RESUMO
This study aimed to assess whether dentists correctly understand the benefit of a dental treatment when it is presented using absolute numbers or relative risk reduction (RRR). This parallel-group randomized controlled trial recruited dentists from 3 postgraduate courses in Rio de Janeiro, Brazil. Participants received, in sequentially numbered sealed opaque envelopes, the description of a hypothetical scenario of the benefit (avoidance of multiple tooth loss) of nonsurgical periodontal treatment without or with antibiotics. Treatment benefit was presented in 2 different formats: absolute numbers or RRR. Dentists were given 10 minutes to read the treatment scenario and answer 5 questions. The final sample for analysis included 101 dentists. When asked to estimate the number of patients out of 100 who would avoid multiple tooth loss without antibiotics, 17 dentists (33%) in the absolute numbers group and 12 (25%) in the RRR group provided the correct response (p = 0.39). Regarding treatment with antibiotics, 26 dentists (50%) in the absolute numbers group and 14 (29%) in the RRR group provided the correct response (p = 0.04). Only 16 dentists (31%) in the absolute numbers group and 12 (25%) in the RRR group gave correct answers for both questions (p = 0.51). Most dentists did not correctly understand the benefit of the treatment, irrespective of the format it was presented. Slightly more dentists correctly understood the benefit of the treatment when it was presented as absolute numbers than as RRR.
Assuntos
Antibacterianos , Odontólogos , Humanos , Odontólogos/estatística & dados numéricos , Odontólogos/psicologia , Feminino , Masculino , Antibacterianos/uso terapêutico , Brasil , Adulto , Estatísticas não Paramétricas , Comportamento de Redução do Risco , Medição de Risco , Pessoa de Meia-Idade , Doenças Periodontais/terapia , Doenças Periodontais/prevenção & controle , Perda de Dente/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Competência Clínica/estatística & dados numéricosRESUMO
OBJECTIVES: Tooth wear, also referred to as tooth surface loss, occurs due to causes other than caries. This involves the loss of hard tissues, namely enamel, dentin, and/or cementum. Types of tooth wear/tooth surface loss are abrasion, abfraction, attrition, and erosion. These multifactorial conditions can be caused by factors such as lifestyle, diet, or even habits, and may not be symptomatic. The focus of this article is to provide clinicians with detailed examples and explanations of the causes of tooth loss to aid in early diagnosis. Through early identification, the preventive measures outlined can be implemented to avoid excessive tooth wear. The provision of a treatment flowchart and general treatment recommendations aims to help clinicians determine when to restore these lesions and the most appropriate treatment measures for the four types of wear. METHOD AND MATERIALS: The PubMed (MEDLINE) search engine was used to gather information on teeth restricted to a 5-year period (26 August 2018 to 25 July 2022). Only English-language studies and reviews with the best balance of sensitivity and specificity were considered. A Boolean search of the PubMed dataset was implemented to combine a range of keywords: ("tooth wear" OR tooth attrition OR tooth erosion OR tooth abrasion OR tooth abfraction). Additional articles were selected through Google Scholar. RESULTS: By this process, many articles and studies were obtained, and the 48 most relevant published studies were chosen and used in the current review. CONCLUSION: Tooth wear affects an increasing number of individuals and can have detrimental effects physically, mentally, and emotionally. It is important to stress early diagnosis and management of tooth wear through monitoring, prevention, and treatment where indicated.
Assuntos
Desgaste dos Dentes , Humanos , Desgaste dos Dentes/terapia , Desgaste dos Dentes/prevenção & controle , Desgaste dos Dentes/etiologia , Erosão Dentária/prevenção & controle , Erosão Dentária/etiologia , Erosão Dentária/terapia , Abrasão Dentária/prevenção & controle , Abrasão Dentária/etiologia , Abrasão Dentária/terapia , Perda de Dente/prevenção & controle , Perda de Dente/etiologiaRESUMO
OBJECTIVE: Tooth loss affects quality of life. Scaling is a measure to prevent periodontal disease and tooth loss. This study aimed to determine the effect of scaling on tooth loss. BASIC RESEARCH DESIGN: Secondary analysis of the Korean National Health Insurance Services database, comprising 514,866 Koreans as an initial cohort, followed for 14 years up to 2015. The study population comprised people who had received an oral check-up in 2002-2003. Using propensity score matching, we matched the intervention group (receipt of scaling) and controls (no scaling) 1:1. The outcome, tooth loss was defined as including all teeth except for third molars until 2015. The final sample included 94,738 people. Analysis used a Cox proportional hazard regression model. RESULTS: Scaling showed conflicting results in univariate and multivariable analyses. In univariate analysis, people who received scaling were more likely to lose teeth (HR, 1.04; 95% CI, 1.02-1.05). After adjusting for confounders in the multivariable analysis, those who didn't receive scaling were more likely to lose teeth (HR, 0.97; 95% CI, 0.95, 0.99). The effects of scaling were identified in people without diabetes (HR, 0.97; 95% CI, 0.95, 0.99) but not in people with diabetes (HR, 0.97; 95% CI, 0.89-1.06). CONCLUSIONS: Scaling was associated with less tooth loss. Regular scaling might be encouraged for vulnerable groups, such as males, older adults, lower income, handicapped, chronic diseases, and smokers.
