Tooth loss longitudinal study in adults and associated factors

Author(s)

Manoelito Ferreira Silva Junior

• Document type: Master's Dissertation
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2016-02-26

Examining board members

Maria da Luz Rosário de Sousa; Adauto Emmerich Oliveira; Maria Paula Maciel Rando Meirelles

• Advisor: Marília Jesus Batista; Maria da Luz Rosário de Sousa

Abstract

Despite improved conditions in adult oral health in recent times, tooth loss continues very prevalent in this population, and is a matter of great concern in dentistry. The objectives of this study were: I) To characterize the oral health conditions and main self-reported reasons for tooth extraction. II) To evaluate the incidence of tooth loss after a 4 year follow-up. III) To analyze the risk factors for the incidence of tooth loss in a population of adults. This cohort study examined a random sample of 20 to 64 year-olds, representative of the adults living in Piracicaba-SP, Brazil. The home oral examination used the index of permanent decayed, missing and filled teeth (DMFT), Community Periodontal Index (CPI), the use and need for dental prosthesis according to the codes and criteria of the World Health Organization, as well as the presence of visible biofilm. In addition, a baseline questionnaire was applied to collect demographic and socioeconomic data and information on health habits and the use of dental services. Descriptive analyzes were performed through means, standard deviation (SD) and standard error (SE), and stratified into age groups of young (20-44 years) and older adults (45-64 years). For the hierarchical analysis, the outcome was presence of the incidence of tooth loss. A conceptual theoretical model of tooth loss adapted for this study was also used. The reference category for the binary logistic regression was that of people not missing any teeth due to caries or periodontal disease. A significance level of 5% was adopted. At the baseline, a total of 248 adults participated. The average of the missing component (M) was 10.3 (SE=0.82) in this population, with M=3.34 (SE=0.33) in the young and M=13.41 (SE=1.45) in the older adults. Pain was the most common reason for the first extraction (37.5%) and also for other extractions (34.6%). This choice was mainly due to a lack of other treatment options (52%) and was carried out principally in the private service (47.2%). In the follow up, the final sample consisted of 143 adults (57.7%). A total of 51 (35.7%) adults had lost one or more teeth over the study period, yielding a mean of 2.55 (SD=1.86) missing teeth. In the total sample, the incidence of tooth loss averaged 0.91 (SD=1.65), and was higher in older adults 1.14 (SD=1.64) (p = 0.008). As risk factors, the incidence of tooth loss presented as age (RR=2.48; 95%CI:1.09-5.66), pain as the reason for seeking dental service (RR=2.82; 95%CI:1.06-7.52) and untreated caries (RR=2.50; 95%CI:1.06-5.92). Young adults presented a lower prevalence and incidence of tooth loss. Pain was the main self-reported reason for the prevalence of tooth loss, mainly due to a lack of other treatment options, while age, pain as a reason for seeking dental service and untreated caries were the strongest predictors for the incidence of tooth loss. These results point to the importance of of prevention of oral diseases, particularly dental caries and health promotion through healthy habits and choices (AU)

• FAPESP's process: 14/15184-2 - Tooth loss longitudinal study in adults and associated factors
• Grantee: Manoelito Ferreira Silva Junior
• Support Opportunities: Scholarships in Brazil - Master