Total tooth loss without denture wear is a risk indicator for difficulty eating among older adults with intellectual disabilities.

OBJECTIVES: This study tests whether total tooth loss is a risk indicator for difficulty eating among a population with intellectual disability and whether complete denture wear mediates this risk. METHODS: Dentate status and difficulty eating were reported for a Nationally representative sample of 690 adults over forty with intellectual disabilities as part of The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA). A logistic regression model tested the relationship between the Difficulty eating and Dentate status, controlling for the effects of other factors. RESULTS: Of the 690 participants, 505 had some teeth (Group 1), 56 had no teeth and reported wearing dentures (Group 2) and 129 had no teeth, not using dentures (Group 3). A parsimonious regression model was developed including all 406 cases with no missing data. Adjusting for the effects of other factors, it was found that, compared to Group 1, the odds of difficulty eating was twice as great (OR = 2.01, 95% CI = 1.02-4.03) among people without teeth, not using dentures (Group 3). Conversely, edentulous participants who had dentures (Group 2) had far lower odds (OR = 0.21, 95% CI = 0.06-0.64) of reporting difficulty eating compared with Group 1. CONCLUSIONS: For adults with ID, total tooth loss was predictive of difficulty eating only when untreated. People with disabilities should be encouraged to maintain a functional dentition through preventive and conservative treatment. When adults with ID become edentulous, oral rehabilitation may reduce the risk of difficulty eating. Dental assessment should be undertaken if people with ID present with difficulty eating.

Nutritional effects of implant therapy in edentulous patients--a systematic review.

PURPOSE: The aim of this study was to present all the relevant studies that have evaluated, with valid scientific methodology, the possible physical and nutrient intake improvement of edentulous subjects rehabilitated with removable and supported or retained implant denture, without restriction of suprastructure modalities, compared with those wearing conventional removable dentures. METHODS AND MATERIALS: Several electronic databases (Pubmed, Medline-Medline In-Process, Cochrane Library Database, Embase, and Lilacs) were searched, without language limitation. References from the selected articles were also hand searched. Abstracts which appeared to fulfill the initial selection criteria (comparison of nutritional state between conventional removable and supported or retained implant denture wearers) were selected by consensus and their original articles were then retrieved. Clinical trials that included anthropometric measurements or nutrient intake in removable and supported or retained implant denture wearers without syndrome and systemic influences, nor presenting surgical or other simultaneous treatment, which could affect the integrity during the evaluation period were finally selected. RESULTS: Only 5 articles met the selection criteria. Two studies (randomized clinical trials and prospective) found inadequate nutrient intake after treatment. One randomized clinical trial presented an improvement in nutritional state after treatment. One cross-sectional study showed an adequate nutritional state before and after treatment. These 4 studies found no significant difference between implant and conventional treatments. Finally, 1 cross-sectional study presented a difference between treatments, showing that the risk of malnutrition was higher for removable complete denture wearers. CONCLUSION: Considering the available evidence, the effect on the nutritional state in edentulous subjects treated with implant therapy is similar to the 1 obtained with conventional removable dentures. This effect does not necessarily mean an optimum nutritional state, which also depends on other factors not related to prosthodontic treatment.

Osteoporosis and reduction of residual ridge in edentulous patients.

The relationship between the height of the mandibular residual ridge and the severity of osteoporosis in elderly edentulous patients was investigated. The height of the mandibular residual ridge was measured by use of the mental foramen on panoramic radiographs. The severity of osteoporosis was determined by examining frontal and lateral radiographs of the vertebrae. All of the patients received a blood analysis. The correlation coefficient between age and the height of residual ridge was -0.38, which was statistically significant (p < 0.01). The residual ridge in women was lower than that of men, showing a statistical significance (p < 0.01). The correlation coefficient was -0.42 between degree of severity of osteoporosis and the height of the residual ridge, which was significant (p < 0.01). The parathyroid hormone level was high in the patients with a low residual ridge, and the calcitonin (CT) level was low. This study indicates that osteoporosis strongly affects reduction of the residual ridge in edentulous patients.

Oral conditions in individuals with selective immunoglobulin A deficiency and common variable immunodeficiency.

Saliva and serum samples were collected from 36 individuals with selective immunoglobulin A deficiency (IgAd) and 23 patients with common variable immunodeficiency (CVI). The oral examination included registration of the teeth, Russell's periodontal index (PI), pocket formation, and salivary flow rate in both unstimulated and stimulated saliva. No differences were found in salivary flow rate, number of teeth, or pocket depth when donors with IgAd or CVI were compared to age and sex matched controls. However, mucosal manifestations of lichenoid type were more frequent in both types of immunoglobulin deficient individuals. An increased PI was also seen in CVI patients. Increased serum IgG and salivary IgM levels were found in the IgAd population.

The influence of the loss of teeth and attrition on the articular eminence.

A review of the literature revealed that changes in the articular eminence associated with changes in the dentition were usually overlooked in most reports. An attempt was made to determine whether changes in attrition and loss of teeth would correlate with a change (decreased angulation) in the articular eminence. The population consisted of 103 adult skulls and mandibles of both sexes and three different races. They included partial and totol edentulism, mild to severe attrition, and complete dentitions in good condition. An impression of each of the 206 articular eminences was made and the angulation established. The data were transferred to computer cards and a statistical analysis performed. The level of significance for each of the variables was established and conclusions were made.