Impact of xerostomia and the use of dental prosthesis on the quality of life of elderly: a cross-sectional study

Aim: To evaluate the impact of xerostomia, edentulism, use of dental prosthesis, and presence of chronic diseases on quality of life in relation to oral health in institutionalized elderly individuals. Methods: This is a cross-sectional study. A questionnaire was administered containing the following instruments: Oral Health Impact Profile (OHIP-14), which measures the quality of life related to oral health; the Summated Xerostomia Inventory questionnaire (SXI-PL) for evaluation of xerostomia, sociodemographic data, clinical description, and patient-reported factors was assessed (edentulism, use of dental prostheses, and chronic diseases). Results: Most elderly individuals did not have any teeth in their mouths and used dental prosthesis. The impact on quality of life, considering the mean of the OHIP-14 scores, was positive in 58.3% of the elderly. Those who used a dental prosthesis were three times more likely to have their oral health negatively impacted (OR=3.09; 95%CI =1.17 8.11), compared to those who did not use, and individuals with xerostomia were more likely to have their oral health negatively impacted (OR=1.57; 95%CI=1.25-1.98) compared to those without xerostomia. There was no difference in the quality of life of individuals with and without chronic diseases. Conclusions: The feeling of dry mouth and use of dental prostheses negatively impacted the quality of life in relation to oral health of the elderly

Relationship of Anxiety and Depression with Perfectionism in Patients with Aesthetic All-Ceramic Repair of Anterior Teeth.

BACKGROUND Many psychological problems arising from patients undergoing aesthetic repair of teeth should be considered. However, there are no published studies on the relationship between anxiety/depression and perfectionism in patients with aesthetic repair of anterior teeth. MATERIAL AND METHODS A total of 640 patients receiving aesthetic repair of anterior teeth were assessed using the Corah dental anxiety scale (CDAS), a self-rating anxiety scale (SAS), a self-rating depression scale (SDS), and the Chinese version of the Frost Multidimensional Perfectionism Psychological Scale (CFMPS). Statistical analyses included use of the independent-samples t test, correlation analysis, and multiple stepwise regression analysis. RESULTS We found that 156 patients with a high dental anxiety disorder had significantly greater SAS and SDS scores than those without a high dental anxiety disorder. There were significant differences between these patients and the non-high dental anxiety group, based on 3 dimensions of the CFMPS: concern over mistakes (CM), doubt about action (DA), and organization (OR). Patients with dental anxiety had a significant positive correlation with SAS in the categories CM and DA, with SDS in the categories CM and DA, and with personal standard (PS); OR was negatively correlated with SAS and SDS scores. Regression analysis showed that the CM and OR dimension scores of CFMPS and age had strong predictive effects on SAS scores, while CM, DA, PS dimension scores, and age were strong predictors of SDS scores. CONCLUSIONS The incidence of dental anxiety prior to anterior tooth repair treatment is high, and patients with dental anxiety have a significant tendency toward pursuing perfectionism.

Principales factores biopsíquicos relacionados con la rehabilitación protésica dental en ancianos institucionalizados / Main biopsychic factors related to the dental prosthetics rehabilitation in institutionalized elderly

Introducción: El envejecimiento constituye la transformación demográfica más importante del mundo actual. La mayor proporción de personas de edad avanzada en la comunidad supone un reto de extraordinaria trascendencia en cuanto a la satisfacción de sus demandas sociales, sanitarias, económicas y culturales. Objetivo: Determinar los factores biopsíquicos relacionados con la rehabilitación protésica dental en ancianos. Métodos: Se realizó un estudio descriptivo y transversal de 60 ancianos pertenecientes a la Casa de Abuelos "Corazones contentos" del reparto Sueño -categorizados en adaptados y resistentes según factores psicológicos-, quienes acudieron al Departamento de Prótesis de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, desde marzo del 2018 hasta enero de 2020. Resultados: En la serie primaron los pacientes de 80 y más años de edad y del sexo femenino. Como característica biológica relevante figuró el desdentamiento total y como enfermedad crónica no trasmisible fue más frecuente la diabetes mellitus. De igual modo, el mayor número de ancianos correspondió a la categoría psicológica de resistente. Conclusiones: La mayoría de los ancianos se caracterizaron por un perfil psicológico resistente, determinado por un estilo de afrontamiento pasivo, expresión emocional negativa e inexistencia de autonomía, lo que condicionaba una actitud dañina hacia su salud bucal.

