Tooth mortality and prosthetic treatment patterns in urban and rural Chinese aged 20–80 years

The study describes tooth mortality levels and pattern of prosthetic treatments in a sample of 1744 Chinese aged 20-80 yr who are residents of Beijing area. Complete edentulousness was rarely seen before the age of 60 yr. Beyond this age up to 26% were edentulous, depending on age and sex. The mean number of teeth present ranged from 10.0 to 29.7 depending on age, sex, and area of residence. Below the age of 60 yr very few persons had experienced extensive loss of teeth but thereafter the number of teeth missing was substantially increased. Prosthetic treatments in the form of partial dentures, crowns, and bridges were frequently observed even in the younger age groups. In all age groups the number of teeth exhibiting caries lesions involving the pulp was much higher than the number of teeth exhibiting extensive mobility. Although many people retain a high number of teeth even late in life our findings indicate a substantial need for, in particular, relief of pain services. Concurrently, emphasis must be placed on preventive programs aiming at interfering with ongoing disease.     

Associations between self-assessed masticatory ability, nutritional status, prosthetic status and salivary flow rate in hospitalized elders

OBJECTIVES: To compare the association between self-assessed masticatory ability and nutritional status with general health status, salivary flow and dental/prosthetic status. DESIGN: A questionnaire and a cross-sectional clinical investigation combined with a measurement of salivary flow rates. SUBJECTS AND METHODS: A cohort of 99 elderly, non-psychiatric patients in a geriatric hospital; clinical examination to determine dental and prosthetic status, oral health and whole unstimulated (USFR) and stimulated (SSFR) salivary flow rates, examination of anthropometric measures, serum albumin level and body mass index (BMI); questionnaire designed to produce yes or no answers related to masticatory function, nutritional status, appetite and prosthesis function; mini mental score examination (MMES). MAIN OUTCOME MEASURES: USFR, SSFR, BMI, anthropometric measures and serum albumin level; complaints related to appetite and xerostomia. RESULTS: Mean age of the 99 patients was 82.5 +/- 4.04 with a MMES of > 21; 50% with malnutrition of severe or intermediate degree, and 86% with moderately or severely reduced serum albumin concentration; 55% reported recent loss of appetite and 52% had symptoms of oral dryness. Recent loss of appetite was associated with reduced serum albumin and complaints of dry mouth and lack of appetite was associated with BMI < 21, 10% weight loss during the preceding 6 months, SSFR < or = 0.5 ml min-1 and wearing dentures. Complaints on poor retention of the maxillary denture were associated with recent weight loss and SSFR < or = 0.5 ml min-1. CONCLUSIONS: Malnutrition in hospitalized elders is primarily associated with recent loss or lack of appetite whereas complaints related to dentures are associated with poor denture quality.     

1312名大学生牙列缺损及修复情况调查分析

目的：调查1312名山东大学在校大学生牙列缺损及修复情况,为指导大学生口腔保健提供依据.方法：按照1997年世界卫生组织（WHO）《口腔健康调查基本方法》,对山东大学1312名大学生的牙列缺损及修复情况进行调查,调查方式包括问卷调查和口腔检查,对牙列缺损、修复情况与性别、年级、专业、城乡差异的关系,口腔健康行为和认知与专业的关系以及牙列缺损的原因进行统计分析.结果：1312名大学生中,牙列缺损者145名,牙列缺损发病率11.05％,主要病因为龋病.有义齿修复者53名,义齿修复率为36.55％.结论：大学生缺牙后修复情况不佳,且非医学专业学生口腔保健意识不强,需有针对性地制定口腔健康教育计划,提高大学生缺牙后修复率,促进大学生的口腔健康.     

The Association between health-related quality of life and prosthetic status and prosthetic needs in Taiwanese adults

Summary  The objective of this study was to describe aspects of prosthetic statuses and needs and to evaluate their relationship with health-related quality of life in Taiwan. The study participants, aged 18 years and above, were recruited from a community survey, and each of the total 2469 participants received a dental examination and completed a questionnaire. Multivariable analysis was used to assess the adjusted means of health-related quality of life (SF-36) in both prosthetic status and need. The results showed that 12·6% of those aged 65 years and above were edentulous. The proportion of prosthetic need increased as age increased (39·7% to 61·3%). Multivariate analysis revealed that participants with 'removable prosthesis' had higher physical health scores than those with 'non-removable prosthesis'. The scores of mental health measurement decreased in people with need for full prostheses in relation to people without need for any prosthesis. Therefore, fulfilling prosthetic needs is not only about recovering oral masticatory function, but also concerns improvement of both physical and mental health-related quality of life.     

