Residual dentition, prosthesis type and oral health-related quality of life in Uruguayan adults.

OBJECTIVES: To investigate the association between different types of dental prostheses (and residual dentition) and oral health-related quality of life (OHRQoL). METHODS: A population-based study with a representative sample of adults and older adults in Uruguay (2010-2011). The dependent variable was the score on the oral impact on daily performance (OIDP), and the main predictor was the pattern of tooth loss and prosthesis use. Covariates included sex, age, socioeconomic status, education, missing teeth, pain and decayed teeth. Negative binomial regression was used. RESULTS: The sample comprised 762 participants. Those participants not wearing a prosthesis and with extensive tooth loss had a mean OIDP of 3.1 (95% CI = 1.6-6.2), while those wearing removable partial dentures (RPD) and having <12 missing teeth had a mean OIDP of 3.6 (95% CI = 1.3-10.0). Participants with a free-end saddle had the highest mean OIDP, at 4.9 (95% CI = 2.0-12.1). For participants with ≤12 missing teeth, any additional missing tooth was associated with an 11% higher OIDP score. Participants who wore RDPs reported fewer impacts on OHRQoL if they had extensive tooth loss or anterior tooth loss than those with a free-end saddle, or who had lost fewer teeth. CONCLUSIONS: The use of RPDs is associated with better OHRQoL. These findings may be valuable in clinical practice and prosthetic planning.

Predictors of tooth loss in Brazilian older adults: An 8-year follow-up.

OBJECTIVE: To investigate the risk factors for tooth loss after 8 years among community-dwelling older adults in a southern Brazilian city. METHODS: In 2004, 388 dentate community-dwelling older adults from Carlos Barbosa, southern Brazil, were selected using simple random sampling. In 2012, the follow-up consisted of 199 (51.3%) participants. Data collection comprised an interview with data about socio-demographic, behavioural and access to services and an oral examination. The outcome variable of this study is the ratio between the sum of the teeth lost during the 8-year period of follow-up, and the sum of the teeth present in 2004, per person, modelled through binomial regression analysis. RESULTS: Being older (IOR = 1.03, 95% CI: 1.00-1.06), living in a rural area (IOR = 1.56, 95% CI: 1.17-2.07), earning two or more monthly minimum wages (IOR = 1.46, 95% CI: 1.09-1.96), living alone (single, widowed or divorced; IOR = 1.36, 95% CI: 1.00-1.85), having more gingival bleeding sites (IOR = 1.01, 95% CI: 1.00-1.02) and wearing partial removable prosthesis (IOR = 2.82, 95% CI: 2.15-3.71) were risk factors for tooth loss. Approximately 48% of the participants lost one or more teeth over the 8-year follow-up period. CONCLUSION: Socio-demographic, economic and clinical variables were associated with the risk for tooth loss. This might be a result of social determinants of health influencing people's access to oral health care, oral health behaviours and oral health status. Public policy aimed at older adults living in rural areas, living alone and using removable dentures may contribute to reducing the risk of tooth loss.

Percepción de calidad de vida por adultos mayores uruguayos: un estudio cualitativo / The Concept of Quality of Life in the Perception of Older Uruguayans: a qualitative study

Resumen El objetivo de este trabajo fue investigar la concepción de calidad de vida en adultos mayores uruguayos, procurando construir un modelo adaptado a ellos. Basado en Teoría Fundamentada, se realizó un estudio cualitativo entre 2017-2018 en varios departamentos de Uruguay. Se realizaron entrevistas semiestructuradas a adultos mayores (edad promedio 71 años, DE 5,4) con muestreo teórico y por bola de nieve. Emergió teoría a través de la categoría madre "vivir lo mejor que se puede", interpretada como la concepción de adultos mayores sobre calidad de vida. Los temas emergentes fueron: "eventos del contexto", "vínculo con otros", "actividades frente a la vida" y "estrategias de adaptación". Al enfrentar eventos estresantes, los participantes desarrollan estrategias de adaptación por medio del soporte social y locus interno de control, para alcanzar calidad de vida y un envejecimiento exitoso. La evidencia empírica desarrollada a partir de esta investigación cualitativa retrata un modelo establecido en un contexto etario y cultural específico, en el que interactúan dimensiones sociales y psicológicas para enfrentar el envejecimiento y alcanzar calidad de vida.

