Sub-Optimal Oral Health, Multimorbidity and Access to Dental Care
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ABSTRACT INTRODUCTION Emerging research on the links between sub-optimal oral health and multimorbidity (MM), or the co-existence of multiple chronic conditions, has raised queries on whether enhancing access to dental care may mitigate the MM burden, especially in older age. Here, we aim to assess the association between sub-optimal oral health and MM and whether access to dental care can mitigate the risk of MM in individuals with sub-optimal oral health. METHODS We conducted a cross-sectional analysis using data from the Canadian Longitudinal Study on Aging (CLSA) (n=44,815, 45-84 years old). Edentulism, self-reported oral health (SROH), and other oral health problems (e.g., toothache, bleeding gums), were each used as indicators of sub-optimal oral health. MM was defined according to the Public Health Agency of Canada as having 2 or more chronic conditions out of cancer, cardiovascular diseases, chronic respiratory diseases, diabetes, and mental illnesses. Variables for access to dental care included the number of dental visits within the last year, dental insurance status, and cost barriers to dental care. We constructed multivariable step-wise logistic regression models and interaction terms with 95% confidence intervals and estimated prevalence ratio (PR) to assess the associations of interest, adjusting for a priori determined sociodemographic and behavioural factors. RESULTS Each of the sub-optimal oral health indicators were significantly associated with MM (edentulism PR=1.48, 95%CI 1.31, 1.68; poor SROH PR=1.81, 95%CI 1.62, 2.01; other oral health problems PR = 1.91, 95%CI 1.78, 2.06). The magnitude of this association was exacerbated in individuals who lacked dental insurance, could not afford dental care, and those who reported fewer dental visits within the last year. CONCLUSION The association between sub-optimal oral health and MM may be exacerbated by the lack of access to dental care. Policies aiming to enhance access to dental care may help mitigate the risk of MM.Keywords:
Edentulism
Multimorbidity
Toothache
Tooth loss
Background: We conducted this study to gather baseline data on tooth loss and preferred prosthesis as there were only few epidemiological studies on tooth loss, especially in young adults (18–26 years).Aim: The aim of the study is to analyze the prevalence of tooth loss and their preferred prosthesis among young adults (18-26years) who arrived to the private dental institutions for treatment or to accompany them. A total of 634 young adults (18-26 years) were included Materials and methodology: in the study, individual questionnaire were given for assess the oral health followed by examination of edentulism. Out of total samples 28.7% had Results: tooth loss, 71.3% don't. The causes of tooth loss are 67.9% tooth decay, 13.6% trauma, 10% congenital missing, and 8.6% mobility. The population with treatment needs 30.5%, 12.8% underwent treatment for tooth loss and 56.8% are not in need of treatment/not willing for treatment. The population preferred xed prosthesis is 49.8%, 10.2% removable prosthesis, 40% implant. The need for prosthetic Conclusion: care among young individuals and the associated risk factors for tooth loss are highlighted in this study. The purpose of this study was to inform participants about the effects of tooth loss, the signicance of replacing missing teeth, and the many treatment choices that are accessible to them
Edentulism
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Dental prosthesis
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Abstract – 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.
Edentulism
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Cross-sectional study
Removable partial denture
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Tooth loss
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Tooth loss appears to have an important role in the loss of mastication and esthetics. The aim of this systematic review was to investigate the prevalence of tooth loss and edentulism in the Iranian population.Studies reviewed in this article were primarily identified via search of the online bibliographic databases including PubMed and Iranian Biomedical Journals, by using "tooth loss", "edentulism", "epidemiology", and "Iran" as keywords. Studies potentially related to this topic were retrieved and the selection criteria applied. From the chosen studies the eligible articles were reviewed.Of the studies identified after conducting the search, 10 eligible studies were extracted. The prevalence of tooth loss ranges between 0.3% in 3 to 5-year-old children to 70.7% in adults over 65. There is a lack of well-designed epidemiological studies on edentulism and tooth loss in Iran. The prevalence of tooth loss is high and it increases by aging.It seems that the prevalence of tooth loss is high among adults in Iran. It is highly suggested that population-based studies should be established to investigate the epidemiology and risk factors of tooth loss in Iran. The results of such studies will be useful in the adoption of appropriate preventive strategies.
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Abstract Objective: The purpose of this review was to study the prevalence and incidence of edentulism and tooth loss in European countries. Material and method: A literature search was performed by means of Medline/PubMed using various combinations of keywords concerning prevalence and incidence of tooth loss and edentulism, complemented by a hand search. Inclusion criteria were cross‐sectional and longitudinal clinical and questionnaire studies of representative or random samples of ≥100 subjects at the initial examination. Sixty articles were identified; the hand search gave 13 more references. Results: This literature review demonstrated that there is a lack of epidemiological studies on edentulism and tooth loss in many countries in Europe. The quality of available data varied considerably. There is a documented decline of edentulism with still great differences in prevalence between countries, between geographical regions within countries and between groups with various backgrounds. The mean number of lost teeth increases with age. In several countries many dentate subjects aged 60 years and over still have reduced dentitions possibly needing prosthodontic treatment. The incidence of tooth loss is low but with geographical variation between age groups, and there is a trend for decreasing incidence over the last decades. A great number of variables are associated with tooth loss, and there is no consensus whether dental disease related or socio‐behavioural factors are the most important risk factors. Institutionalised elderly people have, in general, more compromised oral health, including fewer teeth, than those at the same age living freely. Conclusion: Tooth loss and edentulism are declining at least in those European countries where reliable data are available. However, the WHO goal of retaining at least 20 teeth at the age of 80 years has not yet been met but is being approached in some countries.