Assuntos
Diabetes Mellitus , Perda de Dente , Idoso , Humanos , Masculino , Estudos de Coortes , Qualidade de Vida , República da Coreia , Perda de Dente/prevenção & controle , Perda de Dente/epidemiologia , Desbridamento PeriodontalRESUMO
BACKGROUND: A learning health system (LHS) is a health system in which patients and clinicians work together to choose care on the basis of best evidence and to drive discovery as a natural outgrowth of every clinical encounter to ensure the right care at the right time. An LHS for dentistry is now feasible, as an increased number of oral health care encounters are captured in electronic health records (EHRs). METHODS: The authors used EHRs data to track periodontal health outcomes at 3 large dental institutions. The 2 outcomes of interest were a new periodontitis case (for patients who had not received a diagnosis of periodontitis previously) and tooth loss due to progression of periodontal disease. RESULTS: The authors assessed a total of 494,272 examinations (new periodontitis outcome: n = 168,442; new tooth loss outcome: n = 325,830), representing a total of 194,984 patients. Dynamic dashboards displaying performance on both measures over time allow users to compare demographic and risk factors for patients. The incidence of new periodontitis and tooth loss was 4.3% and 1.2%, respectively. CONCLUSIONS: Periodontal disease, diagnosis, prevention, and treatment are particularly well suited for an LHS model. The results showed the feasibility of automated extraction and interpretation of critical data elements from the EHRs. The 2 outcome measures are being implemented as part of a dental LHS. The authors are using this knowledge to target the main drivers of poorer periodontal outcomes in a specific patient population, and they continue to use clinical health data for the purpose of learning and improvement. PRACTICAL IMPLICATIONS: Dental institutions of any size can conduct contemporaneous self-evaluation and immediately implement targeted strategies to improve oral health outcomes.
Assuntos
Sistema de Aprendizagem em Saúde , Doenças Periodontais , Periodontite , Perda de Dente , Informática Odontológica , Humanos , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia , Doenças Periodontais/prevenção & controle , Saúde da População , Perda de Dente/epidemiologia , Perda de Dente/prevenção & controleRESUMO
OBJECTIVE: This retrospective study aimed to evaluate tooth loss and the evolution of periodontal inflammatory parameters within a strict nonsurgically treated patient cohort with < 2 supportive periodontal care visits per year, defined as minimal periodontal basic care, of 2.5 to 10.7 years. METHOD AND MATERIALS: Data for nonsurgically treated patients were checked for: complete periodontal examination data at baseline (T0), after active periodontal therapy (T1), and after ≥ 2.5 years of supportive periodontal care (T2); smoking, diabetes mellitus, age (at least 18 years), plaque and gingival indices, bleeding on probing, percentage of residual pockets, supportive periodontal care adherence, and number of supportive periodontal care visits were assessed as risk factors for tooth loss. RESULTS: In total, 132 patients were included (76 female, mean age 56.7 ± 10.3 years), mean T1-T2: 4.5 ± 1.6 years. 26.5% of all patients lost 118 teeth (0.5 teeth/patient, 0.12 teeth/patient/year). Plaque and bleeding parameters were: mean plaque control record, 59.77 ± 28.07%; mean Papilla Bleeding Index, 47.46 ± 34.12%; mean bleeding on probing, 33.46 ± 21.52%. Supportive periodontal care duration (P = .013) and T2 bleeding on probing (P = .048) were identified as patient-related risk factors for tooth loss. CONCLUSION: Minimal periodontal basic care was characterized by elevated bleeding on probing, Papilla Bleeding Index, and plaque control record scores. This possibly highlights a lack of consequent applied surgical intervention (if needed) transitioning into regular supportive periodontal care, including insufficient patient behavioral changes regarding domestic oral hygiene procedures and possibly nonaddressed proinflammatory dietary habits as a negative effect. An apparently low tooth loss rate could be observed. The duration of supportive periodontal care was identified as a risk factor for tooth loss.