Abstract The research objective was to investigate the conception of quality of life in Uruguayan older adults, trying to build a model adapted to them. Based on Grounded Theory, a qualitative study was carried out between 2017-2018 in several regions of Uruguay. Semi-structured interviews were conducted in older adults (mean age 71 years, SD 5.4) with theoretical and snowball sampling. Theory emerged through the core category "living the best as possible", interpreted as the conception of older adults about quality of life. The emerging themes were: "context events", "link with others", "activities facing life" and "adaptation strategies". When facing stressful events, participants develop coping strategies through social support and internal locus of control, to achieve quality of life and successful aging. The empirical evidence developed from this qualitative research portrays a model established from a specific age and cultural context, in which social and psychological dimensions interact to face aging and achieve quality of life.

Aspectos emocionais, apoio social e funcionalidade bucal de idosos robustos e residentes em instituição de longa permanência / Emotional aspects, social support and oral functionality regarding robust older adults' residents in a long-term institution

Objetivo: analisar as questões envolvendo aspectos emocionais e o acesso à informação, escuta qualificada,componentes do macroconceito de apoio social e suas relações com condições sociodemográficas e de funcionalidadebucal em idosos robustos e independentes moradores de uma instituição de longa permanência.Métodos: estudo descritivo observacional e transversal. Para coleta dos dados, foi aplicado o instrumento Escala de Apoio Social e, para análise dos dados, foi proposto um desfecho composto representando o apoio social recebido e análises bivariadas para observação de associações significantes entre o desfecho e as variáveissociodemográficas e de funcionalidade bucal. Resultados: a prevalência da percepção positiva do apoio foi de 54,4%, e é maior em idosos com idade variando entre 60-79 anos e com menor número de dentes.Conclusão: questões emocionais e de informação aos idosos, concebidas por meio das relações interpessoais dentro de uma instituição de longa permanência, precisam ser acessadas por idosos com dentição funcionale em idades mais avançadas.(AU)

Objective: to analyze issues involving emotional aspects and access to information, components of the macro concept of social support, and their relationship with sociodemographic and oral health conditions regarding older people living in long- -term care facilities. Methodology: research design with a transversa approach. To collect the data, the Social Support Scale instrument was applied, and data analysis was performed to compose the social support received and bivariate analyzes for the observation of significant associations between the outcome and socio demographic and oral health variables. Results: the prevalence of positive perception of the social support was 54.4%, higher in older individuals aged 60-79 years, with a higher number of teeth and a non-white colour. Conclusion: emotional and informational issues for the elderly, conceived through interpersonal relationships within a long-term institution need to be optimized.(AU)

Oral health and Obesity in Brazilian elders: A longitudinal study.

OBJECTIVES: Obesity is an important risk factor for chronic diseases and can also result in greater mortality. The aim of this longitudinal study was to investigate whether poor oral health acts as a risk factor for obesity as indicated by body mass index (BMI) and waist circumference (WC). METHODS: We included in this analysis all participants who volunteered in a cohort study entitled 'Carlos Barbosa Cohort Study-CBCS' in the city of Carlos Barbosa, Southern Brazil. The interview questionnaire comprised socio-demographic information, behavioural questions and medical history. Oral examinations and anthropometric assessments were carried out. The outcome was obesity measured by both BMI (≥30 kg/m2 ) and WC (>0.80 for women and >0.94 for men). Variables were collected longitudinally. Those associated with the outcome and epidemiologically relevant to the conceptual framework participated in the analysis and were adjusted for socio-demographic, behavioural, general and oral health conditions. RESULTS: Six hundred and thirty-three independently living elders participated. The baseline mean age was 67.5 ± 6.1 years. Individuals who never visited a dentist (OR = 3.02, 95% CI: 1.25-7.26) as well as participants who needed a dental prosthesis in the lower arch (OR = 4.38, 95% CI: 1.34-14.32) were more likely to be obese, through BMI and WC measures, respectively. Edentulous participants with complete dentures in both arches (OR = 0.23, 95% CI: 0.06-0.84) and those who perceived their oral health as unsatisfactory (OR = 0.41, 95% CI: 0.19-0.88) had a lower likelihood of being obese, according to BMI and WC measures. CONCLUSIONS: Older persons with poor oral health may be at risk for general and central obesity, a relationship that may have important clinical implications.

