Edentulism and number of medications are associated with nutritional status in older adults: a population-based cross-sectional study / Edentuslimo e número de medicações estão associados com estado nutricional em idosos: um estudo transversal de base populacional

ABSTRACT Objective: This study evaluated the nutritional status and associated factors among older adults of a southern Brazilian city. Methods: A cross-sectional home-based study, with a probabilistic sample per cluster, was carried out with 282 older adults aged ≥60 years in the city of Veranópolis, Brazil. Through a structured questionnaire, socioeconomic, general and behavioral health aspects were assessed. Nutritional status was assessed using the Mini Nutritional Assessment (MAN®) instrument, categorizing the sample into eutrophic or nutritional risk (risk of malnutrition + malnourished). Oral health was assessed by counting teeth and the use of and need for dental prosthesis. Two independent multivariate models were constructed, using number of daily medication and polypharmacy (≥2 daily medications). Logistic regression was used to verify associations. Results: The prevalence of nutritional risk was 14.5% (N=41). In the final multivariate analysis, users of ≥6 daily medications demonstrated a greater odds ratio (OR) of being at nutritional risk when compared to those who did not use medication daily (OR: 12.16; 95% confidence interval [95%CI]: 1.47 - 100.82). Non-edentulous older adults had 67.7% (p = 0.006) lower OR for nutritional risk when compared to edentulous. Conclusion: The prevalence of nutritional risk was low among this sample, and it was associated with edentulism and number of daily medications.

RESUMO Objetivo: Esse estudo avaliou o estado nutricional e fatores associados em idosos de uma cidade do Sul do Brasil. Métodos: Um estudo transversal de base populacional, com amostragem probabilística por cluster, foi realizado com 282 idosos com idade ≥60 anos na cidade de Veranópolis, Brasil. Por meio de um questionário estruturado, aspectos socioeconômicos, comportamentais e de saúde geral foram aferidos. Estado nutricional foi verificado usando a Mini Avaliação Nutricional (MAN), categorizando a amostra em eutróficos e risco nutricional (risco de desnutrição + desnutridos). Saúde bucal foi verificada pela contagem dos dentes e uso e necessidade de prótese dentária. Dois modelos multivariados independentes foram construídos, utilizando o número de medicações diárias e polifarmácia (≥2 medicamentos por dia). Regressão logística foi utilizada para verificar as associações. Resultados: A prevalência de risco nutricional foi de 14,5% (N=41). Na análise multivariada final, usuários de ≥6 medicamentos por dia demonstraram uma maior razão de chance (RC) de terem risco nutricional quando comparados com aqueles que não utilizaram medicamento diariamente (RC: 12,164; intervalo de confiança de 95% [IC95%]: 1,468 - 100,821). Idosos não edêntulos tiveram 67,7% (p=0,006) menor RC para risco nutricional quando comparados com não edêntulos. Conclusão: A prevalência de risco nutricional foi baixa nessa amostral, ela foi associada com edentulismo e número diário de medicações.

Obesity is associated with lack of access to dental care and physical activity among older adults: a cross-sectional study / Obesidade está associada com falta de acesso a serviços odontológicos e atividade física em idosos: um estudo transversal

OBJECTIVE: This study evaluated the prevalence of obesity and associated factors among older adults. METHODS: This was a household-based cross-sectional study involving 282 individuals aged ≥ 60 years recruited in the city of Veranópolis, Brazil, using random probabilistic sampling. Participants underwent a clinical oral examination and completed a structured questionnaire. Obesitywas determined based on body mass index (BMI). Individuals were divided into two groups based on the presence (BMI ≥ 30 kg/m2) or absence of obesity (BMI < 30 kg/m2). Uni- and multivariate analyses were performed using Poisson regression with robust variance. RESULTS: The prevalence of obesity was 34% (n = 96). Each 1-year increase in age resulted in a 3.09% decrease in the likelihood of being classified as having obesity (prevalence ratio [PR] = 0.969; 95% confidence interval [95%CI] 0.949 ­ 0.989). Older adults that reported walking < 5 or ≥ 5 times per week were 39.65 and 37.20% less likely to be classified as obese. The PRs of obesity in former and non-smokers were 4.40 and 5 times higher, respectively, than in current smokers (p < 0.05). Older adults with no access to dental care were 51.72% (p = 0.013) more likely to present with obesity. CONCLUSIONS: There was a high prevalence of obesity among older adults. Obesity was associated with lower age, smoking status, no access to dental care, and a lack of physical activity

