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Edentulism and shortened dental arch in Brazilian elderly from the National Survey of Oral Health 2003
Ribeiro,Marco Túlio Freitas; Rosa,Marco Aurélio Camargo da; Lima,Rosa Maria Natal de; Vargas,Andréa Maria Duarte; Haddad,Jo?o Paulo Amaral; Ferreira e Ferreira,Efigênia;
Revista de Saúde Pública , 2011, DOI: 10.1590/S0034-89102011005000057
Abstract: objective: to describe the distribution of edentulism and estimate the prevalence of functional dentition and shortened dental arch among elderly population. methods: a population-based epidemiological study was carried out with a sample of 5,349 respondents aged 65 to 74 years obtained from the 2002 and 2003 brazilian ministry of health/division of oral health survey database. the following variables were studied: gender; macroregion of residence; missing teeth; percentage that met the world health organization goal for oral health in the age group 65 to 74 years (50% having at least 20 natural teeth); presence of shortened dental arch; number of posterior occluding pairs of teeth. the chi-square test assessed the association between categorical variables. the kruskal-wallis and mann-whitney tests were used to assess differences of mean between number of posterior occluding pairs teeth, macro-region and gender. results: the elderly population had an average of 5.49 teeth (sd: 7.93) with a median of 0. the proportion of completely edentulous respondents was 54.7%. complete edentulism was 18.2% in the upper arch and 1.9% in the lower arch. the world health organization goal was achieved in 10% of all respondents studied. however, only 2.7% had acceptable masticatory function and aesthetics (having at least shortened dental arch) and a mean number of posterior occluding pairs of 6.94 (sd=2.97). there were significant differences of the percentage of respondents that met the world health organization goal and presence of shortened dental arch between men and women. there were differences in shortened dental arch between macroregions. conclusions: the brazilian epidemiological oral health survey showed high rate of edentulism and low rate of shortened dental arch in the elderly population studied, thus suggesting significant functional and aesthetic impairment in all brazilian macroregions especially among women.
Relationship between Dental Caries, Edentulism and Self-Perception of Oral Health in Adolescents, Adults and Elderly of a Municipality in Northeastern Brazil
Arinilson Moreira Chaves Lima,Karla Giovana Bavaresco Ulinski,Regina Célia Poli-Frederico,Marina de Lourdes Calvo Fracasso
UNOPAR Científica : Ciências Biológicas e da Saúde , 2013,
Abstract: The diagnosis of conditions and self-perceived oral health status of individuals is fundamental in planning strategies and evaluation of health services. The aim of this study was to describe the prevalence of dental caries, edentulism and self-perception of oral health in adolescents, adults and elderly in a small city in northeastern Brazil. Additionally, we investigated the relationship between self-perception and the clinical variables studied. The study sample consisted of 139 subjects. In clinical examinations the DMFT index was used according to WHO criteria and information about self-perception was collected through interviews. The Chi-square, Mann Whitney and Fisher exact tests were used with 5% significance level . The DMFT index was 6.57 ± 4.17 for adolescents, 22.76 ± 7.63 for adults and 30.96 ± 2.82 for elderly. It was recorded predominance of negative self-perception of oral health among adults (58.6%) and positive self-perception among the elderly (57.7%). Negative self-perceptions of chewing (p <0.001) and speech (p = 0.001) were associated with increasing age. The DMFT index was higher among adolescents with a history of pain (p = 0.028). In adults, the negative self-perception of oral health (p = 0.007), appearance of teeth / gums (p = 0.003) and speech (p = 0.046) was associated with higher number of decayed teeth present. The discrepancy between positive self-perception of oral health and the presence of edentulism was highlighted. The results suggest the need to establish local policies for oral health aimed at promoting health and focused on preventing dental caries and edentulism
The Impact of Edentulism on Oral and General Health  [PDF]
Elham Emami,Raphael Freitas de Souza,Marla Kabawat,Jocelyne S. Feine
International Journal of Dentistry , 2013, DOI: 10.1155/2013/498305
Abstract: An adequate dentition is of importance for well-being and life quality. Despite advances in preventive dentistry, edentulism is still a major public health problem worldwide. In this narrative review, we provide a perspective on the pathways that link oral to general health. A better understanding of disease indicators is necessary for establishing a solid strategy through an organized oral health care system to prevent and treat this morbid chronic condition. 