Assuntos
Placa Dentária , Perda de Dente , Adolescente , Idoso , Antibacterianos/uso terapêutico , Análise de Dados , Feminino , Humanos , Pessoa de Meia-Idade , Bolsa Periodontal , Estudos Retrospectivos , Perda de Dente/etiologia , Perda de Dente/prevenção & controleRESUMO
AIM: To evaluate the longitudinal association between yogurt product intake and oral health in a population-based study. MATERIALS AND METHODS: This study included 1967 Japanese residents aged 40-79 years who underwent dental examinations in 2012. Among them, 1469 participants were followed up in 2017 for the incidence of tooth loss, which was defined as two or more teeth lost over 5 years. The intake of yogurt products, defined as yogurt and lactic acid beverages, was estimated using a semi-quantitative food frequency questionnaire. The composition of the salivary microbiota was evaluated. RESULTS: The Poisson regression model showed that a higher intake of yogurt products was negatively associated with the incidence of tooth loss (p for trend = .020), adjusted for potential confounding factors. Mediation analysis confirmed that periodontal condition partly mediated the effect of yogurt product intake on tooth loss, while dental caries experience did not. Additionally, we confirmed the association of a high intake of yogurt products with a low percentage of the salivary microbiota pattern, which was associated with poor oral health. CONCLUSION: These findings suggest that the intake of yogurt products is associated with a lower risk of tooth loss resulting from periodontal disease, probably via modulation of the oral microbiome composition.
Assuntos
Cárie Dentária , Doenças Periodontais , Perda de Dente , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Humanos , Japão/epidemiologia , Doenças Periodontais/epidemiologia , Perda de Dente/epidemiologia , Perda de Dente/prevenção & controle , IogurteRESUMO
AIM: To assess the importance of achieving a successfully treated stable periodontitis patient status (PPS) during long-term supportive periodontal care (SPC). MATERIALS AND METHODS: This retrospective cohort study included 100 periodontitis patients, who continued for ≥7.5 years after active periodontal treatment with SPC and were judged as overall adherent. The effect of various predictors on three patient-related outcome parameters was assessed: (1) number of diseased teeth at last SPC, (2) number of teeth lost due to periodontitis, and (3) number of teeth lost due to any reason. RESULTS: One-fifth of the patients were classified as stable after active periodontal treatment. After a mean follow-up of 10.77 years, 24 patients lost 38 teeth due to periodontitis. An unstable PPS and a higher number of diseased teeth per patient at first SPC, and inadequate oral hygiene levels over time, significantly increased the risk for a higher number of diseased teeth per patient at last SPC and for more lost teeth due to periodontitis. However, high adherence to SPC appeared to mitigate the negative effect of an unstable PPS, especially regarding tooth loss due to periodontitis. Further, tooth loss due to any reason was about 3 times higher than tooth loss due to periodontitis and was affected by a larger number of predictors. CONCLUSIONS: Successfully treated patients with a stable PPS maintained a small number of diseased teeth and barely lost any teeth during long-term SPC compared to patients who did not achieve a stable PPS after active periodontal therapy.
Assuntos
Periodontite , Perda de Dente , Assistência Odontológica , Humanos , Higiene Bucal , Periodontite/complicações , Periodontite/terapia , Estudos Retrospectivos , Perda de Dente/prevenção & controleRESUMO
AIM: To determine the impact of the degree of furcation involvement (FI) on the longevity of molar teeth and assess the risk variables (tooth- and patient-related factors) associated with the loss of molars (LM) in individuals treated for periodontitis and monitored in a private programme of supportive periodontal care (SPC). MATERIALS AND METHODS: The present retrospective cohort study included 222 individuals with 1329 molars under a 10-year monitoring period in SPC. Periodontal clinical parameters, FI, the type of molar, pulp vitality, and other variables of interest were collected at approximately 50 days after active periodontal therapy and after 10 years. The association of tooth- and patient-related factors with LM was assessed using a multilevel Cox regression analysis. RESULTS: Two-hundred and thirty-five molars were extracted during the SPC period of 12.4 ± 1.9 years. Age >50 years, male gender, diabetes, smoking, and non-compliance were identified as relevant patient-related factors for LM during SPC (p < .05). Significant tooth-related factors for LM were bleeding on probing (BoP) and probing depth (PD) ≥5 mm, tooth non-vitality, and class II and III FI (p < .05). CONCLUSIONS: Class III FI, tooth non-vitality, higher mean PD and BoP, age, male gender, diabetes, and smoking all strongly influenced the prognosis of molars during SPC.
