Fruit and vegetable consumption among older adults by tooth loss and socio‐economic status

Background: The aim of this study was to examine consumption of fruit and vegetables in relation to tooth loss and income. Methods: Data were collected in 2004–06, using a three‐stage, stratified clustered sample, involving a computer‐assisted telephone interview (CATI), oral examination and mailed questionnaire followed by a food frequency questionnaire. Results: A total of 14 123 adults responded to the CATI (49% response) of whom 5505 (44% of those interviewed) agreed to undergo an oral epidemiological examination. In the nutrition sub‐study, a total of n = 1218 persons were approached in New South Wales and Queensland, with n = 1129 responding (92.7% response rate). Among respondents aged 55 years or more 34.5% had <21 teeth. Adjusting for income the prevalence of infrequent consumption (‘never or less than once a month’) was associated with [PR = prevalence ratio (95% CI)] fewer teeth for the fruits, ‘peach, nectarine, plum, apricot’ PR = 1.91 (1.12, 3.25) and ‘grapes or berries’ PR = 1.69 (1.03, 2.76), and for the vegetables ‘stir‐fried or mixed’ PR = 2.34 (1.14, 4.78), ‘sweetcorn’ PR = 1.45 (1.001, 2.10), ‘mushrooms’ PR = 1.62 (1.05, 2.50), ‘lettuce’ PR = 3.99 (1.31, 12.17) and ‘soy beans’ PR = 1.11 (1.01, 1.21). Conclusions: An inadequate dentition was associated with lower consumption of a range of fruits and vegetables indicating that dentition‐related impairment of chewing ability could have adverse consequences on nutritional intake among Australian adults.     

Reasons for permanent tooth extraction in the North of Afghanistan

OBJECTIVES: The aim of this study was to study the pattern of and reasons for permanent tooth extraction in a group of Afghan patients attending a dental clinic in the North of Afghanistan. METHODS: A simple clinical survey was done in Afghan population sample that has undergone or planned for tooth extraction. RESULTS: A total of 184 permanent teeth were extracted from 123 patients ranging in age from 9 to 62 years during the three-month study period. Males were 54.5% while females formed 45.5%. Overall, caries was the most frequent reason for tooth extraction (59.2%), followed by periodontal disease (35.3%), surgical indications (4.9%) and patient request (0.5%). Caries was the main reason for tooth loss up to 50 years of age. However, periodontal disease became the principal reason in 51 years old and over. Posterior teeth represented the highest percentage (84.2%) of extraction. CONCLUSIONS: Both caries and periodontal disease were the main reasons for tooth extraction in the North of Afghanistan, so that proper oral health system including efficient programs focusing on prevention and treatment of these diseases should be created and developed.     

Reasons for tooth extraction in the western states of Germany

Abstract –The purpose of this study was to collect information on the main causes of tooth loss in the western states of Germany as perceived by dentists and their patients. Sixty-eight dentists, out of 80 that were selected with a systematic random method for an epidemiological study in the western states of Germany, recorded their reason for tooth extraction. Included in the study were only extractions of permanent teeth during a period of 2 weeks (March 1990). up to a maximum of 20 patients per dentist. Of 926 returned questionnaires, 882 could be evaluated. In all 1215 teeth in 882 patients were extracted. The extraction of third molars was included as a reason, when caries, periodontal reasons and others were not indicated. Caries was the reason given for 20.7% of all extractions; periodontal diseases for 27.3%; caries and periodontal reasons for 18.7%; third molars for 14.7%: prosthetic reasons for 1 1.2%; orthodontic reasons for 4.1%; trauma for 0.4% and others for 2.9%. While caries is a major reason in all age groups, periodontal diseases and the combination of caries and periodontal reasons are more frequent than all other reasons for the age groups beyond 40 or 45 yr, respectively. The third molar was the most often extracted tooth. The patients were asked for their main reason for tooth extraction. For the patients, pain was the major reason for extraction (47.2%). According to the participating dentists periodontal disease is the most frequent cause of tooth extraction for people over 40 yr of age, while for those below 40 yr of age, caries and third molar extractions are the most frequent reasons.     

Social inequality in tooth extraction in a Brazilian insured working population

OBJECTIVES: Given the scant evidence of the socioeconomic gradient in tooth loss incidence, the purpose of this study was to compare the odds of individuals of distinct social strata being subjected to tooth extraction. METHODS: We undertook a case-control study at the head office of a large Brazilian company whose employees had access to dental care through the company's dental insurance. RESULTS: During 2 years of observation, 264 teeth were extracted and the distribution of such extractions was rather unequal. A strong suggestion of a social gradient was noted and the odds of tooth extraction occurring per social strata, adjusted by age and gender, were five times higher in employees pertaining to the lowest social stratum, when compared with those at the highest. CONCLUSIONS: We concluded that lower social strata were strongly associated with increased risk of having teeth extracted. Dental insurance was not able to equalize the chances of tooth extraction among different social strata, in a population of employed adults.     

