Oral health-related quality of life of older adults living in long-term care facilities and its association with dental prosthesis use and condition / Qualidade de vida relacionada à saúde bucal de idosos residentes em instituições de longa permanência: associação com o uso e condição da prótese

OBJECTIVE: This cross-sectional study aimed to evaluate the association of oral health-related quality of life with prosthetic rehabilitation status and dental prosthesis condition in residents of Brazilian long-term care facilities. METHODS: The oral health-related quality of life of older adults (n = 194; mean [standard deviation] age = 78.93 [9.10]) was assessed by the Geriatric Oral Health Assessment Index and the Oral Health Impact Profile questionnaires. Prosthetic rehabilitation status was recorded according to the absence of teeth and use of dental prostheses. Dental prosthesis condition was considered good or poor based on stability, retention, occlusion, vertical dimension, and defects. Poisson regression models were plotted to analyze the data (α = 0.05). RESULTS: Lower Geriatric Oral Health Assessment Index scores were associated with edentulism with denture use only on one jaw (B = -0.05) and poor dental prosthesis stability (B = -0.04). Similarly, edentulous participants with denture only on one jaw (B = 0.59) and those wearing dental prostheses with poor stability (B = 0.36) are more likely to achieve higher Oral Health Impact Profile scores. Also, lower Oral Health Impact Profile scores were associated with denture defects (B = -0.34). CONCLUSION: In summary, the oral health-related quality of life of older adults living in long-term care facilities is negatively impacted by edentulism with denture only on one jaw and use of dental prostheses with poor stability. Therefore, long-term care facilities should provide oral health training to caregivers, include dental professionals in the staff, and articulate demands with oral health teams in the primary care system. (AU)

OBJETIVO: Este estudo transversal objetivou avaliar a associação da qualidade de vida relacionada à saúde bucal com o status de reabilitação protética e a condição da prótese em residentes de instituições de longa permanência no Brasil. METODOLOGIA: A qualidade de vida relacionada à saúde bucal dos idosos (n = 194; média [desvio padrão] idade = 78,93 [9,10]) foi avaliada pelos questionários Geriatric Oral Health Assessment Index e Oral Health Impact Profile. O status de reabilitação protética foi registrado de acordo com a ausência de dentes e uso de próteses dentárias. A condição da prótese foi considerada boa ou ruim com base na estabilidade, retenção, oclusão, dimensão vertical e defeitos. Modelos de regressão de Poisson foram plotados para analisar os dados (α = 0,05). RESULTADOS: Como resultado, menores escores no Geriatric Oral Health Assessment Index foram associados ao edentulismo com o uso de dentadura em apenas uma arcada (B = -0,05) e ao uso de próteses com estabilidade ruim (B = -0,04). De forma similar, participantes edêntulos que usavam dentadura em apenas uma arcada (B = 0,59) e aqueles que portavam prótese com estabilidade ruim (B = 0,36) são mais propensos a ter maiores escores no Oral Health Impact Profile. Além disso, menores escores no Oral Health Impact Profile foram associados a defeitos na prótese (B = -0,34). CONCLUSÃO: Sumarizando, a qualidade de vida relacionada à saúde bucal de idosos residentes em instituições de longa permanência é negativamente impactada pelo edentulismo com o uso de dentadura em apenas uma arcada e uso de prótese com estabilidade ruim. Assim, instituições de longa permanência devem promover capacitação em saúde bucal aos cuidadores, incluir dentistas no quadro de funcionários e articular com as equipes de saúde bucal da Atenção Primária à Saúde. (AU)

Prosthetic rehabilitation status, dental prosthesis functionality and masticatory function in nursing home residents.

OBJECTIVE: To evaluate the association of masticatory function with prosthetic rehabilitation status and dental prosthesis functionality in nursing home residents. BACKGROUND: Prosthetic rehabilitation status and dental prosthesis functionality may adversely affect mastication of older people, and this relationship is underestimated in nursing home residents. MATERIALS AND METHODS: This cross-sectional study included 179 nursing home residents who used dental prostheses [mean (SD) age: 78.9 (9.0) years]. Masticatory function data were determined by assessing (a) masticatory performance using two-colour chewing gum, and (b) swallowing thresholds by counting the number of peanut chewing cycles. Older adults were categorised as: (1) using dental prostheses in both jaws (n = 100) and (2) partially dentate using removable partial dental prostheses (RPDPs) or complete dentures (CDs) in only one jaw (n = 41), or (3) edentulous using CD in only one jaw (n = 38). Stability, retention, occlusion, vertical dimension and defects were considered in assessing dental prosthesis functionality. RESULTS: Greater variance of hue (VOH) of the chewing gum and lower swallowing thresholds (worse masticatory function) was associated with edentulous using CD in only one jaw. Older adults wearing dental prostheses with poor occlusion and vertical dimensions presented worse masticatory function. Dental prosthesis stability was associated with lower VOH values. Higher number of chewing cycles while eating peanuts was associated with non-broken dental prosthesis use. CONCLUSION: Edentulous participants using CD in only one jaw and non-functional dental prosthesis use negatively affect the masticatory function of nursing home residents.