Pessoas idosas, covid-19 e saúde bucal: interlocuções, particularidades e reflexões / Elderly, covid-19, and oral health: dialogues, particularities, and reflections

Uma pandemia como a da COVID-19 faz a população mundial repensar várias questões envolvendo cuidado em saúde de pessoas idosas. Neste contexto, a assistência odontológica deve se adequar ao enfrentamento da referida pandemia. O presente artigo reflexivo tem como objetivo apresentar uma narrativa sobre questões envolvendo a atualidade do cuidado em saúde bucal das pessoas idosas frente aos novos desafios trazidos pela pandemia do coronavírus. Neste artigo, especialistas da área trazem algumas perspectivas sobre as intersecções entre os cuidados com a saúde e suas pluralidades frente à pessoa idosa. Desse modo, educação em saúde, saúde mental e cuidado compassivo são compreendidos como desafios a serem enfrentados. A COVID-19 em pessoas idosas institucionalizadas e as ações de cuidadores relacionadas à saúde bucal são necessidades emergentes que necessitam ser discutidas para nortear ações atuais e futuras.(AU)

A pandemic such as that of COVID-19 makes the world population rethink several issues involving health care for the elderly. In this context, dental care must be adapted to face the referred pandemic. The present reflective essay aims to present a narrative on issues involving the current oral health care of the elderly in the face of new challenges brought about by the pandemic of the coronavirus. In this article, specialists in the field bring some perspectives on the intersections between health care and its pluralities vis-à-vis the elderly. In this way, health education, mental health, and compassionate care are understood as challenges to be faced. COVID-19 in institutionalized elderly people and the actions of oral health caregivers are emerging situations that need to be discussed to guide current and future actions.(AU)

Evaluation of the Residency Programs of the Federal University of Rio Grande do Sul from the residents view / Avaliação dos Programas de Residência da Universidade Federal do Rio Grande do Sul na percepção dos residentes

Introduction: The multi-professional residencies in the Health area started to improve after the Law n° 11.129 of 2005. They are a modality of Latu-sensu graduate education, with the purpose of training professionals to work in the National Unified Health System (SUS). Objective: This study aimed to investigate the current situation, from a perspective of satisfaction with the training in Residency courses, with the residents of the Federal University of Rio Grande do Sul. Material and method: It is a study with a mixed-methods approach. The quantitative section was conducted through the application of a questionnaire to all residents participating in the UFRGS Residency Programs in 2018. The qualitative part was conducted using the focus group technique. Result: There were 81 participants in the quantitative component, and 14 residents of the Oral Health program participated in the focus groups. The quantitative results showed that residents received little or no guidance at the beginning of the program. The qualitative results showed questions that allow inferences about residents' dissatisfaction and lack of knowledge about the functioning of the Programs. Conclusion: Residents recognize that there are still issues with program administration to be improved, and more especially, the recognition of the importance of the Residency Programs within the University.

Introdução: As residências multiprofissionais em área profissional da saúde ganharam espaço a partir da Lei n°11.129 de 2005. Constituem-se como uma modalidade de ensino de pós-graduação Latu-sensu, com a intenção de capacitar profissionais para trabalhar no Sistema Único de Saúde (SUS). Objetivo: Este estudo teve por objetivo investigar a atual situação, desde uma perspectiva de satisfação com a formação, com cursos de Residência, dos residentes da Universidade Federal do Rio Grande do Sul. Material e método: Constitui-se de um estudo com abordagem mista. O segmento quantitativo ocorreu através da aplicação de um questionário para todos os residentes participantes do Programa de Residência da UFRGS no ano de 2018. O estudo de abordagem qualitativa foi realizado através da técnica de grupos focais. Resultado: Totalizaram 81 participantes na abordagem quantitativa e nos grupos focais participaram 14 residentes, pertencentes ao programa de Saúde Bucal. Os resultados quantitativos representam que os residentes receberam pouca ou nenhuma orientação no início do programa. Os resultados qualitativos apresentam questões que permitem fazer inferências acerca da insatisfação e desconhecimento dos residentes acerca do funcionamento dos Programas. Conclusão: Destaca-se que os residentes reconhecem que há ainda questões de gestão do programa a serem aprimoradas, bem como de reconhecimento da sua importância dentro da Universidade.