Study of tooth loss in an adolescent Brazilian population

Abstract Data concerning tooth loss in developing countries may indicate the dental health status in young people and serve as baseline data for evaluation of future dental health programs. The study population consisted of 304 schoolchildren (145 males, 159 females) from Belo Horizonte, M.G. Brazil. The mean age was 14.5, ranging from 13 to 16 yr. The number of teeth already lost and teeth indicated for extraction were assessed from two posterior bitewing radiographs and one frontal color photo which were obtained from all participants. The results showed that 2/3 of the studied population had lost one or more permanent teeth. The average number of missing teeth was 1.8 in both males and females. Of the various teeth, the mandibular first molars had most frequently been lost. Differences between the sexes concerning amount and pattern of lost teeth were small.     

Oral health‐related quality of life,measured using the five‐item version of the Oral Health Impact Profile,in relation to socio‐economic status: a population survey in Sweden

Oral health‐related quality of life (OHRQoL) is an important patient‐reported outcome measure in dental research. This study was conducted to analyse the association between OHRQoL, as measured using the five‐item version of the Oral Health Impact Profile (OHIP‐5), and different socio‐economic indices. A national survey of randomly selected adult individuals in Sweden (n = 3,500) was performed using telephone interviews. The questions asked for the purpose of this study were defined by the items of the OHIP‐5, just as questions were asked regarding socio‐economic variables, including education, income, and economic resources. Poor OHRQoL, as identified by an OHIP‐5 score of 3 or higher on at least two of the five items, was statistically significantly associated in multivariate analysis with low income (OR = 1.84) and having no economic resources (OR = 2.19). The statistical models were adjusted for age, gender, ethnicity, marital status, dental‐care utilization, dental anxiety, and smoking. The OHIP‐5 may be used in larger epidemiological surveys because it demonstrates the ability to discriminate for a range of important areas of measurement in dental public health, including social determinants.     

Correlates of partial tooth loss and edentulism in the Brazilian elderly

BACKGROUND: In South American older adults the association between tooth loss and demographic, predisposing and enabling factors has not been determined. The purpose of this study was to evaluate the association between partial and complete tooth loss and demographic, predisposing, enabling and need factors, and quality of life variables in the Brazilian older adults. METHODS: In this cross-sectional study, 5349 subjects aged 65-74 years were evaluated using conglomerate random sampling. Data collection included dental examinations and questionnaires evaluating demographic, predisposing, enabling and need factors, and quality of life variables. Multinomial logistic regression was carried out to evaluate correlates of tooth loss. The number of teeth was set as the outcome and categorized as: edentulous, subjects with 1-19 teeth, and subjects with 20 or more teeth. RESULTS: Predisposing factors including age, female gender and schooling were independently associated with edentulism. Female gender was associated with partial tooth loss. The only enabling factor associated with edentulism was car ownership. Need factors were associated with edentulism and partial tooth loss. Edentulous subjects perceived the need for dental treatment less frequently. Quality of life factors were associated with partial tooth loss and edentulism. Subjects with 1-19 teeth and edentulous subjects were more likely to rate their chewing ability as not good. Edentulous subjects were more likely to rate their speech ability and their dental appearance as good. CONCLUSIONS: The results indicate that tooth loss and edentulism were complex phenomena, with intricate predisposing, demographic, enabling and need factors playing a role.     

Dental erosion amongst 13- and 14-year-old Brazilian schoolchildren

Objectives : To assess the prevalence of dental erosion in a sample of 13‐ and 14‐year‐old Brazilian schoolchildren and to assess the relationship of dental erosion and socio‐demographic characteristics. Methods : A convenience sample of 458 children (190 boys and 268 girls) from 14 schools in Três Coraçöes, south east Brazil, was examined. Socio‐demographic data were collected by self‐completion questionnaires. Results : Dental erosion was observed in 34.1% of subjects, involving enamel only and showing a symmetrical distribution. The palatal surfaces of the upper incisors were the most commonly affected surfaces. Erosion experience was higher in boys; pupils from Government funded schools; those resident in rural areas and those from the high economic class, but none of these were statistically significant. Conclusion : These data are the first to show that in a cohort of 13–14‐year old Brazilian schoolchildren, approximately one third of those examined showed mild erosion, requiring clinical preventive counselling. No statistically significant association was observed between erosion, gender and socioeconomic factors.     

