Impact of tooth loss on oral health quality of life among adults

Author(s)

Marília Jesus Batista

• Document type: Doctoral Thesis
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2013-04-30

Examining board members

Maria da Luz Rosário de Sousa; Jose Leopoldo Ferreira Antunes; Marlívia Gonçalves de Carvalho Watanabe; Silvio Rocha Correa da Silva; Eduardo Hebling

• Advisor: Maria da Luz Rosário de Sousa

Abstract

Aim: This research was evaluated the impact of tooth loss on quality of life among adults using tooth mortality indexes and verified associated factors. Methods: This cross-sectional study evaluated caries (DMFT), periodontal disease and dental biofilm (DB) and demographic, socioeconomic, dental care utilization, self-perception and oral health-related quality of life (OHIP-14) data. For chapter 1, we used data from 386 workers 20-64 years old in a company, São Paulo. The tooth mortality index (TMI) was calculated (M/DMF) and a modified index (TMI mod). The outcome was the upper quartile of each index. We performed Poisson Regression. For chapters 2 and 3, 248 (20-64 year-old) residents in Piracicaba-SP, Brazil, through a household probability sample were examined. Position and number of missing teeth, were both considered to evaluate the impact of tooth loss on quality of life. OHIP severity (total score) and OHIP prevalence were outcomes of chapter 2. Tooth loss classification was the outcome for chapter 3. Data analyses were performed through binary logistic regression, negative binomial regression and for multinomial logistic regression. A hierarchical approach was adopted using a conceptual model. Results: The upper quartile for TMI was 50% and 44% for the TMI mod. Being older and visible DB was associated with tooth mortality. Lower family income (PR=1.6, 95%CI=1.0-2.5), and not flossing (PR=1.7, 95%CI=1.1- 2.6) were associated with TMI, and low education (PR=1.6, 95%CI=1.0- 2.4) and seek the dentist motivated by pain (PR=1.8, 95%CI=1.1-3.0) at the TMI mod. OHIP mean was 10.21 (SE=1.16), 48.1% (n=115) reporting one/more impacts fairly/very often. It were associated with OHIP severity those who had lost up to 12 teeth, including anterior teeth (PRR=1.63, 95%CI=1.06-2.51), 13-31 missing teeth (PRR=2.33, 95%CI=1.49-3.63), and the edentulous (PRR=2.66, 95%CI=1.55-4.57), and also for seeking dental care because of pain or dental needs and having caries. For OHIP prevalence: using dental services due to pain, having caries and having low income. The mean number of missing teeth was 10.3 (SE=2.9) and the distribution, according to the tooth loss classification, was 28.3% for those without tooth loss, 4.9% missing 1-4 first molars, 18.2% missing up to 12 posterior teeth, 25.1% missing up to 12 teeth, including anterior(s), 18.2% 13-31 teeth, and 5.3% being edentulous. Age was significant for all categories of tooth loss. Those who had missed up to 12 posterior teeth presented significant PRs for low social class (PR=2.6, 95%CI=1.2-5.2). Who missed up to 12 teeth including anterior, the risk indicators were clinical attachment loss>4mm (PR=2.9, 95%CI=1.1-7.5); for tooth loss >13 teeth, low social class (PR=3.8, 95%CI=1.3-11.4), and visiting a dentist due to emergency (PR=9.4, 95%CI=3.0-28.9). Conclusion: The tooth mortality index utilization was important to evaluate a wider tooth loss. The impact of tooth loss on oral health-related quality of life gradients was consistent with the number and position of missing teeth. The tooth loss classification allowed to differentiating the risk indicators of each condition, age and social class were common to categories (AU)

• FAPESP's process: 09/16560-0 - Tooth Loss study in adults: impact on groups of different socio economic levels and use of dental services by applying index of tooth loss and associated factors."
• Grantee: Marília Jesus Batista de Brito Mota
• Support Opportunities: Scholarships in Brazil - Doctorate