OBJETIVO: O presente estudo avaliou a prevalência de obesidade e fatores associados em idosos. METODOLOGIA: Um estudo transversal domiciliar, com amostragem probabilística, foi realizado com 282 indivíduos de idade ≥60 anos de Veranópolis, Brasil. Um exame clínico de saúde bucal foi realizado e um questionário estruturado foi aplicado. A obesidade foi determinada pelo Índice de Massa Corporal (IMC). Os indivíduos foram categorizados com obesidade (IMC ≥ 30kg/m2) e sem obesidade (IMC < 30kg/m2). Análises uni e multivariadas foram feitas por meio de regressão de Poisson com variância robusta. RESULTADOS: A prevalência de obesidade foi de 34% (n = 96). Cada ano de aumento na idade resultou em uma diminuição de 3,09% (razão de prevalência [RP] = 0,969; intervalo de confiança de 95% [IC95%] = 0,949 ­ 0,989) na RP de ser do grupo de obesos. Idosos que reportaram caminhar < cinco ou ≥ cinco vezes por semana apresentaram menor RP para obesidade, 39,65 e 37,20%, respectivamente. Ex-fumantes e não fumantes obtiveram, respectivamente, 4,40 e 5 vezes maior RP de serem do grupo de obesos quando comparados aos fumantes (p < 0,05). Idosos sem acesso a serviços odontológicos demonstraram 51,72% (p = 0,013) maior RP de serem do grupo com obesidade. CONCLUSÕES: Houve uma alta prevalência de obesidade em idosos, que foi associada com menor idade, estado de fumo e ausência de acesso ao dentista e atividade física.

Low concern rate with oral health and associated factors among older persons: a cross-sectional study / Baixas taxas de preocupação com a saúde bucal e fatores associados em idosos: um estudo transversal

OBJECTIVE: This study aimed to assess the prevalence of concern with oral health and associated factors among older adults. METHODS: Individuals aged >60 years were included from the cities Cruz Alta and Veranopolis, Brazil. Oral health examination and a structured questionnaire were applied in 569 individuals. The main outcome was concern with oral health (yes or no), which was determined by a validated questionnaire. Uni- and multivariate analyses were conducted by Poisson regression with robust variance to assess the association between outcome and independent variables. RESULTS: The prevalence of concern with oral health was 30.58% (n = 174). Non-white individuals presented significantly higher prevalence ratio (PR) of being concerned about their oral health (PR = 1.28; 95% confidence interval [CI] 1.01-1.62). Individuals with medium or high level of education, not retired and without any health problems presented higher PR of being concerned with their oral health when compared to their controls (p < 0.05). Moreover, those that reported toothbrushing frequency > 2 times/day (PR = 1.58; 95%CI 1.01 - 2.48) and non-edentulous (PR = 1.50; 95%CI 1.12 -2.01) also presented higher PR of being concern with their oral health. Older adults that were not concerned with tooth alignment (PR = 0.57; 95%CI 0.44 - 0.74) or tooth color (PR = 0.41; 95%CI 0.31 - 0.54) demonstrated lower concern with their oral health. CONCLUSION: Prevalence of concern with oral health among the older adults was low and associated with non-white individuals, medium and high level of education, individuals not retired, absence of health problems, higher toothbrushing frequency, mild temporomandibular disorder (TMD) and non-edentulism. Additionally, concern with esthetical aspects may be related with this outcome.

OBJETIVO: Esse estudo objetivou verificar a prevalência de preocupação com a saúde bucal e fatores associados em idosos. METODOLOGIA: Idosos com idade ≥60 anos foram incluídos das cidades de Cruz Alta e Veranópolis, Brasil. Exame de saúde bucal e um questionário estruturado foram aplicados em 569 indivíduos. O desfecho primário foi preocupação com saúde bucal (sim ou não), a qual foi determinada por um questionário validado. Análises uni- e multivariadas foram realizadas por meio de regressão de Poisson com variância robusta para verificar a associação entre o desfecho e as variáveis independentes. RESULTADOS: A prevalência de preocupação com a saúde bucal foi de 30,58% (n = 174). Indivíduos não brancos apresentaram razão de prevalência (RP) significativamente maior de serem preocupados com a sua saúde bucal (RP = 1,28 ­ intervalo de confiança [IC] de 95% 1,01 ­ 1,62). Indivíduos com nível educacional médio ou alto, não aposentados e sem qualquer problema de saúde apresentaram maior RP de serem preocupados com sua saúde bucal quando comparados com seus controles (p < 0,05). Além disso, idosos que reportaram escovar os dentes ≥ 2 vezes/dia (RP = 1,58; IC95% 1,01 ­ 2,48) e não edêntulos (RP = 1,50; IC95% 1,12 ­ 2,01) também apresentaram maior RP de serem preocupados com sua saúde bucal. Idosos não preocupados com alinhamento dentário (RP = 0,57; IC95% 0,44 ­ 0,74) ou com a cor dos dentes (RP = 0,41; IC95% 0,31 ­ 0,54) demonstraram menor preocupação com a saúde bucal. CONCLUSÃO: Prevalência de preocupação com a saúde bucal em idosos foi baixa e associada com indivíduos não brancos, com nível educacional médio ou alto, indivíduos não aposentados, ausência de problemas de saúde, alta frequência de escovação, desordem temporomandibular (DTM) leve e não edêntulos. Além disso, preocupação com aspectos estéticos pode estar relacionada com isso.