Health-related quality of life of institutionalized older adults: Influence of physical, nutritional and self-perceived health status.

INTRODUCTION: Institutionalized older adults have higher risks of diseases and worse health-related quality of life (HRQoL) than noninstitutionalized. OBJECTIVE: To evaluate the influence of physical state, nutritional status and self-perceived general health and oral health on the quality of life of institutionalized older adults in two Brazilian cities. METHODS: A multicenter cross-sectional study was conducted in 17 homes for the aged of two Brazilian cities. Six trained researchers interviewed 344 older adults. The performance of activities of daily living (Katz scale) and frailty status (Fried scale) were applied to evaluate the physical state. The Mini Nutritional Assessment Short-Form (MNA-SF®) and the body composition were used to screening the nutritional status. A hand dynamometer was used to measure the dominant hand grip strength. The 12-Item Short Form Survey for self-perceived health (SF-12) was used to determine the HRQoL. A Likert scale was used to assess the general and oral health self-perception. Multiple Poisson regression model was applied to analyze the data (α = 0.05). RESULTS: The mean (SD) score of the SF-12 was 60.89 (14.50) points. The factors associated with the highest SF-12 score were being able to walk, being nonfrail, being normal nourished, taking fewer medications, having greater dominant hand grip strength and higher self- perceived general health (p < 0.05). CONCLUSION: Better HRQoL in institutionalized older adults was associated with better physical state, nutritional status and self-perceived general health.

Masticatory Function and Nutritional Status in Brazilian Institutionalized Elders: Influence of Denture Use

ABSTRACT Objective: To evaluate the influence of tooth loss and the use of removable dentures on chewing function and nutritional status of institutionalized elders. Material and Methods: Cross-sectional study with 155 elders from seven long-stay institutions in João Pessoa, Brazil. The participants were classified according to the presence of reminiscent teeth and use of dentures in four levels: toothless, without denture (1); toothless with a complete denture (2); partial toothless without denture (3) and partial toothless with a partial denture (4). Nutritional status was assessed using the Mini-Nutritional Assessment (MNA) instrument and the Body Mass Index (BMI). Swallowing threshold was used for the assessment of masticatory function, using a portion of roasted peanuts (3.7 g). Comparisons among groups were performed using Kruskal-Wallis test with Bonferroni adjustment, considering p<0.05. Results: MNA (p=0.702) and BMI (p=0.884) were not modified in relation to the presence of teeth and denture use. Toothless individuals without dentures had a lower swallowing threshold (p<0.001), whilst partial toothless with dentures had better masticatory function (p>0.05). Conclusion: The presence of reminiscent teeth and the use of dentures do not influence the nutritional status of the elders but interfere with the masticatory function. Prosthetic rehabilitation is desirable for complete toothless individuals.

Factors associated with oral health-related quality of life of institutionalized elders

Abstract This study aimed to evaluate the correlation between two Oral Health-Related Quality of Life (OHRQoL) questionnaires (the Oral Health Impact Profile (OHIP-14) and the Geriatric Oral Health Assessment Index (GOHAI)) and to investigate the factors associated with the OHRQoL of institutionalized elderly individuals. A cross-sectional multicenter study was performed with 344 institutionalized elderly individuals residing in two Brazilian cities. Six trained researchers interviewed the elderly individuals. Sociodemographic data were collected from medical records. Dental caries experience and the use of and need for dentures were recorded through oral examination performed by two trained examiners. A Likert scale (1-5 points) was used to assess general health and self-perceived oral health. The number of chewing cycles needed to chew a portion of peanuts was used to assess the swallowing threshold. The OHIP-14 and GOHAI were used to evaluate OHRQoL, and statistically significant correlations were assessed using Spearman's correlation test (p < 0.05). Poisson regression (p < 0.05) was used to investigate the association of OHRQoL with independent variables. Scores on the OHIP-14 (7.57 ± 8.63) and GOHAI (32.46 ± 3.85) were strongly and inversely correlated (r2 = -0.671, p < 0.001), although these measures were associated with different factors. A higher OHIP-14 total score (worse OHRQoL) was associated with female gender, a greater number of healthy teeth, worse self-perceived general health and oral health, and a lower swallowing threshold (p < 0.05). A higher GOHAI total score (better OHRQoL) was associated with a greater number of filled teeth, better self-perceived oral health and a greater swallowing threshold (p < 0.05). In conclusion, worse OHRQoL among institutionalized elderly individuals is associated with worse self-perceived oral health and a greater swallowing threshold.