Beliefs about managing dental problems among older people and dental professionals in Southern Brazil.

OBJECTIVES: To explore the sociocultural context in which patients and dentists in urban and rural communities in Southern Brazil interpret dental problems. METHOD: Beliefs and experiences related to dental problems were explored in eight focus groups involving a total of 41 older patients, and in direct interviews with two dentists and two dental assistants. The interactions were audio recorded and transcribed for thematic analysis. RESULTS: The beliefs and experiences of the participants focused on four main themes: cultural beliefs; dental services; decisions to extract teeth; and expectations for change. A culture of pre-nuptial tooth loss and complete dentures was considered beneficial to young women. Although dental services at the time were scarce in the region, demands for relief of pain were extensive despite the fear and anxiety of the participants. Extraction of teeth and fabrication of complete dentures were the usual dental treatments available, although some participants felt that dentists withheld other treatment options. Participants were hopeful that dental services would improve for their children. CONCLUSIONS: Patients and dental professionals in urban and rural communities of Southern Brazil managed dental problems within a culture of limited access and availability of services that favoured dental extractions and complete dentures.

Four-year incidence rate and predictors of root caries among community-dwelling south Brazilian older adults.

OBJECTIVE: This study aimed to assess the incidence density (ID) of new root caries lesions and restorations among community-living south Brazilian older adults and to assess its association with predictor variables. METHODS: We conducted a prospective cohort with a random sample of elders from the municipality of Carlos Barbosa, in south Brazil. Trained dentists performed interviews and oral examinations in 388 individuals at baseline, of which 273 were retained at follow-up 4 years later. Our outcome was root caries ID, with 100 root-years as its unit of measure. Demographic, biological and lifestyle predictors were tested with Poisson regression. RESULTS: The mean number of roots at baseline among participants was 7.0 (SD ± 4.9) and the incidence rate per 100 root-year 4.9 (SD ± 8.9). Incidence of root caries among these older Brazilians was of 47.3%. The associated factors with the incidence of root caries were age, geographic location of residence, frequency of tooth brushing and stimulated saliva flow rate. CONCLUSION: Age, external environment, personal practices and oral status were predictors of the incidence of root caries. Preventive strategies including the use of fluorides and instruction to improve the attitude and behaviour towards oral hygiene are needed.

Incidence and predictors of edentulism among south Brazilian older adults.

OBJECTIVE: To identify socioeconomic, demographic, behavioural and clinical predictors of the 8-year incidence of edentulism in south Brazilian older adults. METHODS: Cohort of a representative sample of older persons in Carlos Barbosa, a south Brazil city. A cohort study was conducted using a simple random sample of 392 older people evaluated in 2004, with follow-ups in 2008 and 2012, when 199 participants were evaluated. Interviews and oral examinations were conducted. The baseline assessment was carried out in 2004, with follow-ups in 2008 and 2012. To evaluate the predictors of edentulism, Poisson regression models with robust variance were carried out. The outcome was modelled through the use of a hierarchical approach based on the conceptual framework proposed by Andersen and Davidson. RESULTS: Some 11.5% of the participants had become edentulous after 8 years. Higher income, use of partial removable dentures and low salivary flow were associated with the incidence of edentulism. CONCLUSIONS: Maintaining a good salivary function may be essential for the prevention of the incidence of edentulism in this age group. Furthermore, our findings suggest that rehabilitations with partial removable dentures may be detrimental to long-term oral health.

Four-year incidence and predictors of coronal caries in south Brazilian elderly.