Introduction: Aging constitutes the most important demographic transformation nowadays. The higher proportion of elderly in the community supposes a challenge of extraordinary transcendence as for the satisfaction of their social, sanitary, economic and cultural demands. Objective: To determine the biopsychic factors related to the dental prosthetics rehabilitation in elderly. Methods: A descriptive and cross-sectional study of 60 elderly was carried out in "Corazones contentos" Home for the elderly at Sueño neighborhood -categorized in adapted and resistant according to psychological factors- who went to the Prosthesis Department of Mártires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba, from March, 2018 to January, 2020. Results: In the series there was prevalence of 80 years and over patients from the female sex. As outstanding biological characteristic there is the total dental loss and as chronic non transmissible disease the diabetes mellitus was more frequent. In a same way, the higher number of elderly corresponded to the psychological category of resistant. Conclusions: Most of the elderly are characterized by a resistant psychological profile, determined by a style of passive confrontation, negative emotional expression and lack of autonomy, what conditioned a harmful attitude toward their oral health.

Satisfaction Level among Patients Treated with Fixed Dental Prosthesis in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: Dental treatment aims at correction of existing disease; prevention of future disease with rehabilitation of patient's lost functional capacity and aesthetics. Fixed dental prosthesis is any prosthesis that is cemented to a natural tooth or dental implants abutments that cannot be removed by patient. The success of prosthodontic treatment is related to prosthesis survival, with its ability to fulfil biologic and patient-evaluated objectives with patient satisfaction. This study is aimed to find the patient satisfaction with fixed prosthodontic treatment. METHODS: This descriptive cross-sectional study was done in a tertiary care hospital among 102 patients rehabilitated with fixed dental prosthesis from August to September 2019 after taking ethical approval from Institutional Review Committee of Kathmandu Medical College. (IRC No. 1207201918). Convenience sampling was done. The questionnaire assessed patient's satisfaction of fixed prosthesis on the basis of appearance, chewing ability, cleansibility, speech and awareness of oral hygiene measures for cleaning of the prosthesis. Data entry was done in Microsoft excel and analysed using Statistical Package for Social Sciences (SPSS)version 20.0, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: The majority of the patients 87 (85.3%) were satisfied with their fixed prosthesis, at 95% confidence interval (93.5- 81%). Eighty one (79.4%) were satisfied with their chewing ability; 99 (97.1%) satisfied with their speech, 78 (76.4%) satisfied with appearance of fixed prosthesis. Ninety eight patients (96.1%) were aware of oral hygiene measures, out of which only 66 (67.3%) used interdental aids for cleaning of their fixed prosthesis. CONCLUSIONS: Several factors (chewing ability, appearance, speech, cleansibility of fixed prosthesis) had positive impact on overall satisfaction in majority of the patients. Dentists should continue to emphasise on the significance of maintaining good oral hygiene and use of interdental aids for the longevity of fixed prosthesis.

Sense of coherence and impact of oral health on quality of life in adults and elderly in Southern Brazil.

This cross-sectional study aimed to investigate the association between the Sense of Coherence and impact of oral health on the quality of life. Was conducted with a sample of 720 individuals of both sexes, between the ages of 50 and 74 years, selected through multistage proportional random sampling. The data collection instruments used were: short version of the Sense of Coherence Scale (SOC-13), Oral Impacts on Daily Performances (OIDP) questionnaire, oral clinical examination and questionnaire containing socio demographic and use of dental services information. Bivariate and multivariate analyses were performed through Poisson regression adjusted for robust variance, with level of significance p < 0.05. Oral impacts were reported by 416 participants (57.8%). In the adjusted model, those with strong SOC were more likely of not having any impact when compared with individuals with weak SOC (PR=1.30). Need for dental prosthesis was also associated with the outcome, individuals who did not require prosthesis had less impact (PR=1.50). The findings showed that SOC is associated with OIDP, supporting the hypothesis that individuals with strong SOC present a lower impact of oral health on the quality of life, suggesting that SOC is a determinant that can provide protection against that impact.