Assuntos
Defeitos da Furca , Perda de Dente , Seguimentos , Defeitos da Furca/complicações , Defeitos da Furca/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Dente Molar , Estudos Retrospectivos , Perda de Dente/complicações , Perda de Dente/prevenção & controleRESUMO
BACKGROUND: Smokers present a higher prevalence and severity of periodontitis and, consequently, higher prevalence of tooth loss. Smoking cessation improves the response to periodontal treatment and reduces tooth loss. So, the aim of this study was to evaluate the efficiency in resources allocation when implementing smoking cessation therapy vs. its non-implementation in smokers with periodontitis. METHODS: We adopted the Brazilian public system perspective to determine the incremental cost-effectiveness (cost per tooth loss avoided) and cost-utility (cost per oral-related quality-adjusted life-year ([QALY] gained) of implementing smoking cessation therapy. Base-case was defined as a 48 years-old male subject and horizon of 30 years. Effects and costs were combined in a decision analytic modeling framework to permit a quantitative approach aiming to estimate the value of the consequences of smoking cessation therapy adjusted for their probability of occurrence. Markov models were carried over annual cycles. Sensitivity analysis tested methodological assumptions. RESULTS: Implementing the therapy saved approximately US$ 100 over the time horizon accompanied by a slightly better effect, both in CEA and CUA. Considering uncertainties, the therapy could be cost-effective in the most part of simulated cases, even being cheaper and more effective in 35% of cases in which the oral-health related outcome is used as effect. Considering a willingness-to-pay of US$100 per health effect, smoking cessation therapy was cost-effective, respectively, in 72% and 99% of cases in cost-utility and cost-effectiveness analyses. CONCLUSIONS: Implementation of smoking cessation therapy may be cost-effective, considering the avoidance of tooth loss and oral health-related consequences to patients.
Assuntos
Periodontite , Abandono do Hábito de Fumar , Perda de Dente , Análise Custo-Benefício , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/prevenção & controle , Anos de Vida Ajustados por Qualidade de Vida , Perda de Dente/prevenção & controleRESUMO
BACKGROUND: This cross-sectional study aimed in the comparison of periodontal parameters, number of remaining teeth and oral behaviour between patients with ischemic- (ICM) and non-ischemic dilative cardiomyopathy (DCM). METHODS: Patients with HF from the Department for Cardiac Surgery at the Heart Center Leipzig were included. The two groups (ICM and DCM) were composed by matching according to age, gender and smoking habits. All participants received a comprehensive periodontal examination, including a periodontal probing on six measurement points of each tooth. RESULTS: A total of 226 patients (n = 113 each group) was included. Patients in DCM group used interdental cleaning significantly more often than ICM (23.9% vs. 12.5%, p = 0.04). The majority of patients in both groups (ICM: 83.6%, DCM: 84.6%, p = 0.23) were diagnosed with stage III-IV periodontitis. Periodontal parameters were comparable between groups (p > 0.05). Variance analysis revealed no influence of the group (ICM vs. DCM) on the number of remaining teeth (p = 0.16), periodontitis stage (p = 0.27) or the periodontal inflamed surface area (p = 0.62). CONCLUSIONS: Patients with severe HF show high periodontal burden, without any differences between ICM and DCM group. Therefore, increased attention should be payed to periodontal health of patients with severe heart disease, irrespective of their underlying disease.
Assuntos
Cardiomiopatias/epidemiologia , Cardiomiopatia Dilatada/epidemiologia , Insuficiência Cardíaca/epidemiologia , Isquemia Miocárdica/epidemiologia , Saúde Bucal , Periodontite/epidemiologia , Perda de Dente/epidemiologia , Idoso , Cardiomiopatias/diagnóstico , Cardiomiopatia Dilatada/diagnóstico , Estudos Transversais , Feminino , Alemanha/epidemiologia , Insuficiência Cardíaca/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico , Higiene Bucal , Periodontite/diagnóstico , Periodontite/prevenção & controle , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Perda de Dente/diagnóstico , Perda de Dente/prevenção & controleRESUMO
BACKGROUND/OBJECTIVES: Tooth loss is associated with reduced functional capacity, but so far, there is no relevant causal evidence reported. We investigated the causal effect of tooth loss on the instrumental activities of daily living (IADL) among older adults in England. DESIGN: Natural experiment study with instrumental variable analysis. SETTING: The English Longitudinal Study of Aging (ELSA) combined with the participants' childhood exposure to water fluoride due to the community water fluoridation. PARTICIPANTS: Five thousand six hundred and thirty one adults in England born in 1945-1965 participated in the ELSA wave seven survey (conducted in 2014-2015; average age: 61.0 years, 44.6% men). MEASUREMENTS: The number of natural teeth predicted by the exogenous geographical and historical variation in exposure to water fluoride from age 5 to 20 years old (instrumental variable) was used as an exposure variable. The outcome, having any limitations in IADL (preparing a hot meal, shopping for groceries, making telephone calls, taking medications, doing work around the house or garden, or managing money), was assessed by self-reported questionnaires. RESULTS: Linear probability model with Two-Stage Least Squares estimation was fitted. Being exposed to fluoridated water was associated with having more natural teeth in later life (coefficient: 0.726; 95% confidence interval (CI) = 0.311, 1.142; F = 11.749). Retaining one more natural tooth reduced the probability of having a limitation in IADL by 3.1 percentage points (coefficient: -0.031; 95% CI = -0.060, -0.002). CONCLUSION: Preventing tooth loss maintains functional capacity among older adults in England. Given the high prevalence of tooth loss, this effect is considerable. Further research on the mechanism of the observed causal relationship is needed.
