which dental health care visits in the past year differed among older adults with and without edentulism.

MATERIAL AND METHODS

We conducted a cross-sectional study using the 2017 Medical Expenditure Panel Survey among participants aged ≥50 years (n = 10,480, weighted = 112,116,641). Two self-reported outcome variables were used: loss of all teeth from upper and lower jaws (yes/no) and dental visit in the last 12 months (yes/no). Logistic models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI).

RESULTS

Overall, 11.4% of the non-institutionalized U.S. population aged ≥50 years were edentulous; the prevalence was higher in those with advanced age. Adherence to annual oral health visits was 16% among those with edentulism, 52% among those without. The prevalence of dental care visits in the past year was higher among those with advanced age without edentulism, but for those with edentulism, the odds of visiting a dental care provider was lower in all age groups compared to those 50-59 years ((60-69 years): aOR: 0.58, CI:0.36-0.95; (70-79 years): aOR: 0.51, CI: 0.30-0.88; (≥ 80 years): aOR: 0.45, CI: 0.26-0.80)).

CONCLUSION

Although the prevalence of edentulism was higher in those with advanced age, oral health visits during the last 12 months were less frequent in older adults with edentulism. Interventions to improve adherence to dental care recommendations in the growing aging population are warranted.

History of Inflammatory Bowel Disease and Self-Reported Oral Health: Women's Health Initiative Observational Study

Background and Objective: Both periodontal disease and inflammatory bowel disease (IBD), are chronic inflammatory conditions, which are mediated by a complex interplay among a dysbiotic microbiota, dysregulated host immune-inflammatory responses, and lifestyle factors. Despite substantial differences in physical and chemical environments, rather strong correlations have been detected between microbial compositions of the oral cavity and stool. In this study, we tested the hypothesis that oral health conditions are affected by the presence of IBD. Materials and Methods: We analyzed the data from 73,621 women who were enrolled in the Women's Health Initiative observational cohort study and completed a follow-up questionnaire that surveyed oral health status specifically at year 5. Among these, 880 reported IBD at the baseline, including 47% who were symptomatic cases and 27% who were on immunosuppressive treatment. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for the association of IBD and medication status for self-reported oral health outcomes, using logistic regression models, adjusted for selected covariates. Results: IBD was not associated with periodontal disease history itself in a multivariable model; however, poorer self-rated oral health was modestly associated with the presence of IBD (OR = 1.15, 95% CI: 1.01-1.30). Likewise, more frequent eating limitations due to teeth were associated with the presence of IBD history (OR = 1.22, 95% CI: 1.07-1.39). When IBD cases were limited to those who were symptomatic, the associations with these two self-rated oral health outcomes were more pronounced with ORs of 1.28 (95% CI: 1.07-1.54) and 1.36 (95% CI: 1.07-1.54), respectively. Immunosuppressive treatment had little effect on these risk estimates. Conclusions: Among this nation-wide cohort of women 50-79 years of age, history of IBD was associated with poorer perceived oral health status.