Sense of coherence and impact of oral health on quality of life in adults and elderly in Southern Brazil / Senso de coerência e impacto da saúde bucal na qualidade de vida em adultos e idosos do sul do Brasil

Abstract This cross-sectional study aimed to investigate the association between the Sense of Coherence and impact of oral health on the quality of life. Was conducted with a sample of 720 individuals of both sexes, between the ages of 50 and 74 years, selected through multistage proportional random sampling. The data collection instruments used were: short version of the Sense of Coherence Scale (SOC-13), Oral Impacts on Daily Performances (OIDP) questionnaire, oral clinical examination and questionnaire containing socio demographic and use of dental services information. Bivariate and multivariate analyses were performed through Poisson regression adjusted for robust variance, with level of significance p < 0.05. Oral impacts were reported by 416 participants (57.8%). In the adjusted model, those with strong SOC were more likely of not having any impact when compared with individuals with weak SOC (PR=1.30). Need for dental prosthesis was also associated with the outcome, individuals who did not require prosthesis had less impact (PR=1.50). The findings showed that SOC is associated with OIDP, supporting the hypothesis that individuals with strong SOC present a lower impact of oral health on the quality of life, suggesting that SOC is a determinant that can provide protection against that impact.

Resumo Este estudo transversal objetivou investigar a associação entre Senso de Coerência (SOC) e o impacto da saúde bucal na qualidade de vida. Foi realizado com uma amostra de 720 indivíduos de ambos os sexos, com idade entre 50 e 74 anos, selecionados por amostragem aleatória proporcional em múltiplos estágios. Os instrumentos de coleta de dados foram: versão curta da Sense of Coherence Scale, questionário Oral Impact on Daily Performance (OIDP), exame clínico bucal e questionário sociodemográfico e de uso de serviços odontológicos. As análises bivariadas e multivariadas foram realizadas por regressão de Poisson ajustada para variância robusta, com nível de significância p < 0,05. O impacto da saúde bucal foi relatado por 416 participantes (57,8%). No modelo ajustado, aqueles com SOC forte foram mais propensos a não ter nenhum impacto, comparados aos indivíduos com SOC fraco (PR=1,30). A necessidade de prótese dentária também foi associada ao desfecho e os indivíduos que não necessitavam prótese tiveram menor impacto (PR=1,50). Os resultados mostraram que o SOC está associado ao OIDP, apoiando a hipótese de que os indivíduos com SOC forte apresentam menor impacto da saúde bucal na qualidade de vida, sugerindo que o SOC é um determinante que pode proporcionar proteção contra esse impacto.

Impact of Seniors Centers on oral health-related quality of life of older adults.

OBJECTIVE: This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC). METHODS: Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics-Sense of Coherence (SOC), anxiety and depression using HADS, happiness-, and oral clinical evaluation-use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05). RESULTS: In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0-4.2) for older adults who did not participate in SC. CONCLUSION: Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.

Quality of life related to tooth loss and prosthetic replacements among persons with dependency and functional limitations.

Objectives: To examine if tooth loss or treatment with different prosthetic replacements are associated with oral health-related or health-related quality of life (OHRQoL or HRQoL) among persons with dependency and functional limitations.Material and Methods: Comparisons between results of questionnaires and clinical data (number of teeth, Eichner index, presence, type, and condition of prosthetic replacements) from a population of 180 individuals with dependency and functional limitations sampled from the register of increased financial support in Norrbotten County, Sweden.Results: The associations between clinical variables and the questionnaire responses were weak overall, e.g. Spearman's rho was 0.162 (p = .033) for correlation between number of teeth and GOHAI, 0.094 (p = .249) for number of teeth and OHIP, -0.070 (p = .356) for complete dentures and GOHAI, and -0.108 (p = .185) for complete dentures and OHIP.Conclusions: The weak associations between clinical variables and questionnaire results in the present study suggest that good results on measured QoL do not necessarily indicate good oral health. As we cannot expect this specific population to report oral disorders by themselves, regular check-ups are necessary.