Assuntos
Atividades Cotidianas , Avaliação da Deficiência , Fluoretação/estatística & dados numéricos , Avaliação Geriátrica , Perda de Dente/epidemiologia , Idoso , Inglaterra/epidemiologia , Feminino , Estado Funcional , Humanos , Análise dos Mínimos Quadrados , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Autorrelato , Perda de Dente/fisiopatologia , Perda de Dente/prevenção & controleRESUMO
OBJECTIVE: In this 5-year cohort study, we aimed to determine whether the intake of natto, a fermented soya bean food product, has an indirect effect on tooth loss incidence through BMD changes among postmenopausal women. BACKGROUND: Evidence indicates (1) that natto has a beneficial effect on bone health and (2) that a decrease in bone mineral density (BMD) is associated with tooth loss. METHODS: The study recruited 435 postmenopausal women (average age = 64.2 years). Natto intake (exposure) was assessed at baseline using a food frequency questionnaire. Lumbar spine BMD and number of teeth were measured at baseline and 5-year follow-up. BMD change (mediator) and the number of teeth lost (outcome) over time were calculated. The mediation model consisted of these 3 variables. Mediation analysis was performed to test the indirect effect of the natto intake measured through BMD change on tooth loss. RESULTS: During the study, the mean number of teeth lost was 1.2 (standard deviation = 1.8), and the mean BMD decline was 2.5% (standard deviation = 7.1). After adjusting for potential confounders, increasing habitual natto intake was significantly indirectly associated with a lower incidence of tooth loss mediated by BMD change (incidence rate ratio of tooth loss among women with "≥1 pack/day" natto intake was 0.90 [95% confidence interval = 0.82-0.99] compared to those with natto consumption of "rarely"). CONCLUSIONS: Dietary natto intake is significantly indirectly associated with a lower incidence of tooth loss among postmenopausal women, and systemic bone density could be a mediator of this association.
Assuntos
Osteoporose Pós-Menopausa , Alimentos de Soja , Perda de Dente , Densidade Óssea , Estudos de Coortes , Feminino , Humanos , Osteoporose Pós-Menopausa/epidemiologia , Osteoporose Pós-Menopausa/prevenção & controle , Pós-Menopausa , Perda de Dente/epidemiologia , Perda de Dente/prevenção & controleRESUMO
BACKGROUND: Odontological effects of ionizing radiation (IR) as a result of radiotherapy, the consequences of accidents at nuclear power plants and industry, individual occupational exposure, etc. deserve significant attention interns of radiation medicine and radiation safety. OBJECTIVE: to analyze and summarize clinical and experimental data on the odontological radiation effects. OBJECT: the pathological changes in the hard tissues of teeth, pulp, periodontium, mucousmembranes of the mouth and jaws due to exposure to IR. METHOD: search in the PubMed / MEDLINE, Google Scholarabstract medical and biological databases, scientific libraries of the relevant sources of scientific information. RESULTS: Radiobiological effects of IR due to its direct and indirect action are manifested throughout the period ofodontogenesis and formation of the facial skeleton. Experimental and clinical data (in children and adults) indicatethe increased risk of dental caries, reduction of pain threshold and vascularization of tooth pulp along with its fibrosis and atrophy, periodontal dysfunction, which predispose to a high probability of tooth loss. Abnormalities in theactivity of osteoblasts and cementoblasts of dental periosteum and osteoblasts of alveolar process in combinationwith circulatory disorders due to endothelial cell death, hyalinization, thrombosis and vascular obliteration increasethe risk of jaw osteoradionecrosis. Children who have undergone a prenatal exposure to IR as a result of theChornobyl NPP accident have a premature change of teeth. Deterioration of periodontal tissues and early development of acute and complicated dental caries are typical for children and adults affected by the Chornobyl disaster. CONCLUSIONS: Summarized data on the effects of radiation exposure under different conditions on teeth primordia(i.e. immature teeth), their formation and eruption in experimental and clinical settings, as well as on the odontological radiation effects in adults are summarized. Condition of the teeth in the Chornobyl NPP accident survivorsis described. Understanding and taking into account the radiobiological odontological effects is necessary in thelight of planning, preparing, and conducting local radiation therapy and developing the standards of radiation safety and measures to protect professionals and the public in the event of possible radiation accidents at the nuclearpower plants and industry facilities.