1. Epidemiology of Tooth Loss Edentulism is a debilitating and irreversible condition and is described as the “final marker of disease burden for oral health” [1]. Although the prevalence of complete tooth loss has declined over the last decade, edentulism remains a major disease worldwide, especially among older adults [2] (Table 1). However, there are intra- and intercountry variations in the prevalence of complete edentulism [3], and direct comparison between national samples is difficult because of the impact of various factors like education, economic circumstances, lifestyle, oral health knowledge and beliefs, and attitudes to dental care [4]. In the United States, the number of edentate individuals is likely to stay stable at 9 million and, according to the most recent information, the prevalence of edentulism amongst adults over 60 years of age was 25% [5]. In 2010, the overall rate of edentulism in Canada was 6.4%, and among adults between 60 and 79 years of age, it was 21.7% [6]. The rate of edentulism tends to vary among different regions within a country. In Canada, there is a wide variation between provinces, from 14% (Quebec) to 5% (Northwest Territories) due to associated factors such as access to fluoridated water and smoking [3]. In Brazil, the wealthier, more industrialized states tend to have lower rates than other parts of the country [7]. Table 1: Prevalence of edentulism in the elderly from different countries. Studies show that edentulism is closely associated with socioeconomic factors and is more prevalent in poor populations and in women [3, 16]. In 2003, the ratio of edentulism was 6 times higher in low-income than in higher income Canadian families [3]. Other factors contributing to the prevalence of complete tooth loss are age, education, access to dental care, dentist/population ratios, and insurance coverage [17, 18]. Most edentate people are elders who wear complete dentures in one or both jaws. Studies have demonstrated that denture wearing continues to increase due to the increase in the aging population; a large number of people still depend on removable dentures
Socio-demographic factors and edentulism: the Nigerian experience
Temitope Esan, Adeyemi Olusile, Patricia Akeredolu, Ayodeji Esan
BMC Oral Health , 2004, DOI: 10.1186/1472-6831-4-3
Abstract: A total of 152 patients made up of 80 (52.6%) males and 72 (47.4%) females who presented in two prosthetic clinics located in an urban and a rural area were included in the study. The relationship between gender, age, socio-economic status and edentulism in this study population was established.No significant relationship between gender and denture demand was noted in the study. The demand for complete dentures increased with age while the demand for removable partial dentures also increased with age until the 3rd decade and then started to decline. A significant relationship was found between denture demand and the level of education with a higher demand in lower educational groups (p < 0.001). In addition, the lower socio-economic group had a higher demand more for prostheses than the higher group.The findings in this study revealed a significant relationship between socio-demographic variables and edentulism with age, educational level and socio-economic status playing vital roles in edentulism and denture demand.Edentulism (partial or total) is an indicator of the oral health of a population [1]. It may also be a reflection of the success or otherwise of various preventive and treatment modalities put in place by the health care delivery system [2]. Many patients also regard edentulism as self-mutilating and may be a strong incentive to seek dental treatment [3].While the rate of total edentulism is decreasing in developed countries, the reverse is the case with developing countries and this had been attributed mainly to the high prevalence of periodontal diseases and caries [5-7].Previous studies have also shown that several non-disease factors such as attitude, behavior, dental attendance, characteristics of health care system and socio-demographic factors play important roles in the aetiopathogenesis of edentulism [3].Some studies reported that the incidence of edentulism correlated with educational levels and income status, with those in the lower levels exh
Clinical Evaluation of Periodontal Parameters in Correct Marginal Dental Restorations
International Journal of Stomatological Research , 2012, DOI: 10.5923/j.ijsr.20120103.03
Abstract: Marginal restorations are appropriate places for plaque accumulation and bacteria reproduction causing periodontal disease . The present study was conducted to compare the periodontal status in patients with correct marginal restorations and their controls referred to department of Oral Medicine and Operative Dentistry of Mashhad Dental School in 2009. Fifty patients with one or more marginal restorations as well as their controls were studied in a cross-sectional method. Gingival bleeding and plaque indices were evaluated in both groups for the purpose. Periodontal probes were used for measuring plaque, bleeding index and probing depth and gingival index was examined by observation. 50 percent of cases had plaque index of 0 as the rate was 60 percent in control samples. Considering gingival index, the percentage of patients with 0 gingival index was 58 and 74 in case and control groups respectively. Bleeding index of 0 was reported to be 38 and 72 per cent in case and control groups. Probing depth in case group was more than control. Statistical analysis showed significant difference between the two groups considering four measured ariables (P < 0.05). According to the results of this study, even the correct marginal restoration may have effect on periodontal status.