Impact of seniors centers on oral health-related quality of life of older adults

ABSTRACT OBJECTIVE This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC). METHODS Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics—Sense of Coherence (SOC), anxiety and depression using HADS, happiness—, and oral clinical evaluation—use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05). RESULTS In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0-4.2) for older adults who did not participate in SC. CONCLUSION Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.

Impact on the Quality of Life of Older Adults Who Use Inadequate Dental Prostheses: A Cross-Sectional Study

Abstract Objective: To investigate the impact of inadequate prostheses on older adult's quality of life at the Integrated Health Center for Older Adults in the northeastern city of Brazil. Material and Methods: A cross-sectional study involving 147 older adults aged 60-90 years old in João Pessoa, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and gender) and clinical dental measures (use of inadequate upper and/or lower dental prosthesis) and Oral Health Impact Profile (OHIP-14 Questionnaire). The Pearson Chi-square and Fisher's exact tests were used to evaluate the association between the OHIP-14 dimensions and the use of unsatisfactory prostheses (p<0.05). Results: The sample consisted of 90.5% of women being a mean age of 69.86 (± 6.60) years. Individuals with inadequate prostheses had a higher impact on quality of life, with a predominant prevalence ratio for developing physical pain (PRR = 3.52; CI = 4.69-2.65), psychological discomfort (PRR = 5.0; CI = 5.85-4.26) and psychological inability (PRR = 1.71; CI = 2.56-1.14). Conclusion: The use of inadequate prostheses had a negative impact on the quality of life of the older adult population. Therefore, services, which provide health care for older adults, should overcome this reality by providing broad access to oral rehabilitation that is appropriate to the needs of each individual.

Autoperception of food conditions of elderly dental prosthetic users. / Autopercepção das condições alimentares de idosos usuários de prótese dentária.

PURPOSE: To evaluate the self-perception of the food conditions of elderly users of dental prosthesis, in order to verify the interference that dental prosthesis has in their feeding. METHODS: The present study counted with 60 elderly, participants of the Centro de Convivência Nair Ventorin Gurgacz (Community Center), aged between 60 and 88 years old. All participants answered to a questionnaire elaborated by the researchers and the Geriatric Oral Health Assessment Index (GOHAI). RESULTS: The elderly who participated in this study, mostly women, used a bimaxillary removable prosthesis for over 30 years; although they classified their nutrition as "good" and did not present preference for specific food consistency, they frequently felt pain while chewing. The average score of the GOHAI was 29.73, considered "low", the index dimension with worst score was physical function, that includes eating, speaking and swallowing. No relation was observed between time of use of dental prosthesis, age and the GOHAI scores. CONCLUSION: The elderly rarely complaint about discomfort or embarrassment on feeding, however, they present an average lower than expected in the GOHAI index, which indicates that, although they do not report it, many deteriorations, that seem to be natural may be happening and may be the cause of worst quality of life.