Assuntos
Acidente Nuclear de Chernobyl , Cárie Dentária/patologia , Osteorradionecrose/patologia , Exposição à Radiação/efeitos adversos , Lesões por Radiação/patologia , Perda de Dente/patologia , Cárie Dentária/etiologia , Cárie Dentária/terapia , Cemento Dentário/patologia , Cemento Dentário/efeitos da radiação , Polpa Dentária/patologia , Polpa Dentária/efeitos da radiação , Células Endoteliais/patologia , Células Endoteliais/efeitos da radiação , Humanos , Arcada Osseodentária/patologia , Arcada Osseodentária/efeitos da radiação , Mucosa Bucal/patologia , Mucosa Bucal/efeitos da radiação , Odontogênese/efeitos da radiação , Osteoblastos/patologia , Osteoblastos/efeitos da radiação , Osteorradionecrose/etiologia , Osteorradionecrose/terapia , Periodonto/patologia , Periodonto/efeitos da radiação , Doses de Radiação , Lesões por Radiação/etiologia , Lesões por Radiação/terapia , Radiação Ionizante , Dente/patologia , Dente/efeitos da radiação , Perda de Dente/etiologia , Perda de Dente/prevenção & controleRESUMO
Data sources MEDLINE (PubMed), Web of Science and Cochrane Library in September 2019.Study selection Cross-sectional and cohort studies that explored the relationship between smoking cessation and tooth loss.Data extraction and synthesis The reviewers extracted data and contacted authors if relevant data were missing. Risk of bias was assessed using modified versions of the Newcastle-Ottawa scale (NOS) for both cohort and cross-sectional studies. For cross-sectional studies, random-effects model was used to assess the outcome (tooth loss). Estimates were presented as odds ratios (with 95% confidence interval). For cohort studies, random-effects model was also used to compare former and current smokers to never smokers. The estimates were presented as risk ratio (with 95% confidence interval). Heterogeneity was tested for both types of studies.Results Twenty-one studies were included in the review (14 cross-sectional and seven cohort). Of the cross-sectional studies, five studies were of low risk of bias while seven and two studies were of moderate and high risk of bias respectively. Former vs current smokers showed no significant difference in all levels of tooth loss. Of the cohort studies, the risk of tooth loss was twice as much for current smokers compared to former smokers.Conclusions There was not a significant difference in tooth loss between former smokers and never smokers. Current smokers are at a higher risk for tooth loss than former smokers.
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Abandono do Hábito de Fumar , Perda de Dente , Estudos de Coortes , Estudos Transversais , Humanos , Fumar/efeitos adversos , Perda de Dente/prevenção & controleRESUMO
BACKGROUND: Many studies have reported risk factors for tooth loss. Oral health instruction is considered effective at improving oral health behavior and oral health. However, few studies have examined the relationship of dental clinic factors, such as the number of dental hygienists and implementation of oral health instructions, with tooth loss. Here, we conducted a multilevel analysis to clarify the dental clinic risk factors associated with tooth loss. METHODS: Baseline surveys were conducted at 1216 dental clinics in 46 prefectures in Japan, and 12,399 dental patients aged 20 years and over underwent oral examinations and completed a questionnaire. The dental clinics also completed a questionnaire at baseline. A 3-year follow-up survey included 2488 patients in 585 dental clinics. Multilevel multivariate logistic regression analysis was used to examine the risk of tooth loss at the patient and clinic levels. RESULTS: Of the patient variables, older age, higher mean probing pocket depth, current or past smoking, and bleeding during tooth brushing were associated with higher risks of tooth loss. Individuals with many teeth who visited dental clinics for maintenance were at significantly lower risk of tooth loss. Of the clinic variables, patients attending dental clinics with four or more dental hygienists had a significantly lower risk of tooth loss (OR 0.68, 95% CI 0.50-0.99). Patients attending dental clinics that provide oral health instructions for 20 min or more had a significantly lower risk of tooth loss (OR 0.69, 95% CI 0.50-0.96). CONCLUSIONS: In addition to individual risk factors for tooth loss, dental clinic factors such as length of oral health instruction and number of dental hygienists are associated with tooth loss. In dental clinics, ensuring sufficient time for dental hygienists to provide oral health instructions can help prevent tooth loss in dental patients.