OBJECTIVES: To determine the incidence and predictors of coronal caries among community-dwelling elderly in a southern Brazilian city. METHODS: A cohort study was conducted using a simple random sample of persons aged 60 years or older in Carlos Barbosa city, southern Brazil. Interviews and oral examinations were conducted among 388 dentate individuals at baseline and among 273 at 4-year follow-up. The incidence of coronal caries was modeled by means of negative binomial regression. RESULTS: Some 184 (76.7%) participants presented with new coronal caries lesions or restorations, whose mean number was 2.2 ± 2.1, whereas the 4-year mean coronal caries incidence rate was 0.28 ± 0.29. In the multivariate model that controlled for baseline predictors, older age, male gender, living in a rural area, current smoking, and negative self-perception of oral health were associated with coronal caries incidence. Among clinical variables, the use of partial dentures was a predictor, whereas higher saliva flow rate was a protective factor for the outcome. CONCLUSIONS: Demographic factors, primary determinants of health, behavioral, and clinical variables were predictors of the incidence of coronal caries. As people enter old age, even stronger emphasis should be put on preventive strategies.

The prevalence of elder abuse in the Porto Alegre metropolitan area.

Abuse of the elderly is a form of violence to come to the public's attention. Dental professionals are in an ideal position to identify physical abuse. The aim of this study was to assess the prevalence of elderly abuse and analyze the database of injury reports that can be identified by dental teams. A documentary analysis study developed by the Elderly Protection Police Station of Porto Alegre, Rio Grande do Sul, was carried out. The information used came from 2,304 complaints filed at the aforementioned institution between the years of 2004 and 2006. The records of abuse are categorized as injury, neglect, mistreatment, theft, financial abuse, threat, disturbing the peace, atypical fact, and others. The injuries that could be identified by the dental team were classified according to the injury's location in the area of the head, face, mouth and neck. Descriptive analysis was performed, and chi-square tests were used to evaluate the distributions of the types of elder abuse in relation to sex and age. The most frequent of the different types of abuse was theft, with a prevalence of 17.8%, followed by disturbing the peace at 11.8%. Disturbing the peace, threat, and bodily injury were significantly associated with women. Elder abuse among women and men declines with age. The prevalence of head injury was 25% of the total injuries, most often in females, and in those aged < 70 years. Based on these results, it is necessary that the dental team observe the elderly person's appearance for suspicious physical signs.

Assessing changes in oral health-related quality of life and its factors in community-dwelling older Brazilians.

OBJECTIVE: To describe changes in oral health-related quality of life and to evaluate the associations of these changes in community-dwelling older people. MATERIALS AND METHODS: In this longitudinal study a representative sample of 872 older people, living in Brazil, was evaluated during 2004. The follow-up was carried out during 2008, with 587 older persons evaluated. A questionnaire assessing socio-demographic information, health history, oral health-impact profile and number of natural teeth was used. Changes in oral health-related quality of life were categorized as improvement or deterioration. Data analysis was performed using a hierarchical approach based in a conceptual framework. A hierarchal approach was carried out using Poisson regressions. RESULTS: Older persons living in rural areas, those who reported brushing once a day or less and older persons with fewer natural teeth had an increased chance of reporting deterioration in oral health-related quality of life. Women and participants who received a minimum wage of less than US $219.50 were more likely to report improvement in oral health-related quality of life. CONCLUSION: The results of this study suggest that changes in the oral health-related quality of life are influenced by many of the variables that were included in the conceptual framework.

Odontologia e os ciclos de vida: aspectos relevantes da saúde bucal do idoso / Dentistry and life cycles: relevant aspects of geriatric oral health

É incontestável o aumento da expectativa de vida, com alterações do perfil epidemiológico das doenças bucais. No Brasil, em épocas passadas, a maioria dos idosos era totalmente edêntula. Estudos epidemiológicos demostram que, cada vez mais, os idosos apresentam dentes funcionais. A presença de dentes nos idosos gera um desafio à profissão: entender, nos planos biológico e social, como dar a atenção mais adequada a esse grupo populacional crescente. Nesse sentido, destaca-se o entendimento de que as possibilidades reabilitadoras modificam-se, tendo-se de levar em conta aspectos sociais e biológicos, incluindo-se crenças, atitudes, hábitos, necessidade sentida, além de aspectos nutricionais e outros relacionados ao envelhecimento. A atenção bucal ao idoso, assim, precisa ser priorizada, com foco nas peculiaridades desse ciclo de vida