Factors associated with oral health-related quality of life of institutionalized elders.

This study aimed to evaluate the correlation between two Oral Health-Related Quality of Life (OHRQoL) questionnaires (the Oral Health Impact Profile (OHIP-14) and the Geriatric Oral Health Assessment Index (GOHAI)) and to investigate the factors associated with the OHRQoL of institutionalized elderly individuals. A cross-sectional multicenter study was performed with 344 institutionalized elderly individuals residing in two Brazilian cities. Six trained researchers interviewed the elderly individuals. Sociodemographic data were collected from medical records. Dental caries experience and the use of and need for dentures were recorded through oral examination performed by two trained examiners. A Likert scale (1-5 points) was used to assess general health and self-perceived oral health. The number of chewing cycles needed to chew a portion of peanuts was used to assess the swallowing threshold. The OHIP-14 and GOHAI were used to evaluate OHRQoL, and statistically significant correlations were assessed using Spearman's correlation test (p < 0.05). Poisson regression (p < 0.05) was used to investigate the association of OHRQoL with independent variables. Scores on the OHIP-14 (7.57 ± 8.63) and GOHAI (32.46 ± 3.85) were strongly and inversely correlated (r2 = -0.671, p < 0.001), although these measures were associated with different factors. A higher OHIP-14 total score (worse OHRQoL) was associated with female gender, a greater number of healthy teeth, worse self-perceived general health and oral health, and a lower swallowing threshold (p < 0.05). A higher GOHAI total score (better OHRQoL) was associated with a greater number of filled teeth, better self-perceived oral health and a greater swallowing threshold (p < 0.05). In conclusion, worse OHRQoL among institutionalized elderly individuals is associated with worse self-perceived oral health and a greater swallowing threshold.

Physical and psychological states interfere with health-related quality of life of institutionalized elderly: a cross-sectional study.

BACKGROUND: Nursing home elders experience many problems that may influence their quality of life, in example of cognitive, mental, nutritional and physical disabilities. Concerning about elders' wellbeing may help them living with dignity. This study aimed to investigate factors associated with Health-Related Quality of Life (HRQoL) of institutionalized elders in a capital city of Brazilian Northeast. METHODS: A cross-sectional study was conducted with 125 institutionalized elders living in the metropolitan region of João Pessoa (Brazil). The following variables were tested regarding their association with the elders' HRQoL: Socio-demographic characteristics; Performance of daily-living activities, Frailty status, Cognitive status, Nutritional status, Self-perception of oral health and Depression status. Hierarchical multiple Poisson loglinear and binary logistic regressions analyses were performed in order to assess the impact of each independent variable on HRQoL, considering a significance level of 5%. RESULTS: The median of HRQoL of institutionalized elders was 64. Multivariate regression models showed that retirement, frailty and depression were statistically associated with poor HRQoL (p < 0.05). Not-frail elderly and less depressed were more likely to present higher HRQoL scores. CONCLUSIONS: Lower HRQoL of institutionalized elderly is associated with decline of physical and psychological states. Institutions should be advised to plan and implement actions that would improve the HRQoL of institutionalized elderly.

Masticatory function in nursing home residents: Correlation with the nutritional status and oral health-related quality of life.