Tooth mortality in plantation workers and residents in Sri Lanka

Abstract The tooth mortality of 787 Sri Lanka tea plantation workers and residents aged between 15 and 85 yr was studied in terms of missing teeth as well as teeth requiring extraction for various reasons. The mean number of missing teeth per person was 6.7±9.0. A pattern relating actual tooth loss and tooth loss adjusted to lake account of teeth needing extraction was observed. Such adjustment increased the mean number of missing teeth per person by about two teeth in most age groups. The age specific pattern of tooth loss was calculated. There was an abrupt increase in tooth mortality at the ages 45–54. The age specific tooth mortality for the Sri Lankan group was consistently less than for people in several Western countries. These trends were also apparent in the mortality pattern of individual tooth types. Although there was a tendency for more women to be edentulous, a significantly higher proportion of women than men had a full complement of teeth.     

Associations between missing teeth with unmet needs and socioeconomic status among South Korean dentate government employees

OBJECTIVE: This study aims to examine associations between missing teeth with unmet needs (MTUN) and socioeconomic status, represented by income and place of residence. METHODS: The National Health Insurance Corporation dataset of 822,325 dentate Korean government employees' dental examinations results, questionnaire responses in the year 2000, and basic information collected for administrative purposes was used for this analysis. The main outcome variable was the number of MTUN, categorized into three groups: none, 1-2, and > or = 3. Explanatory variables were assessed and a multinomial logistic regression was employed. RESULTS: Seventy percent were men, with a mean age of 39.1 years (range 18 to 74). The mean number of MTUN was 0.34, and 19.1 percent had > or = 1 MTUN. After adjusting for other variables, age and income were the most salient independent predictors. Rural residents, men, older adults, persons having smoking experience, and persons visiting a dental clinic in the past year were more likely to have >1 MTUN than their counterparts. People performing frequent toothbrushing or having received professional scaling in the past year were less likely to have > or = 1 MTUN than their counterparts. CONCLUSION: Among South Korean government employees with a general dental care insurance benefit, exclusive of prosthetic services, having normative unmet prosthetic need was significantly associated with older age, lower income, and rural residence, taking into account other demographic factors, personal health practices, and dental service utilization.     

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.     

Is tooth loss associated with irritable bowel syndrome?

Although the relationship between number of teeth and gastric disturbances has been recognised, limited data are available linking tooth loss and irritable bowel syndrome (IBS). This study aimed to investigate the relation between dental status and IBS among Iranian adults. In a cross‐sectional study on 4669 Iranian adults, dental status was evaluated using a self‐administered questionnaire. Participants were categorised into five main groups: those with full dentition (without denture), those with denture, individual who had lost 1–2 teeth, 3–5 teeth and half of one jaw or more. IBS and its subtypes were defined using Rome III criteria. After adjusting for different confounding variables, those who had lost 1–2 and 3–5 teeth had 1·35 and 1·33 times greater odds for IBS than fully dentate subjects, respectively. After controlling for different confounders, individuals who had denture had 103% greater odds to have constipation‐predominant IBS than those with full dentition (95% confidence interval: 1·29–3·21). Neither in crude nor in adjusted models were any significant association between dental status and other subtypes of IBS. In addition, we did not find any association between losing half of one jaw or more and IBS. We found that losing 1–2 or 3–5 teeth might significantly be associated with increased risk of IBS. Having denture might be related to constipation‐predominant IBS. There should be further prospective studies to confirm these findings.     

