Validity of self-reported oral conditions among Brazilian older women: Do socio-economic factors matter?

OBJECTIVE: To validate the level of agreement between self-report and clinical examination for oral conditions and evaluate the effect of sociodemographic conditions on the validity of self-report among women aged 60 and older. METHODS: A cross-sectional study was conducted in a social community center for seniors in Southern Brazil. Sociodemographic data (age, level of education, and income) were measured. Participants were interviewed and clinically examined for the number of teeth (DMF-T index) and the use of dental prostheses. The self-reported number of teeth in each arch and the use of dental prostheses were gathered through interviews. The level of agreement was estimated using the observed agreement, Kappa statistics, sensitivity/specificity (edentulism/prostheses) and Lin's concordance correlation coefficient, and related tests (number of teeth). The validity of the oral conditions was estimated according to sociodemographic information. RESULTS: Ninety-nine women participated in the study. High levels of agreement were observed for edentulism (97.8%; 95%CI 92.8;99.7; Kappa 0.947) and the use of dental prostheses (97.0%; 95%CI 91.3;99.4; Kappa 0.922). In both conditions, despite achieving similar concordance correlation coefficients (ranging from weak to moderate), the mean number of upper teeth was lower in clinical examination (7.1 ± 5.2) compared with self-reported (8.6 ± 3.6), while the opposite was observed for lower teeth (clinical examination: 9.1 ± 3.4; self-reported: 6.6 ± 5.3). Larger differences were found among women of low income and educational levels. CONCLUSIONS: Our findings suggest that the participants' socio-economic position might influence their self-reported number of teeth.

Oral health-related quality of life in older adults-Longitudinal study.

OBJECTIVE: The aim of the present study was to investigate oral health-related quality of life (OHRQoL) and determine associations with demographic, socio-economic and oral health variables at two evaluation times (2009 and 2015) among older adults assisted by Family Health Units in the Brazil. METHODS: A longitudinal study was conducted involving the evaluation (2009) and re-evaluation (2015) of 161 older adults (≥60 years of age). Demographic, socio-economic and general health variables were collected using a standardised questionnaire. Clinical oral health variables were also collected. OHRQoL was measured using the Oral Health Impact Profile-14 (OHIP-14). Multiple regression analysis was employed for the evaluation of OHRQoL considering the variables from the two evaluations. RESULTS: The severity of impact (mean OHIP-14) was 9.12 (SD: 10.81) in 2009 and 8.50 (10.52) in 2015. The greatest impact regarded the psychological discomfort domain at both evaluations (28.8% in 2009 and 22.9% in 2015). In the adjusted multiple linear regression, the mean OHIP-14 score increased 4.8 points (95% CI: 0.11-9.49) among individuals who experienced tooth loss between the two evaluations in comparison with those who maintained the same number of teeth. An increase in the OHIP-14 score occurred between 2009 and 2015 among 40.6% of the older adults. CONCLUSIONS: The findings of the present study reveal that the oral health status of older adults exerts an influence on OHRQoL, indicating the need for oral health policies directed at this portion of the population.

Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults.

BACKGROUND: Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population-based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full-mouth examination. METHODS: Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full-mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health-related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated. RESULTS: Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full-mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors. CONCLUSION: Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.