Social network, social support and dental status in elderly Swedish men

Associations between psychological stress, discrimination, and oral health-related quality of life: the buffering effects of social support networks

Stress and discrimination negatively affect quality of life, but social support may buffer their effects. This study aims: (1) to examine the associations between psychological stress, discrimination, and oral health-related quality of life (OHRQoL); and (2) to assess whether social support, stress and discrimination interact to modify their associations with OHRQoL. We used cross-sectional household-based data from a study including 396 individuals aged 14 years and over from families registered for government social benefits in a city in Southern Brazil. OHRQoL was measured with the Oral Impacts on Daily Performance (OIDP) scale; psychological stress was assessed with the Perceived Stress Scale (PSS); social support was assessed based on the number of close relatives or friends of the participant, and discrimination was assessed with a short version of the Everyday Discrimination Scale. Interactions were estimated using the relative excess of risk due to interaction (RERI). Adjusted effects were calculated with logistic regression. The prevalence of oral impacts among people with higher and lower PSS scores was 81.6% and 65.5%, respectively (p < 0.01). Social support was found to have no interactions with stress levels and discrimination. The association between social discrimination and OHRQoL (OIDP score > 0) was OR = 2.03 (95%CI: 1.23; 3.34) among people with a low level of stress, but was OR = 12.6 (95%CI: 1.31; 120.9) among those with higher levels (p = 0.09, for interaction). Individuals who reported experiencing higher levels of psychological stress and discrimination had worse OHRQoL; a synergistic effect with social support was not clear.

Perceived Stress, Social Support, and Dry Mouth Among US Older Chinese Adults

OBJECTIVES

Dry mouth is a common condition among older adults that negatively influences oral health, general health, and quality of life. The role of psychosocial factors in oral health conditions and diseases remains largely unknown. We conducted a study to examine the relationship between perceived stress and dry mouth among US older Chinese adults and further investigated the potential moderating role of social support and social strain from different sources in the relationship.

DESIGN

Cross-sectional analysis.

SETTING

Baseline of the Population Study of Chinese Elderly in Chicago, a community-engaged, population-based longitudinal study of health and well-being among community-dwelling US older Chinese adults.

PARTICIPANTS

Individuals 60 years or older (N = 3157).

MEASUREMENTS

Perceived stress was measured by the 10-item Chinese Perceived Stress Scale to evaluate the degree to which life situations were perceived as stressful during the preceding month on a 5-point scale, ranging from 0 ("never") to 4 ("very often"). Dry mouth was a binary self-reported outcome variable (1 = "dry mouth"). Social support was measured by the Health and Retirement Study's social support and strain scale from sources including spouse, other family members, and friends with a 3-point response set, ranging from 0 ("hardly ever") to 2 ("often"). Sociodemographics and disease processes were assessed as covariates. We conducted stepwise logistic regressions with interaction terms.

RESULTS

Having higher levels of perceived stress was significantly associated with a higher likelihood of reporting dry mouth (odds ratio = 1.03; 95% confidence interval = 1.02-1.04). The effect of perceived stress on dry mouth may vary by levels of family and friend support.

CONCLUSION

Perceived stress may influence dry mouth either directly or indirectly. To prevent or reduce dry mouth, in addition to disease processes, interventions need to consider psychosocial factors in dry mouth, especially perceived stress and social support, in this growing population. J Am Geriatr Soc 67:S551-S556, 2019.

Impact of Seniors Centers on oral health-related quality of life of older adults

OBJECTIVE

This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC).

METHODS

Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics—Sense of Coherence (SOC), anxiety and depression using HADS, happiness—, and oral clinical evaluation—use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05).

RESULTS

In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0–4.2) for older adults who did not participate in SC.

CONCLUSION

Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.

Patient-reported effect in patients receiving implant or tooth-supported fixed prosthesis

OBJECTIVES

To compare the patient-reported effect of treatment with implant-supported fixed prosthesis (ISFP) and fixed dental prosthesis (FDP) in patients with a small number of tooth losses to replace.

METHODS

From a population of 155 patients receiving either ISFP or FDP, 68 patients were matched in pairs based on gender, number of teeth replaced, zone of replacement, age and number of remaining teeth. The patient-reported effect was prospectively obtained by measuring change in the short-form oral health impact (OHIP-14) from before to one month after treatment. Effect size (ES), standardised response mean (SRM) and a minimal important difference of two units were applied to estimate the magnitude of the change.