Oral health-related quality of life and associated factors in the elderly: a population-based cross-sectional study / Qualidade de vida relacionada à saúde bucal e fatores associados em idosos: um estudo transversal com amostra representativa

Abstract This study aimed to evaluate the oral health-related quality of life (OHRQoL) and associated factors in the elderly. A cross-sectional study was conducted with 287 elderly of Cruz Alta, Brazil. The following variables were collected: age, sex, ethnicity, level of education, marital status, retirement, medical/dental history, smoking/alcohol exposure, oral hygiene habits, use and need of dental prosthesis, missing teeth, temporomandibular disorder symptoms (TMD), nutritional status, and halitosis. OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14). The sample was categorized into low impact (sum scores ≤6) and high impact (sum scores ≥7). Associations were analyzed by Poisson regression with robust variation. Mean scores of OHIP-14 was 5.92±8.54. Divorced individuals and those who did not use dental floss presented 77% and 54%, respectively, higher prevalence ratio (PR) of having higher OHRQoL impact. Elderly that did not need dental prosthesis demonstrated a lower impact on OHRQoL (P<0.01). Elderly with TMD presented a higher PR of having higher OHRQoL impact (P<0.01). It was concluded that higher impact on OHRQoL was associated with marital status, non-users of dental floss and those with TMD. No need dental prosthesis were associated with lower impact on OHRQoL.

Resumo O estudo avaliou a qualidade de vida relacionada à saúde bucal (QVRSB) e fatores associados em idosos. Estudo transversal foi realizado em 287 idosos de Cruz Alta, Brasil. As seguintes variáveis foram coletadas: idade, sexo, etnia, nível educacional, estado civil, aposentadoria, histórico médico/odontológico, exposição ao fumo/álcool, hábitos de higiene oral, uso e necessidade de prótese, dentes ausentes, sintomas de desordem temporomandibular (DTM), estado nutricional e halitose. QVRSB foi avaliada pelo OHIP-14 (Perfil de Impacto de Saúde Bucal) e categorizado em baixo impacto (soma dos escores ≤6) e alto impacto (soma dos escores ≥7). Associações foram avaliadas por regressão de Poisson com variância robusta. A média OHIP-14 foi 5,92±8.54. Indivíduos divorciados e aqueles que reportaram não usar fio dental apresentaram 77% e 54%, respectivamente, maior razão de prevalência (RP) de terem maior impacto na QVRSB. Idosos que não necessitam próteses dentárias demonstraram menor impacto na QVRSB (P<0,01). Além disso, idosos com DTM apresentaram maior RP de terem maiores escores de OHIP-14 (P<0,01). Foi concluído que maiores impactos na QVRSB estão associados com estado civil, não uso de fio dental e DTM. Não necessitar de prótese dentária esteve associado com menores impactos na QVRSB.

Efficacy of two mouthwashes with cetylpyridinium chloride: a controlled randomized clinical trial

Abstract This study aimed to evaluate the anti-plaque and anti-gingivitis effects of two mouthwashes containing cetylpyridinium chloride (CPC), in comparison to negative control mouthwash. One hundred and twenty subjects were randomly assigned to study groups: test (0.075% CPC and 0.28% zinc lactate), positive control (0.07% CPC) and negative control mouthwash without CPC. All volunteers were examined by a calibrated examiner for the Quigley-Hein Plaque Index (Turesky modification) and Löe-Silness Gingival Index (GI). Gingival severity was also measured by the percentage of sites with positive gingival bleeding. During six weeks, oral hygiene consisted of brushing twice daily with a toothbrush and toothpaste and rising with their assigned mouthwash. Plaque and gingival parameters were assessed at baseline, after four and six weeks of product use. Statistical analyses were performed separately for plaque and gingival indices, by ANOVA, paired t-test and ANCOVA (α < 0.05). After 4 and 6 weeks, all mouthwashes groups presented statistically significant reductions in plaque and gingival parameters as compared to baseline. In comparison to the positive control, the test group presented additional reductions in dental plaque of 19.8% and 16.8%, after 4 and 6 weeks, respectively. For GI, the additional reductions in the test group were 9.7% and 14.3%, at 4 and 6 weeks, respectively. The test group showed additional reduction of 35.3% and 54.5% in the gingival severity, at week 4 and 6, respectively. It is concluded that the mouthwash containing CPC and zinc lactate presents significant anti-plaque and anti-gingivitis effects as compared to positive and negative control mouthwashes.