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Perda de Dente , Adulto , Idoso , Educação em Saúde Bucal , Humanos , Japão/epidemiologia , Análise Multinível , Saúde Bucal , Perda de Dente/epidemiologia , Perda de Dente/prevenção & controle , Adulto JovemRESUMO
The effect of preventive oral habits is largely unexplored in older individuals. The purpose of this study was to evaluate the associations between home use of flossing and prevalence of periodontal disease and caries in older adults. Five-year incident tooth loss was also evaluated. Data on 686 individuals ≥65 y-old from the Piedmont 65+ Dental Study were examined including: 1) interproximal clinical attachment level (iCAL), 2) interproximal probing depth (iPD), 3) numbers of caries, and 4) missing teeth. Flossing behavior was evaluated according to the Periodontal Profile Class (PPC) system. Five-year follow-up data (n = 375) was evaluated for incident tooth loss. Dichotomous and categorical variables were analyzed using Pearson chi-square tests as well as covariate-adjusted Cochran-Mantel-Haenszel tests. Multiple linear regression compared clinical parameters based on flossing behavior. Elderly flossers had lower (mean, SE) %iCAL≥3 mm (38.2, 2.38 vs. 48.8, 1.56) and %iPD≥4 mm (8.70, 1.41 vs. 14.4, 0.93) compared to nonflossers (P ≤ 0.005). Flossers showed less coronal caries compared to nonflossers (P = 0.02). Baseline number of missing teeth (mean, SE) was 11.5 (0.35) in nonflossers compared to 8.6 (0.53) in flossers (P < 0.0001). Regular dental visitors had lower oral disease levels compared to episodic dental users. The majority of flossers classified into PPC-Stage I (health) whereas nonflossers classified as PPC-Stages V, VI, and VII (disease). At the 5-y follow-up visit, the average tooth loss for flossers was ~1 tooth compared to ~4 teeth lost for nonflossers (P < 0.0001). Among all teeth, molars showed the highest benefit (>40%) for flossing behavior (P = 0.0005). In conclusion, the extent of oral disease for older individuals was significantly less in flossers than in nonflossers. Flossers showed less periodontal disease, fewer dental caries, and loss of fewer teeth over a 5-y period. These findings further support flossing as an important oral hygiene behavior to prevent oral disease progression in older adults.
Assuntos
Cárie Dentária , Doenças Periodontais , Perda de Dente , Idoso , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Dispositivos para o Cuidado Bucal Domiciliar , Feminino , Humanos , Masculino , Saúde Bucal , Higiene Bucal , Doenças Periodontais/epidemiologia , Doenças Periodontais/prevenção & controle , Perda de Dente/epidemiologia , Perda de Dente/prevenção & controleRESUMO
OBJECTIVE: This randomized, clinical trial investigated whether zoledronic acid combined with oral health maintenance can improve periodontal disease associated with osteoporosis, thus reducing the risk of tooth loss. METHODS: Participants were those of the ZONE (ZOledroNate treatment in efficacy to osteoporosis) study. None of the participants had symptomatic periodontal disease at baseline. Participants received either zoledronic acid (5âmg; nâ=â333 [male 21, female 312]) or placebo (nâ=â332 [male 19, female 313]) once yearly for 2 years, and their age was 74.0â±â5.3 (65-88) and 74.3â±â5.4 (65-87) years, respectively. Participants were instructed to maintain good oral hygiene at baseline and every 3 months. Participants with signs or symptoms involving their oral cavity at the monthly visit with their physician were referred to dentists for examination of oral disease. All cases were included to analyze adverse events in this study. Testing for significance was conducted using Fisher exact test (Pâ<â0.05). RESULTS: The incidence of oral adverse events was significantly higher in the control group (67 cases, 20.2%) than in the zoledronic acid group (47 cases, 14.1%; Pâ=â0.04). The frequency of symptomatic periodontal disease observed during the study was significantly higher in the control group (40 cases, 12.0%) than in the zoledronic acid group (18 cases, 5.4%; Pâ=â0.002). Loss of teeth was more frequent in the control group (36 cases, 10.8%) than in the zoledronic acid group (24 cases, 7.2%), although the difference was not significant. CONCLUSIONS: Zoledronic acid effectively prevented symptomatic periodontal disease in patients with osteoporosis who maintained good oral hygiene. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A438.