RESULTS

Both the ISFP and FDP groups decreased significantly in OHIP-14 after treatment (P < .01). The change was not significantly different between the ISFP and FDP groups. The magnitude of the change was for both treatments moderate and slightly higher in the ISFP group (ES = 0.52 and SRM = 0.58) than in the FDP group (ES = 0.48 and SRM = 0.47). Applying the minimal important difference showed that 23 participants in the ISFP group and 21 in the FDP group had good effect.

CONCLUSIONS

The patient-reported effect of treatment with ISFP or FDP was similar, clinically meaningful and of moderate magnitude in patients with a small number tooth losses to replace.

Associations between tooth loss, prostheses and self-reported oral health, general health, socioeconomic position and satisfaction with life

OBJECTIVES

To investigate whether the location of tooth loss and prosthesis are associated with self-reported oral health, general health, socioeconomic position and satisfaction with life.

METHODS

From the Copenhagen Aging and Midlife Biobank (CAMB) investigation, 1517 persons had their oral status ranked (full dentition, fixed prosthesis in the masticatory zone, tooth loss in the masticatory zone, fixed prosthesis in the aesthetic zone, removable prosthesis, tooth loss in the aesthetic zone). Self-reported oral health, general health, socioeconomic position and satisfaction with life were obtained. Information on gender, normative socioeconomic position, frequency of seeing a dentist, acute dental treatment within the last 5 years and general diseases was also recorded.

RESULTS

Patients with tooth loss in the aesthetic zone and removable prosthesis showed high odds ratios for reporting poor rather than good oral health compared to patients having a full dentition. Having a removable prosthesis was further associated with rating socioeconomic position as low rather than high (odds ratio = 27.7 [95% CI: 5.07; 151.6]) compared to a full dentition after controlling for normative socioeconomic position and gender. In the bivariate analyses, a tendency towards poorer general health and poorer satisfaction with life was found with worse oral status, meanwhile the multiple regression analyses did not show significant associations between oral status and general health and satisfaction with life.

CONCLUSIONS

Missing teeth and having prostheses are associated with worse self-reported oral health compared to having a full dentition. Removable dental prosthesis may be associated with a worse self-perception of socioeconomic status.

The prevalence of edentulism and their related factors in Indonesia, 2014/15

BACKGROUND

Little information exists about the loss of all one's teeth (edentulism) among older adults in Indonesia. The aim of this study was to investigate the prevalence of edentulism and associated factors among older adults in Indonesia.

METHOD

This study examines the self-reported prevalence of edentulism and associated factors among older adults (50 years and older) in a cross-sectional national study using the Indonesia Family Life Survey IFLS-5, 2014/15. The community-based study uses a multi-stage stratified sampling design to interview and assess household members, with a household response rate of over 90%.

RESULTS

The overall prevalence of edentulism was 7.2, 29.8% in 80 years and older and 11.8% in those with no formal education. In adjusted Poisson regression analysis, older age, living in five major island groups and having functional disability were associated with edentulism. In addition, among men, having quit and current tobacco use and among women, having low social capital were associated with edentulism. Further, in adjusted analysis, among men, edentulism was positively associated with hypertension and negatively associated with diabetes, and among women, edentulism was associated with functional disability.

CONCLUSIONS

Results suggest that overall and/or among men or women that older age, living in five major island groups, having functional disability, tobacco quitters and users and those with low social capital was associated with edentulism. The identified associated factors of edentulism may be utilized in oral health programmes targeting older adults in Indonesia.

Factors Affecting Older Persons' Ability to Manage Oral Hygiene: A Qualitative Study