Chronic kidney disease and use of dental services in a united states public healthcare system: a retrospective cohort study
Vanessa Grubbs, Laura C Plantinga, Delphine S Tuot, Neil R Powe
BMC Nephrology , 2012, DOI: 10.1186/1471-2369-13-16
Abstract: In this retrospective cohort study of 6,498 adult patients with (n = 2,235) and without (n = 4,263) CKD and at least 12 months of follow-up within the San Francisco Department of Public Health Community Health Network clinical databases, we examined the likelihood of having a dental visit within the observation period (2005-2010) using Cox proportional hazards models. To determine whether dental visits reflected a uniform approach to preventive service use in this setting, we similarly examined the likelihood of having an eye visit among those with diabetes, for whom regular retinopathy screening is recommended. We defined CKD status by average estimated glomerular filtration rate based on two or more creatinine measurements ≥ 3 months apart (no CKD, ≥ 60 ml/min/1.73 m2; CKD, < 60 ml/min/1.73 m2).Only 11.0% and 17.4% of patients with and without CKD, respectively, had at least one dental visit. Those with CKD had a 25% lower likelihood of having a dental visit [HR = 0.75, 95% CI (0.64-0.88)] than those without CKD after adjustment for confounders. Among the subgroup of patients with diabetes, 11.8% vs. 17.2% of those with and without CKD had a dental visit, while 58.8% vs. 57.8% had an eye visit.Dental visits, but not eye visits, in a US public healthcare setting are extremely low, particularly among patients with CKD. Given the emerging association between oral health and CKD, addressing factors that impede dental access may be important for reducing the disparate burden of CKD in this population.Chronic kidney disease (CKD) affects an estimated 14% of the adult US population [1]. Over a half million adults have progressed to end-stage renal disease, which confers considerable societal cost—in excess of $30 billion in 2008 [2]—and is the ninth leading cause of death in the United States [3]. Further, CKD disproportionately affects racial/ethnic minorities and the poor [4-8]—populations that are over-represented in public healthcare systems [9,10]. Prevention of CKD
Monitoring Edentulism in Older New Zealand Adults over Two Decades: A Review and Commentary  [PDF]
William Murray Thomson
International Journal of Dentistry , 2012, DOI: 10.1155/2012/375407
Abstract: Historically, New Zealand has had the highest rates of edentulism in the world, but that rate has been falling quickly in recent decades. In 1997, projections were made for edentulism prevalence among 65–74-year-olds using national survey data from 1976 (where it was 72.3%) to 1988 (58.6%). That process assumed a logistic decline in edentulism, given that it would never have been 100% and will never get to 0%. This paper examines the validity of the projections using the estimate (29.6%) from the third national oral health survey, conducted in 2009 and considers the implications of this fall. Edentulism is the state of having lost all of one’s natural teeth [1]. It is conceptually distinct from the more common incremental loss of teeth which tends to occur throughout adult life [2], in that the transition to edentulism involves an explicit decision to undergo complete removal of the dentition (or what remains of it) in a single operation. That process usually involves the removal of some intact functioning teeth, meaning that the decision to opt for a full clearance is likely to be as much a social decision as it is a clinical one. Thus, the reasons for edentulism are complex, being both disease-related and societal [3], and this is reflected in well-documented international variations in the state’s occurrence. For example, a major finding of the first international collaborative study was that the prevalence of edentulism did not appear to be associated with rates for dental caries and periodontitis in the participating countries [4], at least at the cross-national level. As Sussex highlighted in his comprehensive 2008 review [1], this underlined the strong influence of social (lay) and professional norms in edentulism occurrence. Only Scotland and Australia had anywhere near the same prevalence of edentulism, and countries outside the British Commonwealth had, on average, considerably lower rates. The former experienced marked declines in edentulism during the latter half of the 20th Century, but New Zealand had the highest initial rates and appeared to be the slowest to show the decline: the 50% edentulism prevalence rate among adults aged 21+ in 1950 had declined to only 47% by 1968. A degree of caution should be exercised in interpreting those estimates, however, because they did not come from national surveys. The general finding was later confirmed in the first New Zealand national oral health survey, conducted in 1976 [5], and that study underlined a strong association with socioeconomic status (SES), with rates among low-SES adults being
Influence of dental bleaching on marginal leakage of Class V restorations  [PDF]
Andréia Cristina Ramos Dorini,Rafael Francisco Lia Mondelli,Larissa Marinho Azevedo,Juliano Sartori Mendon?a
RGO : Revista Gaúcha de Odontologia , 2010,
Abstract: Objective: Evaluate the in vitro effect of bleaching performed in the dental office and waiting time on the degree of microleakage in class V cavities with margins in enamel, restored with resin composite. Methods: Forty-five human third molars were used, in which the vestibular faces were bleached with 35% hydrogen peroxide activated with LED and the palatine faces were not bleached (control). The teeth were randomly divided into 3 groups with 15 teeth in each: Group 1, restored immediately after bleaching; Group 2, seven days after bleaching; and Group 3, fourteen days after bleaching. After cavity preparation, 35% phosphoric acid, Adper Single Bond 2 adhesive (3M ESPE, St. Paul, Mn, USA), and resin composite Filtek Z250 (3M ESPE, St. Paul, MN, USA) were applied. The teeth were thermal cycled and sealed with red nail polish on the bleached faces and blue on the non bleached faces, except for 1mm around the restored region. The samples were classified according to the following scores: 0 = no leakage, 1 = minimum leakage (less than 1 / 3 the length of the wall), 2 = moderate leakage (1/3 to 2/3 of the wall) and 3 = extensive leakage (over 2/3 of the wall). The data were submitted to the Kruskal-Wallis test at a level of significance of 5%. Results: The restorative procedure immediately after bleaching resulted in statistically higher microleakage values (p <0.05) than those in the non bleached group. In seven and fourteen days after bleaching, no statistically significant differences were found among the experimental groups (p>0.05). Conclusion: Based on the results, it is advisable to wait at least 7 days after bleaching to make the definitive restoration.