OBJETIVO: Avaliar a autopercepção das condições alimentares de idosos usuários de prótese dentária, verificando sua interferência na alimentação. MÉTODO: Participaram 60 idosos com idade entre 60 e 88 anos, usuários de prótese dentária total ou parcial, que frequentam assiduamente o Centro de Convivência Nair Ventorin Gurgacz ­ FAG em Cascavel, Paraná. Todos os indivíduos responderam a um questionário de identificação e ao protocolo Índice de Determinação da Saúde Bucal Geriátrica (GOHAI). RESULTADOS: Os idosos do estudo, maioria mulheres e usuários de prótese removível bimaxilar com mais de 30 anos, classificam sua alimentação como "boa" e não possuem preferência por consistência alimentar, embora frequentemente sintam dor ao mastigar os alimentos. A média pontuada no protocolo GOHAI foi classificada como "ruim" e o maior prejuízo dos idosos ocorreu no domínio físico, que engloba questões relacionadas à mastigação, deglutição e fala. Não foram constatadas relações entre o tempo de utilização da prótese dentária com a idade e os escores do GOHAI. CONCLUSÃO: Embora os idosos raramente tenham queixa sobre o modo de se alimentar, referindo desconforto ou constrangimento, apresentam uma média abaixo do esperado no protocolo, indicando que, ainda que não relatem, muitas modificações podem estar acontecendo, gradativamente, e que soam como naturais, gerando prejuízos à qualidade de vida em alimentação do idoso.

Is reduced dentition with and without dental prosthesis associate with oral health-related quality of life? A cross-sectional study.

BACKGROUND: Oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional judgment about restorative treatments and prosthetic replacement in patients who had reduced dentitions. The aim was to compare the OHRQoL among adults (35-44 years) categorized according to different definitions of reduced dentition and considering the use (or non-use) of dental prosthesis. METHODS: This study used data from a probabilistic sample of adults in Sao Paulo, Brazil, 2015. OHRQoL was based on none items of Oral Impacts on Daily Performance (OIDP) index, as prevalence (at least one impact) and extent (the number of items with non-zero score). We used different criteria to assess dentition status: (1) Shortened Dental Arch (SDA): having 3-5 natural occlusal units (OUs) in posterior teeth and intact anterior region; (2) hierarchical functional classification system: a five-level stepwise classification of dentition; and (3) presence of ≥21 teeth. The use or nonuse of dental prosthesis was recorded. Negative binomial regression models involved the adjustment for social determinants of health. RESULTS: Nearly half (53.1%) of the 5753 participating adults had at least one oral health issue impacting OHRQoL. OIDP prevalence in adults with SDA did not differ from those with more OUs (PR = 1.02; 95%CI 0.91-1.13). Individuals with non-functional dentition had worse OHRQoL regardless of their use of a dental prosthesis. Adults with fewer than 21 remaining teeth, ranked significantly higher in OIDP extent, regardless of dental prosthesis use (PR = 1.38; 95%CI 1.16-1.63 with prosthesis; PR = 1.62; 95%CI 1.19-2.20 without dental prosthesis). CONCLUSIONS: Individuals with more missing teeth reported worse OHRQoL regardless of using a dental prosthesis. Preserving a functional dentition, even with missing teeth, is compatible with OHRQoL.

Prosthetic dental restorations in Swedish samples: prevalence and agreement between self-report, clinical findings, and influence on quality of life.

OBJECTIVE: To determine the prevalence of dental prosthetic restorations in an adult population, to study the agreement between self-reports and clinical findings of prosthetic restorations, and to study answers from a questionnaire in relation to the prevalence of prosthetic restorations. MATERIAL AND METHODS: A questionnaire was sent to a sample of 10,000 adults. A further sample of 1000 individuals was invited to answer the questionnaire and also participate in a clinical study. The agreement between self-report and clinical findings was analyzed, as were the associations between prosthetic restorations and questionnaire responses, using the chi2 test. RESULTS: A total of 40% of the sample had fixed dental prostheses (FDP), 2.7% had removable dentures. The agreement between self-report and clinical findings was 93%. 34.7% of the individuals with no prosthetic restorations were university graduates and 4% of individuals with removable complete dentures. Oral health had the greatest impact on the quality of life of younger individuals with FDP, with an OHIP-14 (Oral Health Impact Profile) score of 7.3 for the age group 20-39 years compared to 4.9 for the age group 65-89 years. CONCLUSION: The questionnaire method can be a cost-effective way to determine the prevalence of prosthetic restorations.