Undoubtfully, life expectancy has increased with changes in the epidemiological profile of oral diseases. In Brazil, in past times, the majority of old individuals was totally edentulous. Epidemiological studies demonstrate that elderly people are increasingly presenting more functional teeth. The presence of teeth in old individuals is a challenge for the profession, ie, to understand the biological and social aspects involved in providing the most adequate attention to this increasing population. In this sense, it is important to keep in mind that rehabilitation possibilities change, in order to comprehend biological and social aspects, including beliefs, attitudes, habits, perceived need, in addition to nutritional and other aging-related aspects. Oral health attention to the elderly, thus, needs to be prioritized, focusing in the peculiarities of this life cycle

Four-year incidence and predictors of tooth loss among older adults in a southern Brazilian city.

BACKGROUND: Tooth loss is still prevalent among older adults and may negatively affect their health and well-being. Previous evidence has shown that oral disease-related factors are the more consistent predictors of tooth loss. Although certain models have considered oral health behaviour as a key construct in explaining oral health inequalities, others have favoured the role of social structure and the social environment in determining oral health outcomes. OBJECTIVE: To determine the tooth loss incidence and its predictors among community-living older adults in a southern Brazilian city. METHODS: A cohort study was conducted using a simple random sample of 388 older people evaluated in 2004. The follow-up was carried out during 2008, with 273 older persons examined. Interviews and oral examinations were conducted. The incidence of tooth loss was modelled through a conceptual framework with the use of negative binomial regression. RESULTS: Some 67.8% of people lost one or more teeth, whereas 12.5% became edentulous during the follow-up period. In the multivariate model that controlled for baseline predictors, older age; male gender; living in a rural area; being married; less schooling; current smoking; and dissatisfaction with the access to health services were associated with tooth loss. Among the clinical variables, the use of partial dentures and gingival bleeding index were predictors, whereas higher saliva flow rate was a protective factor for the outcome. DISCUSSION: As proposed in the conceptual framework, demographic factors; primary determinants of health; behavioural; and clinical variables were predictors of tooth loss. These results are important, because understanding the causal association between lifestyle practices such as oral hygiene or smoking with tooth loss does not elucidate why individuals and communities engage in such practices. CONCLUSION: Interventions aiming to reduce tooth loss and edentulism in the elderly should account for social and environmental factors, in combination with clinical and behavioural components.

Association between number of teeth, edentulism and use of dentures with percentage body fat in south Brazilian community-dwelling older people.

OBJECTIVE: To evaluate if poor oral status was associated with percentage body fat in a representative sample of south Brazilian community-dwelling elderly. BACKGROUND: Evidence suggests that elders with extensive tooth loss and edentulism present with compromised chewing function, which results in dietary changes. However, few studies have assessed whether poor oral status is associated with percentage body fat in community-dwelling elderly. MATERIALS AND METHODS: A random sample of 471 south Brazilians =>60 years of age was evaluated. Measurements included a questionnaire to assess socio-demographic, behavioural, general, and oral health data. Percentage body fat was measured with a Tanita TBF 612 digital scale, which measures foot-to-foot bioelectrical impedance; and oral status assessment, by means of oral examinations assessing the number of teeth and use of dental prostheses. Correlates of risk of inadequate percentage body fat were assessed by means of multinomial logistic regression. RESULTS: Edentulous participants were more likely to be underfat [OR: 3.11 (1.27-7.61)] or overfat/obese [OR: 1.82 (1.05-3.16)]. CONCLUSION: The present study shows that edentulous older people had higher odds for inadequate percentage body fat. The maintenance of teeth had a crucial role in increasing the chance of having an adequate body fat percentage in the study population.

Resilience and self-perceived oral health: a hierarchical approach.