Assuntos
Conservadores da Densidade Óssea/administração & dosagem , Osteoporose/tratamento farmacológico , Doenças Periodontais/prevenção & controle , Perda de Dente/prevenção & controle , Ácido Zoledrônico/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Esquema de Medicação , Feminino , Humanos , Masculino , Osteoporose/complicações , Doenças Periodontais/etiologia , Perda de Dente/etiologia , Resultado do TratamentoRESUMO
Tooth loss is a risk factor for pneumonia mortality, but it is unclear whether oral care negates excess mortality due to pneumonia among community-dwelling elderly with tooth loss. The purpose of this study was to examine the influence of oral care on the association between the number of remaining teeth and the risk of pneumonia death. We analyzed for 18,098 individuals (aged ≥ 65 years) participating in a prospective cohort study. In a 2006 baseline survey, the following data were collected: the number of remaining teeth, oral care, history of disease, smoking, alcohol drinking, education level and so forth. We also obtained data on dates and causes of death between 2006 and 2014. The primary outcome was mortality due to pneumonia. Compared with those having ≥ 20 teeth, the risk of pneumonia mortality was increased among participants having 10-19 or 0-9 teeth; the multivariate hazard ratios (HRs) (95% confidence intervals [CI]) were 1.45 (1.03-2.04) and 1.38 (1.01-1.87), respectively. Among those having 0-9 teeth, a significantly increased risk of mortality due to pneumonia was disappeared for those who brushed their teeth ≥ 2 times per day, for those with visiting a dentist, and for those with use of denture, whereas the risk persisted among those who brushed their teeth ≤ 2 times per day, for those without visiting a dentist, and for those without use of denture. Tooth-brushing, visiting a dentist or use of denture may negate the increased risk of pneumonia death among the elderly with tooth loss.
Assuntos
Saúde Bucal , Pneumonia/mortalidade , Pneumonia/prevenção & controle , Autocuidado , Perda de Dente/complicações , Perda de Dente/prevenção & controle , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pneumonia/complicaçõesRESUMO
OBJECTIVES: To describe the oral health and oral health-related quality of life among social vulnerable adults enrolled in a special oral care program, and to evaluate the effect of oral care on their oral health-related quality of life. METHOD: Social workers identified social vulnerable persons in social centres and referred them to the program. Dental clinics were arranged including a well-motivated staff to be special responsive to these clients. The participants, (n = 235, mean age 43.5 years) with drug abuse, being homeless, permanently unemployed, or with mental problems were offered low-cost treatment services. Data collection was made by clinical registration and questionnaires. Oral health-related quality of life was measured by means of the Oral Health Impact Profile-14 index (OHIP-14). RESULTS: 94% of the participants had actual decayed teeth (mean 9.5). Forty-four per cent had not visited a dentist within 5 years and less than one-third reported tooth brushing twice a day, 17% even less frequent. One hundred and forty-six completed the dental program within the program period. Mean OHIP-14 score was 28.6 at baseline. Among those who fulfilled the program, the OHIP-14 score was reduced to 9.9 (p < .001). CONCLUSION: Oral health among the study population was very poor. However, oral problems in this group can be solved, and their oral health-related quality of life can be increased although it requires special arrangements and special clinical environment.
Assuntos
Odontologia Comunitária/organização & administração , Serviços de Saúde Comunitária/organização & administração , Cárie Dentária/prevenção & controle , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pessoas Mal Alojadas/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Adulto , Dinamarca , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal/estatística & dados numéricos , Qualidade de Vida , Perda de Dente/prevenção & controle , Odontalgia/prevenção & controleRESUMO
OBJECTIVE: To explore the association between long-term pattern of dental attendance and tooth retention among British adults. METHODS: This study analysed data from 2970 dentate adults who participated in the Adult Dental Health Survey. Data were collected through home interviews and clinical examinations. Individuals were categorized into four trajectories according to their responses to three questions on dental attendance over their life span. The four trajectories were always, current, former and never regular attenders. Tooth retention was measured as the number of natural teeth retained and having a functional dentition (20 or more teeth). Associations were examined in regression models adjusted for demographic (sex, age and country of residence), socioeconomic (education, equivalized household income and social class) and clinical factors (untreated caries and periodontal disease). RESULTS: Never and former regular attenders had fewer teeth retained (rate ratios with 95% confidence interval: 0.93 [0.89-0.97] and 0.97 [0.96-0.99], respectively) and lower odds of having functional dentition (odds ratios with 95% CI: 0.36 [0.22-0.60] and 0.53 [0.34-0.83], respectively) than always regular attenders after adjusting for demographic, socioeconomic and clinical characteristics. However, no differences in number of teeth retained or having a functional dentition were found between always and current regular attenders. CONCLUSION: Long-term regular dental attendance was associated with greater tooth retention. Never and former regular attenders had fewer teeth retained than always regular attenders. No difference in tooth retention was found between always and current regular attenders.