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Edentulism, Severe Tooth Loss and Lack of Functional Dentition in Elders: A Study in Southern Brazil
Abstract The aim of this study was to estimate self-reported prevalence of edentulism, severe tooth loss and lack of functional dentition in elders, and to identify potential associated factors. A population based cross-sectional study was carried out with 1,451 elders (≥60 years), in Pelotas, RS, Brazil. Crude and adjusted prevalence ratios were estimated using Poisson regressions. The prevalence of edentulism, severe tooth loss and lack of functional dentition was 39.3%, 60.9% and 82.7%, respectively. The factors positively associated with tooth loss in the three-degree severity were sex (females), older individuals, low familial income, low level of schooling and having the last dental visit longer than 24 months ago. The high prevalence of tooth loss in its different degrees of severity and the association with preventable factors highlight the need of programs focused on elders, emphasizing the prevention of tooth loss and need for prosthetic rehabilitation.
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Summary This study conducted a systematic review to assess the bi‐directional association between tooth loss/edentulism and obesity. Electronic searches were performed in four different databases. Observational studies that tested associations between tooth loss/edentulism and obesity as either exposures or outcomes were included. Additionally, meta‐analyses, funnel plots and sensitivity analyses were conducted to synthesize the evidence. A total of 549 articles were identified in the electronic database search. Out of which, 16 studies were included within the meta‐analyses: 75% considered tooth loss/edentulism as exposure and obesity as outcome, whereas 25% alternatively considered obesity as exposure and tooth loss/edentulism as outcome. Pooled estimates showed that obese individuals had 1.49 (95%CI 1.20–1.86) and 1.25 (95%CI 1.10–1.42) times higher odds of having any tooth loss and edentulism, respectively. Alternatively, when tooth loss or edentulism were considered as exposures, individuals with any tooth loss had 1.41 (95%CI 1.11–1.79) times higher odds for obesity, while edentates had even higher odds (OR 1.60; 95%CI 1.29–2.00). The results indicate a bi‐directional association between tooth loss and obesity. Considering that all selected studies were of cross‐sectional study design limiting inferences on temporality, longitudinal prospective studies are required to test the causal relationship between tooth loss/edentulism and obesity or vice a versa. © 2016 World Obesity
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Edentulism is a condition which is associated with tooth loss. It can be partial or complete edentulism and is the most common oral health issue. It affects subjects of every age group. Multiple factors are believed for causing tooth loss including from poor oral hygiene to systemic diseases. Aim of this study is to highlight the causative factors which are believed to be associated with increased number of tooth loss. Hence, by identifying these factors, preventive techniques could be opted in time in order to prolong the tooth life. Study Design: Cross-sectional study. Setting: Fatimah Memorial Medical and Dental College, LHR. Period: August 20118 to December 2018 Material & Methods: 100 students which were recruited. By trained dentist after following standard protocols. After approval from ethical committee all the demographic data and relevant information was entered into predesigned proforma. Data was analyzed in SPSS version 21.0. Result: Study showed significant results showing that smoker diabetic subjects have more number of tooth loss. Conclusion: Smoking and diabetes are strong contributory factors for increased number of tooth loss.
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IntroductionOral diseases are still a major global health burden, in spite of big efforts in research and dental services, where disbursement on treatment may exceed that for other diseases, including major illnesses such as cancer, heart disease, stroke, and dementia (Williams, 2011).In this context, tooth loss is a topic of public health concern, since it is the final result of the first and second most prevalent diseases in dentistry: caries and periodontitis (Pihlstrom et al., 2005;Pitts et al., 2011).Although the prevalence of edentulism has decreased over the last decades, there will be a relevant proportion of edentulous individuals worldwide (Polzer et al., 2010a).Tooth loss is a problem complex to be solved all over the world which affects children, adults and elderly.Complete edentulism prior 65 years old was associated with all-cause mortality, an evidence supporting the notion that poor oral health is an important public health issue across the lifespan (Brown, 2009).Although edentulism is not a life threatening condition, tooth loss impairs several orofacial structures, such as bony tissues, nerves, receptors and muscles.Consequently, most orofacial functions are diminished in edentate subjects (Polzer et al., 2010a).Regarding partially edentulous people, tooth loss is found in 5-20% of most adult populations all over the world (Petersen et al., 2005).Quality life levels were reported to be direct related to the number of remaining teeth (Polzer et al., 2010a).Thus, edentulism was found to be a global problem, with estimates for an increasing demand for oral rehabilitation in the future (Felton, 2009).In this context, oral health restoration should aim to restore function and esthetics.Dentistry has the challenge of improving the access and quality of oral rehabilitation (Tilman, 1985), although oral health care is still being conducted without a solid research evidence base (Pang et al., 2011). Oral rehabilitationA wide variety of treatments is available to replace tooth loss.Osseointegrated dental implant is the gold standard treatment modality to replace missing teeth in terms of www.intechopen.com
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Loss of all natural permanent teeth (edentulism) substantially reduces quality of life, self-image, and daily functioning. Although loss of teeth results from oral diseases such as dental caries and periodontitis, it also reflects patient and dentist attitudes, availability and accessibility of dental care, and the prevailing standard of care. One of the national health objectives for 2000 is to reduce to no more than 20% the proportion of persons aged > or =65 years who have lost all their natural teeth (objective 13.4). Edentulism has been declining in the United States since the 1950s, but few state-specific data are available on adult tooth loss. To estimate the prevalence of edentulism among persons aged > or =65 years, CDC analyzed data from the 46 states that participated in the oral health module of the 1995-1997 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the findings from this analysis, which indicate a large state-specific variation in edentulism and that many states have not yet achieved the national health objective for preventing total tooth loss.
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