OBJECTIVES: To determine whether positive self-perceived oral health is associated with sociodemographic health variables, with an emphasis on resilience, in community-dwelling older adults in southern Brazil. DESIGN: Cross-sectional study nested within a cohort study. SETTING: Carlos Barbosa in southern Brazil. PARTICIPANTS: Four hundred ninety-six community-dwelling adults aged 64 and older. MEASUREMENTS: Sociodemographic information, a health history, and health perceptions were assessed using a structured questionnaire. Resilience was assessed using a resilience scale. For each participant, a brief oral examination was performed to assess number of teeth. Positive self-perceived oral health was the outcome of interest. RESULTS: A final, fully adjusted Poisson regression model showed that high resilience potential (prevalence ratio (PR)=1.18, 95% confidence interval (CI)=1.06-1.32), income (PR=1.18, 95% CI=1.07-1.30), and no reported change in diet because of dental problems (PR=1.34, 95% CI=1.13-1.60) were associated with positive self-perceived oral health. Participants living in rural areas were less likely to report positive self-perceived oral health (PR=0.83, 95% CI=0.75-0.93). CONCLUSION: Using a hierarchical approach, positive self-perceived oral health was found to be associated with several variables included in the conceptual framework of oral health outcomes, such as resilience. Resilience may act as a potentiating agent in the positive adaptation to tooth loss.

Association between oral health status and nutritional status in south Brazilian independent-living older people.

OBJECTIVE: Evidence suggests that older people with partial tooth loss and edentulism change their diet and lack specific nutrients, but few studies have assessed whether poor oral status is associated with risk of malnutrition and malnutrition in independent-living older people. We evaluated if poor oral status was associated with risk of malnutrition and malnutrition in this population. METHODS: A random sample of 471 south Brazilians > or =60 y of age was evaluated. Measurements included a questionnaire to assess sociodemographic, behavioral, general, and oral health data; nutritional status assessment, according to the Mini-Nutritional Assessment (MNA); and oral status assessment, by means of oral examinations assessing the number of teeth and use of dental prostheses. Correlates of risk of malnutrition/malnutrition according to the MNA were assessed by means of multivariate logistic regression. RESULTS: Participants who reported dissatisfaction with their gingival health and edentulous persons wearing only one denture were more likely to be at risk of malnutrition, according to the screening MNA. Dissatisfaction with gingival health was a risk indicator, whereas having one to eight natural teeth was protective against the risk of malnutrition/malnutrition according to the full MNA. CONCLUSION: In the present study, older people with a compromised oral status had higher odds for risk of malnutrition. The maintenance of a few teeth had a crucial role in increasing the chance of maintaining an adequate nutritional status in the studied population. In cases where edentulism was present, complete dental prosthetic use was associated with better nutritional status.

Oral health behaviour and socio-demographic profile of subjects with Alzheimer's disease as reported by their family caregivers.

OBJECTIVE: To evaluate the oral health care provided to subjects with Alzheimer's disease (AD) as reported by their family caregivers. METHOD: Structured interviews were performed with 56 Alzheimer caregivers from the Group of relatives and friends of subjects with AD of the Hospital de Clínicas de Porto Alegre. Spearman and Pearson correlations were performed. RESULTS: The mean age of the subjects with AD was 76.09 (+/-7.76) years, 53.6% were female and 58.9% were in the advanced stage of AD. The mean number of teeth present was 11.66 (+/-10.94), and oral hygiene was performed 2.21 (+/-1.04) times/day. The provision of oral health care to subjects with AD was carried out by caregivers in 85.7%. Oral hygiene was provided by the caregivers to the subjects with AD with the aid of a toothbrush and/or gauze embedded with non-fluoridated mouthwash in the majority of the cases. Complete dental prostheses were cleaned with the aid of mouthwashes instead of denture brushes by 44% of the subjects/caregivers. There was a significant association between the number of teeth in the subjects with AD and the number of oral hygiene procedures performed per day and current smoking. CONCLUSION: Oral health care planning for subjects with AD should take into account caregivers' perceptions and knowledge about oral health and hygiene as caregivers represent the primary providers to these patients when the disease progresses from early to more advanced stages.