Autopercepção das condições alimentares de idosos usuários de prótese dentária / Autoperception of food conditions of elderly dental prosthetic users

RESUMO Objetivo Avaliar a autopercepção das condições alimentares de idosos usuários de prótese dentária, verificando sua interferência na alimentação. Método Participaram 60 idosos com idade entre 60 e 88 anos, usuários de prótese dentária total ou parcial, que frequentam assiduamente o Centro de Convivência Nair Ventorin Gurgacz - FAG em Cascavel, Paraná. Todos os indivíduos responderam a um questionário de identificação e ao protocolo Índice de Determinação da Saúde Bucal Geriátrica (GOHAI). Resultados Os idosos do estudo, maioria mulheres e usuários de prótese removível bimaxilar com mais de 30 anos, classificam sua alimentação como "boa" e não possuem preferência por consistência alimentar, embora frequentemente sintam dor ao mastigar os alimentos. A média pontuada no protocolo GOHAI foi classificada como "ruim" e o maior prejuízo dos idosos ocorreu no domínio físico, que engloba questões relacionadas à mastigação, deglutição e fala. Não foram constatadas relações entre o tempo de utilização da prótese dentária com a idade e os escores do GOHAI. Conclusão Embora os idosos raramente tenham queixa sobre o modo de se alimentar, referindo desconforto ou constrangimento, apresentam uma média abaixo do esperado no protocolo, indicando que, ainda que não relatem, muitas modificações podem estar acontecendo, gradativamente, e que soam como naturais, gerando prejuízos à qualidade de vida em alimentação do idoso.

ABSTRACT Purpose To evaluate the self-perception of the food conditions of elderly users of dental prosthesis, in order to verify the interference that dental prosthesis has in their feeding. Methods The present study counted with 60 elderly, participants of the Centro de Convivência Nair Ventorin Gurgacz (Community Center), aged between 60 and 88 years old. All participants answered to a questionnaire elaborated by the researchers and the Geriatric Oral Health Assessment Index (GOHAI). Results The elderly who participated in this study, mostly women, used a bimaxillary removable prosthesis for over 30 years; although they classified their nutrition as "good" and did not present preference for specific food consistency, they frequently felt pain while chewing. The average score of the GOHAI was 29.73, considered "low", the index dimension with worst score was physical function, that includes eating, speaking and swallowing. No relation was observed between time of use of dental prosthesis, age and the GOHAI scores. Conclusion The elderly rarely complaint about discomfort or embarrassment on feeding, however, they present an average lower than expected in the GOHAI index, which indicates that, although they do not report it, many deteriorations, that seem to be natural may be happening and may be the cause of worst quality of life.

[Factors behind self-perceived need for dental treatment and prosthesis in Brazilian elderly people]. / Fatores associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros.

The scope of this study was to identify individual and contextual factors associated with the self-perceived need for dental treatment and for prostheses among elderly Brazilians. An analysis was performed with data from the SB Brazil 2010 epidemiological survey conducted by the Ministry of Health with a sample of 7,619 elderly individuals. Multilevel logistic regression models of mixed random and fixed effects were used to the estimate odds ratio (OR) with 95% confidence interval (95% CI) between the dependent variables and individual and contextual factors. Of the individuals assessed, 3,848 (50.5%) reported a need for dental treatment and 4,236 (55.6%) believed they have the need for prostheses. The results of multilevel logistic regression showed that gender, self-reported skin color, income and coverage by the oral health teams in the Family Health Program were associated with self-perception. This study revealed a greater influence of individual factors on the self-perceived need for dental treatment and prostheses by elderly Brazilians. This information can help to identify the inequalities that affect this population group and in setting priorities for the planning of health services.