Dental Health Behaviors, Dentition, and Mortality in the Elderly: The Leisure World Cohort Study  [PDF]
Annlia Paganini-Hill,Stuart C. White,Kathryn A. Atchison
Journal of Aging Research , 2011, DOI: 10.4061/2011/156061
Abstract: In the last decade the effect of oral health on the general health and mortality of elderly people has attracted attention. We explored the association of dental health behaviors and dentition on all-cause mortality in 5611 older adults followed from 1992 to 2009 ( years) and calculated risk estimates using Cox regression analysis in men and women separately. Toothbrushing at night before bed, using dental floss everyday, and visiting the dentist were significant risk factors for longevity. Never brushing at night increased risk 20–35% compared with brushing everyday. Never flossing increased risk 30% compared with flossing everyday. Not seeing a dentist within the last 12 months increased risk 30–50% compared with seeing a dentist two or more times. Mortality also increased with increasing number of missing teeth. Edentulous individuals (even with dentures) had a 30% higher risk of death compared with those with 20+ teeth. Oral health behaviors help maintain natural, healthy and functional teeth but also appear to promote survival in older adults. 1. Introduction Only in the last decade has the possible effect of oral health on the general health and mortality of elderly people attracted much attention. An association between number of teeth and mortality has been reported in several studies [1–11]. As people age, many lose teeth. Tooth loss reduces masticatory capacity, which can influence food selection, nutritional status, and general health. Evidence is also increasing that oral infections play a role in the pathogenesis of some systemic diseases and may be especially debilitating in the old and frail [12, 13]. The focus of the present study was to examine the possible role not only of dentition status, especially the number of natural teeth and use of dentures, but also of dental health practices as predictors of mortality in elderly men and women. In addition, we wanted to determine if any observed effects would remain after adjusting for other health and lifestyle factors related to mortality. We hypothesized that more teeth and better dental health behaviors would be related to increased longevity. We report here the results in a large cohort (over 5000) of elderly (median age 81 years) men and women followed for 17 years. 2. Materials and Methods The Leisure World Cohort Study was established in the early 1980s when 13,978 (8877 female and 5101 male) residents of a California retirement community (Leisure World Laguna Hills) completed a postal health survey. Residents were recruited in four waves: those who owned homes in Leisure World on June
Clinical and Radiographic Evaluation of Marginal Bone Loss and Periodontal Parameters after Various Dental Reconstruction Procedures  [PDF]
Mohammed M. A. Abdullah Al-Abdaly, Anas Abdullah Q Khawshal, Ahmed YahiaAlmojathel Alqisi, Hamoud Hassan Al-shari, Nourah Falah Alshahrani, Ayesha Nasser Alshahrani
International Journal of Clinical Medicine (IJCM) , 2018, DOI: 10.4236/ijcm.2018.91005
Abstract: Background: Periodontal disease is a bacterial infection that causes bone resorption of bone supporting teeth and leads to change in the normal architecture of the alveolar process. There are instances where the technique sensitive nature of restorative procedures or the faulty restorative margins may inadvertently lead to conditions which could bring about periodontal disease/ destruction. Therefore, this study was designed to determine the impact of dental restorations type on marginal bone among some patients being treated for chronic periodontitis. Material and Methods: Three hundred patients from the periodontics clinics in college of dentistry, King Khalid university were participated in our study. A total of 292 patients completed the study, 152 males and 140 female. They were divided according to dental reconstructions into three groups: Group I was without dental reconstructions (control group), group II patients received amalgam class II fillings and group III received fixed bridge denture. Plaque index (PLI) gingival index (GI), clinical attachment loss (CAL) and marginal bone loss (MBL) were recorded. All data were collected and were analyzed by ANOVA test. Results: In the present study, the restored teeth revealed significantly higher mean values for PLI, GI, CAL and MBL than the non-restored teeth (p-value < 0.05). Conclusion: Although the limitations of the present study, the patients in group II had the highest clinical attachment loss and value of marginal bone loss which can explain the more extension of amalgam fillings into subgingival direction, leading to increased plaque accumulation and increased periodontal destruction.
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