Efficacy of two soft-bristle toothbrushes in plaque removal: a randomized controlled trial

Abstract The aim of this study was to compare the efficacy in supragingival plaque removal of two soft-bristle toothbrushes. Seventy volunteers were allocated randomly to the Colgate Slim Soft or Curaprox CS5460 toothbrush grourps. At baseline appointment, volunteers underwent plaque examination using the Rustogi Modification of the Navy Plaque Index. Under supervision, they then brushed their teeth for 1minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers performed daily oral hygiene with their assigned toothbrush and a regular dentifrice provided by the researchers for 7 days. The baseline experimental procedures were then repeated. Separate analyses of variance were performed for the whole-mouth, interproximal, and gumline plaque scores (p < 0.05). No difference in baseline pre-brushing scores was found between groups. After a single toothbrushing, the mean plaque score was significantly reduced in both groups (p < 0.05), with greater reduction of whole-mouth and interproximal plaque scores observed in the SlimSoft group compared with the Curaprox group (p < 0.05). After 7 days, the SlimSoft group showed greater reduction of the whole-mouth and interproximal plaque scores compared with the Curaprox group (p < 0.05). In conclusion, the SlimSoft toothbrush presented greater efficacy in supragingival plaque removal than did the Curaprox CS5460 toothbrush, as reflected by whole-mouth and interproximal plaque scores.

Associação entre obesidade e fatores sociodemográficos, médico-odontológicos e comportamentais em adultos: um estudo transversal / Association between obesity and sociodemographic, medical, dental and behavioral in adults: a cross sectional study

Obesidade é o acúmulo excessivo ou anormal de gordura em relação à massa magra, podendo ser modificada por fatores ambientais, genéticos e comportamentais. Na literatura, é bem estabelecida a associação entre diabetes, tabagismo e, mais recentemente, obesidade e periodontite. Entretanto, estudos de prevalência e de associação entre obesidade e gengivite ainda são bastante escassos, especialmente em indivíduos adultos. O presente estudo objetivou verificar a associação entre obesidade e diferentes fatores sociodemográficos, médico-odontológicos e comportamentais em uma amostra de indivíduos adultos da cidade de Porto Alegre, Brasil. Esse estudo, de caráter epidemiológico transversal, avaliou 614 indivíduos maiores de 18 anos. Foram incluídos apenas os indivíduos com pelo menos quatro dentes em boca e que não utilizem aparelhos ortodônticos fixos. Os participantes foram identificados por meio de uma amostragem probabilística multi-estágios, considerando também a distribuição de acordo com o gênero e faixa etária. Dez setores censitários foram visitados. Uma entrevista estruturada foi realizada por pesquisadores treinados, obtendo-se informação de gênero, idade, hábitos comportamentais e estado de saúde sistêmica. Um examinador treinado e calibrado realizou exames de Índice de Placa Visível, Índice gengival de Lõe-Silness, modificado por Lõe, e cálculo. Além disso, peso, altura e percentual de gordura, obtido através de um aparelho portátil de microcorrente elétrica, também foram coletados. Regressão multivariada de Poisson foi utilizada para avaliar a associação entre obesidade e os diferentes fatores médico-odontológicos e sociodemográficos. Dos indivíduos examinados, 33,89% foram classificados como obesos por apresentarem índice de massa corporal pelo menos de 30 kg/m²...

Obesity is the excessive or abnormal accumulation of fat in relation to lean body mass that may be modified by environmental, genetic and behavioral factors. It is well established the relationship between diabetes, smoking and, more recently, obesity and periodontitis. However, studies regarding the association between obesity and gingivitis are quite scarce, especially in adults. This study aimed to verify the association between obesity and different sociodemographic, medical, dental and behavioral factors in a sample of adults in the city of Porto Alegre, Brazil. This is as an epidemiological cross-sectional study that evaluated 614 subjects with at least 18 years old. Only subjects with the minimum of four teeth and those who did not use fixed orthodontic appliances were included. Participants were identified through a multi-stage probability sampling, considering the distribution according to gender and age. Ten census tracts were visited. A structured interview was conducted by trained researchers to collect information about gender, age, behavioral habits and systemic impaired conditions. A trained and calibrated examiner performed the Plaque Visible Index, Lõe-Sillness Gingival Index modified by Lõe and calculus. Additionally, weight, height and body fat percentage, obtained through a portable electrical microcurrent, were collected. Multivariate Poisson regression was used to evaluate the association between obesity and the sociodemographic, medical, dental and behavioral factors. Obesity, defined as body mass index ≥30kg/m2, were found in 33.89% of the examined subjects. It was showed that females, self-reported hypertension, no smoking, higher visible plaque percentage, and bigger number of teeth were significantly associated with obesity compared to non-obese subjects...