BACKGROUND: Masticatory function of institutionalised elders and its relationship with nutrition and oral health-related quality of life (OHRQoL) are unknown. OBJECTIVES: This multicentre cross-sectional study evaluated the influence of the presence of teeth and dentures on masticatory function (masticatory performance and swallowing threshold) in institutionalised elders. Correlation of masticatory function with nutrition and OHRQoL was also verified. METHODS: Older adults (n = 344; mean age (SD) = 77.70 (9.10)), selected from nursing homes in two Brazilian cities, were classified as edentulous with or without complete dentures (CDs), and partially dentate with or without prosthesis. Masticatory performance was assessed using a two-colour chewing gum. Swallowing threshold was set by the number of chewing cycles performed until swallowing 3.7 g of peanuts. Nutrition was screened by Mini-Nutritional Assessment-Short Form and body composition. OHRQoL was evaluated through Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-14). The Kruskal-Wallis test and Spearman's correlation were used (α = 0.05). RESULTS: Edentulous elders without CDs had lower masticatory performance than those with CDs and partially dentate with or without prosthesis (P < .05). Swallowing threshold of edentulous elders with CDs and partially dentate with prosthesis was greater than edentulous elders without CDs and partially dentate without prosthesis (P < .05). Masticatory function was not correlated with nutrition. Masticatory performance was correlated (P < .05) with GOHAI (r2  = -.154) and swallowing threshold with GOHAI (r2  = .162) and OHIP-14 (r2  = -.146). CONCLUSION: The absence of teeth and dentures negatively affected the masticatory function. Although the masticatory function was not correlated with institutionalised elders' nutrition, their OHRQoL was negatively impacted.

Factors associated with the overlap of frailty and nutrition in institutionalized older adults: A multicenter study.

OBJECTIVES: This multicenter cross-sectional study aimed to investigate the factors associated with the overlap of frailty and nutrition in older adults residing in nursing homes. METHOD: Older adults (n = 344, mean age ±â€¯SD = 77.7 ±â€¯9.1) were selected from 17 nursing homes, 10 in Piracicaba and seven in João Pessoa, Brazil. The modified Fried's questionnaire and the Mini Nutrition Assessment Short-Form (MNA-SF) were used for screening frailty phenotypes and nutritional status, respectively. These variables overlapped into (1) frail and malnourished; (2) nonfrail and malnourished or frail and nourished; and (3) nonfrail and nourished. The independent variables were sex, age, mobility, number of medications, dependence for activities of daily living (ADL), maximal grip strength, muscle mass, body fat and body mass index (BMI). Spearman's correlation and Poisson regression were used to analyze the data (α = 0.05). RESULTS: The Spearman's test demonstrated a moderate correlation (r2=-0.441) between frailty (mean ±â€¯SD = 2.8 ±â€¯1.7) and nutritional status (mean ±â€¯SD = 10.5 ±â€¯2.9). Regarding the overlap of frailty and nutrition, 139 participants (40.5 %) were frail and malnourished, 121 (35.3 %) were nonfrail and malnourished or frail and nourished, and 83 (24.2 %) were nonfrail and nourished. The Poisson regression showed association of the coexistence of frailty and malnutrition with age (PR = 1.009, 95 % CI = 1.003-1.016), number of medications (PR = 1.016, 95 % CI = 1.006-1.027), dependence for ADL (PR = 1.061, 95 % CI = 1.016-1.108), maximal grip strength (PR = 0.992, 95 % CI = 0.986-0.998) and BMI (PR = 0.997, 95 % CI = 0.996-0.998). CONCLUSIONS: The findings showed that frailty and malnutrition were prevalent in institutionalized older adults and associated with advanced age, greater use of medicines, dependence for ADL, lower maximal grip strength and lower BMI.

Needlestick and Sharp Instruments Injuries among Brazilian Dentistry Students.

BACKGROUND: The occurrence of occupational accidents is common among students and dentists. The present study is aimed to evaluate the prevalence and characteristics of needlestick and sharp instrument injuries among dentistry students. MATERIALS AND METHODS: A documentary research was carried out with data being obtained from the analysis of 137 medical records of injuries caused by needlestick and sharp instruments occurring in the period from 2012 to 2016 and were analyzed regarding the characteristics of the victim (gender and age) and the accident (year, time, environment, and time interval between exposure and search for care). Data were organized in the Statistical Package for Social Sciences software version 18 and were presented through descriptive statistics. RESULTS: The occurrence of accidents was high (43.1%), with the predominance of female victims (66.1%) and aged up to 23 years (55.9%). The majority of events occurred in the afternoon (54.4%), in the clinical setting (70.7%), and in 75% of the cases, the search for care occurred within 2 h after exposure. CONCLUSION: Accidents with needlestick and sharp instruments have high frequency and involve mainly female students. They are more common in the afternoon and in the clinical setting and the time interval was between exposure and the search for care complied with recommendations of the Brazilian legislation.