Rehabilitation with removable dentures among the dentate population in Finland

Qualitative evaluation of elderly home residents' fixed and removable prostheses in relation to the ADL index

Functional diversity and biopsychosocial state is a significant issue, which greatly influences elderly oral health and state of fixed and removable prostheses.

OBJECTIVES

The goal of the investigation was to evaluate the quality of fixed and removable prostheses in a group of elderly home residents in relation to the ADL index.

METHODS

The group consisted of 175 institutionalised elderly, mean age 76.8 years. Special care need was assessed on ADL scale. To evaluate the quality and need for replacement of fixed and removable prostheses Karlsson's and modified Nevalainen et al. indices were used.

RESULTS

Spearman's correlation analysis showed significant correlation of ADL index scores and both Karlsson's index values (rho=-0.468, p<0.01) as well as for modified Nevalainen's indices (rho=-0.572, p<0.01). Lower ADL score was correlated with poorer oral hygiene and condition of fixed or removable dentures. It was determined that 87% of the examined patients were in objective need of fixed, removable or combined prosthodontic treatment.

CONCLUSIONS

The study showed that lower ADL index scores of functionally dependent elderly patients correlate with poorer condition of fixed and removable prostheses and greater need of fixed, removable or combined prosthodontic treatment.

Occurrence of periodontal pockets and oral soft tissue lesions in relation to sulfuric acid fumes in the working environment

The effect of inorganic acid fumes from the working environment on the occurrence of periodontal pockets and soft oral tissues was investigated in a cross-sectional, blind study. A sample of 186 workers was drawn from 4 factories. Of the 170 participants, 82 were working in departments containing acid fumes, and 88 controls had never worked under such conditions. Of the workers exposed to acid fumes 36.9% and of the controls 30.9% had periodontal pockets. The presence of periodontal pockets increased with age significantly more among the acid-exposed workers than among the controls (p less than 0.0001). Oral mucous membrane lesions were observed among 23.2% of the acid-exposed workers and 21.6% of the controls. The findings suggest that acid fumes in the workplace air do not increase the occurrence of oral mucous lesions but may lead to an increase in the prevalence of periodontal pockets.

Wearing of removable partial dentures in relation to periodontal pockets

Using a representative sample of 5028 dentulous Finnish adults the occurrence of periodontal pockets was studied separately for the maxillae and the mandibles among removable partial denture (RPD) wearers and non-wearers. RPD(s) were worn in 11.2% of the 3444 maxillae with at least four natural teeth remaining, and in 7.7% of the 4706 corresponding mandibles (P less than 0.001). Periodontal pockets were more frequently observed in maxillae than mandibles. Wearing of RPDs highly significantly (P less than 0.0001) increased the odds of having periodontal pockets in general (4 mm or more) as well as the odds of having deeper periodontal pockets (exceeding 6 mm). This phenomenon was observed both in the maxillae and in the mandibles. These results suggest that wearing of RPD is a threat to periodontal tissues and that dentists should take care to frequently recall their patients fitted with RPD(s). During the recall visits more attention should be paid to the periodontal conditions of patients wearing RPD(s).

Wearing of removable partial dentures in relation to dental caries

Using a representative sample of 5028 dentulous Finnish adults the occurrence of dental caries was studied among removable partial denture (RPD) wearers and non-wearers. Of the subjects wearing no RPD(s) 61.4% had one or more carious teeth, among those wearing a single RPD the figure was 60.5% and among those wearing RPDs in both jaws 62.7%, respectively. When sociodemographic background, other oral status measures than caries and oral health care habits were simultaneously controlled, subjects wearing RPDs in both jaws had slightly increased (P less than 0.05) probability of having one or more carious teeth compared to those with no RPD(s). Subjects with a single RPD did not have a statistically significantly increased probability of having carious teeth. Among those 3075 subjects who had one or more carious teeth the wearing of one or two RPDs did not significantly increase the number of carious teeth. Because the subjects wearing RPDs in both jaws were seen to have a slightly increased risk of having caries, this confirms the view that dentists should emphasize good oral hygiene habits and regular dental attendance among RPD wearers.