Association of total tooth loss with socio-behavioural health indicators in Korean elderly

This study examined the association between total tooth loss, and socio-behavioural factors and general health indicators in elderly Koreans using national databases. Cross-sectional data for this study were from the third Korean National Health and Nutrition Examination Survey (KNHANES III), which was conducted among non-institutionalised civilians by the Korean Ministry of Health and Welfare in 2005. KNHANES III used a stratified, multistage probability sampling design on a representative of total South Korean population, according to geographical areas, age and sex groups. Among them, 1091 subjects aged 65 years and above were identified as potential participants in this study. The dependent variable in this study was the self-reported total tooth loss. The independent variables consisted of the following four categories: demographic information, socio-behavioural factors, psychological factors and general health indicators. The data were weighted to adjust for the sampling complexity, and SPSS version 14 for Windows software was used for data analysis. There were significant differences in total tooth loss odds according to the socio-behavioural backgrounds (education and smoking), psychological conditions (perceived oral health) and general health status (diabetes and body mass index as underweight). This suggests that the total tooth loss is associated with the socio-economic status, health-related behaviour and general health. However, more extensive longitudinal data and research will be needed to better explain the relationship between the total tooth loss and these variables.     

Reasons for tooth extraction in Scotland

OBJECTIVES: A 1984 study investigated the reasons underlying the extraction of teeth in Scotland. The survey described in this paper, used a similar methodology and aimed to determine the reasons for the extraction of permanent teeth by general dental practitioners and investigate changes in the influences on tooth extraction over a 10 year period. METHODS: During a 1 week period in November 1994, 139 general dental practitioners working throughout Scotland, recorded the reasons for all permanent tooth extractions. RESULTS: A total of 917 permanent teeth were extracted from 613 patients, the reason for extraction being stated as dental caries (51%), periodontal disease (21%), orthodontics (11%) and failed endodontics (4%). Trauma, pericoronitis and other reasons accounted for 5.5% of extractions whilst, in 7.5% of cases, patients requested extraction in preference to other treatments. The proportion of extractions attributed to periodontal disease increased from age 31-60 years, but declined thereafter. CONCLUSIONS: Comparing the results with those obtained in the 1984 study, whilst the mean number of teeth extracted by each practitioner had reduced, the overall relative contribution of different reasons for extraction was similar.     

Incidence and predictors of self-reported tooth loss in a representative sample of Norwegian adults

OBJECTIVES: The purpose of this study was to determine the self-reported 12-month incidence of tooth loss among Norwegian adults and to assess the association between tooth loss and some predictor variables. METHODS: Of a two-stage nation-wide, representative random sample (n = 3958), information was obtained from 2682 subjects aged 20-79 years and the response rate was 68%. Telephone or face-to-face interviews by interviewers employed by the Central Bureau of Statistics (CBS) of Norway. Information was collected about demographic characteristics, the number of natural teeth present, the number of teeth lost during the last 12 months, and belief in keeping natural teeth for life. The present analyses are based on 2520 persons 20-79 years of age. RESULTS: The proportion of respondents who reported losing one or more teeth was 6.45% (95% confidence limits (CL) = 5.49, 7.41). The participants who reported extractions had lost on average 1.54 (range 1-9) teeth. Multiple logistic regression analysis revealed a borderline significant effect of the level of education (OR = 0.68, 95% CL = 0.46, 1.00), i.e. the odds of losing one or more teeth during the last 12 months were lower among persons with more than 12 years of education than among persons with less education. The explained variance was 1.9%. CONCLUSION: The annual incidence rate of tooth loss among Norwegian adults was found to lie within the range reported from other industrialized countries. After controlling for socio-demographic variables and the number of teeth present, the only borderline significant predictor of the incidence of tooth loss was the level of education.     

Open surgical approach for a tooth aspirated during dental extraction: a case report

Foreign body aspiration is a common problem in children necessitating prompt recognition and early treatment to minimize the potentially serious and sometimes even fatal consequences. Most foreign bodies can usually be extracted by skilful application of endoscopic techniques. Nevertheless, spherical foreign bodies, such as pen caps and some teeth remain difficult to manage. In this case report clinical presentation and treatment options in the treatment of a patient who had a tooth lodged in the right lung are discussed. The complications of foreign body ingestion or aspiration associated with dental treatment is emphasized.     

Reasons for extraction of permanent teeth in Greece: a five-year follow-up study

Aim: To investigate the reasons for tooth extraction and their correlations with age and gender in Greece. Materials and methods: The study population consisted of 1,018 patients, 560 males and 458 females, aged 18–74 years from a private practice in Greece. Each patient’s age, gender, number of extracted teeth and the reasons for the extraction were recorded for a period of 5 years. Results: Two thousand four hundred and eighteen permanent teeth were extracted for various reasons during the study period. The results showed that the main reasons for extraction were caries (45.6%), periodontal disease (32.1%), failed root canal treatment (7.3%) and root fracture (4.4%). Caries was the main reason for extraction in patients up to 44 years old (64.7%), while periodontal disease was the main reason for extraction in patients over years of age (77.6%). Maxillary and mandibular 1st and 2nd molars, were the most frequently extracted teeth due to dental caries. Premolars of the mandible and maxillary and mandibular anterior teeth were the most frequently extracted teeth due to periodontal disease. Conclusions: Although the targets of the WHO regarding the reduction of dental caries were accomplished, dental caries and periodontal disease are still the main reasons for tooth extraction regardless of the age of the patients.