Serum albumin levels and 10‐year tooth loss in a 70‐year‐old population

Serum albumin levels are a practical marker of general health status in the elderly and have been used to determine the severity of underlying diseases and the risk for death. This longitudinal study evaluated the relationship between serum albumin concentrations and tooth loss over 10 years in elderly subjects, after controlling for confounding factors. A sample of 554 dentate subjects among enrolled subjects (n = 600) was involved in this planned longitudinal study with follow‐up examinations after 5 and 10 years. At the 5‐year follow‐up, 373 (67·3%), subjects were available for re‐examination. In addition, 331 (59·7%) were available at the 10‐year follow‐up. Multiple Poisson regression analysis was conducted to evaluate the relationship between the number of missing teeth over 5 or 10 years and serum albumin levels at baseline after adjusting for 10 variables: gender, serum markers levels at baseline, dental status, smoking habits and educational years and oral health behaviour. The number of missing teeth over 5 or 10 years was significantly negatively associated with serum albumin levels at baseline [incidence rate ratios (IRR) = 0·373, P < 0·0001 for 5 years; IRR = 0·570, P < 0·0001 for 10 years]. We conclude that elderly subjects with hypoalbuminemia are at high risk for 5‐ and 10‐year tooth loss.     

Risk indicators of edentulism, partial tooth loss and prosthetic status among black and white middle-aged and older adults

OBJECTIVES: To describe the prevalence and risk indicators of edentulism; to describe the frequencies of wearing removable dentures; to describe the prevalence and risk indicators of fixed prosthetic restorations; to test the hypothesis that fixed prosthetic restorations are most likely to have been placed in persons at lower risk for dental and periodontal diseases, and to test the hypothesis that, with dental disease, dental behaviors, dental attitudes and ability to afford crowns taken into account, blacks are less likely than whites to have received crowns. METHODS: The Florida Dental Care Study is a cohort study of subjects 45 years old or older. A telephone screening interview was done as a first stage to identify 5254 subjects who met eligibility requirements and who self-reported whether they were edentulous. In a second stage, a subsample of dentate subjects was contacted after they completed their telephone screening interview. Of these, 873 subjects completed a baseline in-person interview and dental examination. RESULTS: A total of 19% of first-stage subjects were edentulous. In a single multiple logistic regression, having a poorer self-rated level of general health was significantly associated with edentulism, as were being poor, older and white. Among the second-stage participants (all of whom were dentate), several prosthetic patterns were observed. For example, a total of 64% of maxillary full denture wearers reported wearing their denture all the time. Participants had also received numerous fixed prosthodontic services. The proportion of subjects with at least one crown varied widely by subject characteristics. CONCLUSIONS: A substantial percentage of non-ideal frequencies of wearing removable prostheses was reported, as were prosthesis-related soreness and broken prostheses. Although we expected and observed an association between having a fixed prosthetic crown and periodontal status, dental fillings, dental attitudes and financial resources, a residual association with race suggests that blacks are much less likely to receive prosthetic crowns. The several possible reasons for this circumstance warrant further investigation.     

Intra-category determinants of global self-rating of oral health among the elderly

Kim H-Y, Patton LL. Intra-category determinants of global self-rating of oral health among the elderly. Community Dent Oral Epidemiol 2010; 38: 68–76. © 2009 John Wiley & Sons A/S
Abstract –  Global self-ratings of oral health (GSROH) have been used in population surveys to assess oral health status. The aim of this study was to assess various candidate predictors for each response level (very poor, poor, fair, and good/very good) of GSROH among Korean elders. Data from a national representative sample of Korean adults aged 65 years and over was analyzed. The mean age of the 1173 subjects was 72.7 years and 60.2% were women. After bivariate analysis, a generalized multinomial logit model with individual slope parameters was performed. Only 29.5% of elders rated their oral health as good or very good, while 53.1% assessed their oral health as poor or very poor. Significant determinants for GSROH for elders (including dentate and edentulous) were difficulty chewing, concern about oral health, the number of missing teeth, and denture state. Income and education were not significant determinants. The number of decayed teeth was an additional determinant in the model for the dentate only subgroup. The indicator demarcating response at a good/very good oral health level compared with poorer oral health levels for all (dentate and edentulous) elders was not reporting having much difficulty chewing. Experiencing loss of 10 or more teeth and being concerned about their oral health distinguishes those in the poor or very poor GSROH levels from the others. For dentate elders, having untreated dental caries was also distinguishing for those reporting very poor oral health. Public health programs aimed at correcting significant chewing functional difficulties in the elderly, by restoring or replacing missing teeth, may alleviate the oral health concerns and improve the overall oral health of the elderly.