Este estudo teve como objetivo identificar fatores individuais e contextuais associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros. Foram utilizados dados secundários de 7.619 indivíduos idosos do levantamento epidemiológico SB Brasil 2010. As associações entre as variáveis dependentes e os fatores individuais e contextuais foram estimadas através da razão de chances (odds ratio ­ OR) e intervalo de confiança de 95%, obtidas por regressão logística multinível. Dos idosos avaliados pelo SB Brasil 2010, 3.848 (50,5%) afirmaram necessitar de tratamento odontológico e 4.236 (55,6%) acreditavam necessitar de prótese. Os resultados da regressão logística multinível mostraram que sexo, cor da pele autorreferida, renda e cobertura pelas equipes de saúde bucal na Estratégia de Saúde da Família estiveram associados à autopercepção. O presente trabalho evidenciou maior influência de fatores individuais na autopercepção da necessidade de tratamento odontológico e de prótese entre idosos brasileiros. Essas informações podem auxiliar na identificação de desigualdades que afetam essa parcela da população e na definição de prioridades para o planejamento dos serviços de saúde.

Fatores associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros / Factors behind self-perceived need for dental treatment and prosthesis in Brazilian elderly people

Resumo Este estudo teve como objetivo identificar fatores individuais e contextuais associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros. Foram utilizados dados secundários de 7.619 indivíduos idosos do levantamento epidemiológico SB Brasil 2010. As associações entre as variáveis dependentes e os fatores individuais e contextuais foram estimadas através da razão de chances (odds ratio - OR) e intervalo de confiança de 95%, obtidas por regressão logística multinível. Dos idosos avaliados pelo SB Brasil 2010, 3.848 (50,5%) afirmaram necessitar de tratamento odontológico e 4.236 (55,6%) acreditavam necessitar de prótese. Os resultados da regressão logística multinível mostraram que sexo, cor da pele autorreferida, renda e cobertura pelas equipes de saúde bucal na Estratégia de Saúde da Família estiveram associados à autopercepção. O presente trabalho evidenciou maior influência de fatores individuais na autopercepção da necessidade de tratamento odontológico e de prótese entre idosos brasileiros. Essas informações podem auxiliar na identificação de desigualdades que afetam essa parcela da população e na definição de prioridades para o planejamento dos serviços de saúde.

Abstract The scope of this study was to identify individual and contextual factors associated with the self-perceived need for dental treatment and for prostheses among elderly Brazilians. An analysis was performed with data from the SB Brazil 2010 epidemiological survey conducted by the Ministry of Health with a sample of 7,619 elderly individuals. Multilevel logistic regression models of mixed random and fixed effects were used to the estimate odds ratio (OR) with 95% confidence interval (95% CI) between the dependent variables and individual and contextual factors. Of the individuals assessed, 3,848 (50.5%) reported a need for dental treatment and 4,236 (55.6%) believed they have the need for prostheses. The results of multilevel logistic regression showed that gender, self-reported skin color, income and coverage by the oral health teams in the Family Health Program were associated with self-perception. This study revealed a greater influence of individual factors on the self-perceived need for dental treatment and prostheses by elderly Brazilians. This information can help to identify the inequalities that affect this population group and in setting priorities for the planning of health services.

Awareness, attitudes, need and demand on replacement of missing teeth among a group of partially dentate patients attending a University Dental Hospital.

OBJECTIVE: Our objective was to assess awareness, attitudes, need and demand on replacement of missing teeth according to edentulous space, age, gender, ethnicity, educational level and socio-economical status of the patient. RESULTS: 76.2% of the study group was opined that the missing teeth should be replaced by prosthetic means. Majority were keen in getting them replaced mainly for the comfort in mastication. Although 77.9 and 32.9% were aware of the removable prostheses and implants respectively, only 25.2% knew about tooth supported bridges as an option of replacement of missing teeth. Participants' awareness on tooth and implant supported prostheses is at a higher level. Participants' opinion on need of regular dental visit was statistically significant when gender, ethnicity and education level were considered. The highest demand for replacement of missing teeth was observed in Kennedy class I and II situations in both upper and lower arches. Demand for fixed prostheses was significantly highest in Kennedy class II in upper and lower arches. In conclusion, although removable prosthodontic options are known to most of the patients, their awareness on tooth and implant supported prostheses is also at a higher level. The highest demand for replacement of missing teeth is by patients with Kennedy class I and II situations whereas Kennedy class II being the category with highest demand for fixed prostheses. We recommend that the location of missing teeth to be considered as a priority when educating patients on the most appropriate prosthetic treatment options. Dentists' involvement in educating patients on prosthetic options needs to be improved.

Oral health-related quality of life in socially endangered persons in Copenhagen, Denmark.

OBJECTIVE: The aims of this study were to investigate and describe the Oral Health Related Quality of Life (OHRQoL) in a socially endangered group of people and to compare the OHRQoL to other patient groups. MATERIAL AND METHODS: About 294 socially endangered persons attending a volunteer clinic in Copenhagen Denmark filled in the OHIP-14 questionnaire. The group was compared in mean score and reported problems to a group of patients with tooth loss and about to have a removable dental prosthesis (RDP), a group with tooth loss about to have a fixed dental prosthesis (FDP) and a control group without tooth loss. RESULTS: Significantly higher OHIP-14 score was seen in the socially endangered group (15.5 (SD 12.6)) compared with the control (1.9 (SD 2.7)) and the FDP group (9.4 (SD 8.2)) but not the RDP group (13.1 (SD 10.5)). This difference was not changed after stratifying in age groups. Problems related to psychological disability, social disability, and handicap were more frequent in the social endangered group than for the other groups. The items pain, tense, diet, relax, life, and function stand out as problems in the socially endangered group compared to the other groups. CONCLUSION: The OHRQoL is highly impaired in the socially endangered persons and at least to the level of persons with great tooth loss about to have an RDP. The problems seem to be more handicapping in the socially endangered compared with other patient groups known to have high impairment.

Saúde bucal em usuários da atenção primária: análise qualitativa da autopercepção relacionada ao uso e necessidade de prótese dentária / Oral health in primary care users: qualitative analysis of self-perceived associated to use and need of dental prosthesis

Resumo Este estudo de caso de abordagem qualitativa propôs-se a analisar a autopercepção da saúde bucal em usuários da Atenção Primária de Porto Alegre que usam e/ou necessitam de prótese dentária. A coleta de dados aconteceu por meio da análise de prontuários odontológicos, diários de campo e entrevistas domiciliares semiestruturadas com 70 usuários do serviço de saúde nas faixas etárias de 15 a 19, 35 a 44 e 65 a 74 anos, que usam e/ou necessitam de prótese dentária (amostra intencional por saturação). Os relatos das entrevistas foram interpretados pela análise de conteúdo de Bardin com o apoio do software ATLAS.ti. A autopercepção positiva de saúde bucal foi percebida por adultos e idosos usuários de próteses bem adaptadas, que não machucavam a boca e não interferiam na mastigação, na fala e na comunicação. Houve grande valorização do uso de próteses pela possibilidade da reabilitação bucal. O desejo do uso de próteses esbarrou em seu alto custo e no acesso limitado a tal procedimento no serviço público do município. Essas informações permitem a análise do significado da saúde bucal para os usuários do Sistema Único de Saúde, podendo ser utilizadas como uma ferramenta de avaliação complementar da necessidade de tratamento odontológico.

Abstract This qualitative study aimed to perceive the self-perception of oral health in users of Primary Care in Porto Alegre who use and/or need dental prosthesis. Data collection performed by odontology records analysis, field diaries and semi-structured home interviews with 70 health service users in age groups 15-19, 35-44 and 65-74 years who use and/or need dental prosthesis (intentional sample saturation). The reports of interviews were interpreted by Bardin thematic content analysis and ATLAS.ti software to support. The positive self-perception of oral health was perceived by adults and elderly who use well-fitting dental prosthesis that do not hurt the mouth and did not interfere in chewing, speech and communication. There was great appreciation of the use dental prosthesis for the possibility of oral rehabilitation. The desire of using dental prosthesis bumped in their high cost and limited access in the public service of the municipality. This information allows the analysis of the significance of oral health to Unified Health System users and can be used as a tool assessment need for dental treatment.