A great challenge for the dental service is to support the growing group of elderly people with preserving good oral health throughout their lives. Limitations in the ability to manage oral hygiene and an increased number of risk factors are often reflected by poor oral health. Thus, the need for individualized support and oral health procedures based on the older person's condition is significant. Deficiencies in the motor skills needed to manage oral hygiene are well known, but other factors that affect the ability are not well studied. The aim of the present study was to identify factors that may affect an elderly person's ability to perform oral hygiene self-care, which is the first step to develop a more comprehensive "oral hygiene ability index." The design of the study was qualitative. Data were collected from 4 focus group interviews with a total of 23 participants. Three of the groups consisted of dental hygienists, occupational therapists, and assistant nurses, all working with elderly persons. The fourth group was made up of elderly people (72-89 years). Content analysis was used to analyze the data. The latent content was formulated into the core category, "oral hygiene-a complex activity." Three categories emerged: "psychological," "environmental," and "functional" dimensions. The psychological dimension described attitude/motivation, emotions, and cognitive factors. The environmental dimension included practical conditions and social context. The functional dimension dealt with bodily and oral function as well as the senses. In conclusion, self-care with respect to oral hygiene is a complex activity for elderly persons and includes a large number of factors. These factors should be taken into consideration when developing a future oral hygiene ability index. Knowledge Transfer Statement: Various factors may affect the ability to manage oral hygiene self-care. Impaired ability to manage oral hygiene, in combination with an increased number of risk factors, often results in deteriorating oral health and impaired quality of life in older persons. Factors necessary to manage oral hygiene were identified in a qualitative study of dental hygienists, occupational therapists, and assistant nurses, all working with elderly patients, and a group of elderly persons. The results of this study may be important for clinical oral health work with older patients and for the planning of oral health and social care interventions for the growing group of older people.

[Prospective study on tooth loss in a cohort of dentate elderly]

The aim of this study was to assess factors associated with tooth loss in elderly 60 years or older during a four-year observation period. A representative cohort of dentate elderly from the city of São Paulo, Brazil, participated in the study. The outcome was teeth loss incidence from 2006 to 2010. Demographic and socioeconomic characteristics, health services access and use, behavior, reported diseases, cognitive status, functional status, state of dentition, and use of dental prosthesis were recorded as independent variables in 2006 and the outcome was measured in 2010. Negative binomial regression models were used. Participation included 440 dentate elderly. Increased likelihood of tooth loss was associated with use of two removable prostheses (RR = 1.57; 95%CI: 1.02-2.41), fair self-rated oral health (RR = 1.62; 95%CI: 1.11-2.36), bad/very bad self-rated oral health (RR = 1.87; 95%CI: 1.11-3.17), male gender (RR = 1.74; 95%CI: 1.28-2.37), and living alone (RR = 2.03; 95%CI: 1.11-3.72).

Impact of Dental Disorders and its Influence on Self Esteem Levels among Adolescents

INTRODUCTION

Self esteem is more of a psychological concept therefore, even the common dental disorders like dental trauma, tooth loss and untreated carious lesions may affect the self esteem thus influencing the quality of life.

AIM

This study aims to assess the impact of dental disorders among the adolescents on their self esteem level.

MATERIALS AND METHODS

The present cross-sectional study was conducted among 10 to 17 years adolescents. In order to obtain a representative sample, multistage sampling technique was used and sample was selected based on Probability Proportional to Enrolment size (PPE). Oral health assessment was carried out using WHO type III examination and self esteem was estimated using the Rosenberg Self Esteem Scale score (RSES). The descriptive and inferential analysis of the data was done by using IBM SPSS software. Logistic and linear regression analysis was executed to test the individual association of different independent clinical variables with self esteem.

RESULTS

Total sample of 1140 adolescents with mean age of 14.95 ±2.08 and RSES of 27.09 ±3.12 were considered. Stepwise multiple linear regression analysis was applied and best predictors in relation to RSES in the descending order were Dental Health Component (DHC), Aesthetic Component (AC), dental decay {(aesthetic zone), (masticatory zone)}, tooth loss {(aesthetic zone), (masticatory zone)} and anterior fracture of tooth.

CONCLUSION

It was found that various dental disorders like malocclusion, anterior traumatic tooth, tooth loss and untreated decay causes a profound impact on aesthetics and psychosocial behaviour of adolescents, thus affecting their self esteem.

Social and health-related factors associated with refraining from seeking dental care: A cross-sectional population study

BACKGROUND

Social inequities are considered to affect healthcare utilization, whereas less is known about the factors associated with refraining from seeking dental care. This study aimed to investigate whether people with no social support, long-term illness, caregiver burden and low socioeconomic status (SES) refrained from seeking dental care in higher proportion than the general Swedish population.

METHODS

This study used cross-sectional questionnaire data from repeated nationwide health surveys during 2004-2013 of a total of 90 845 people. The questionnaire included questions on demographic characteristics, social support, long-term illness, caregiving burden, SES and dental care-seeking behaviour. Descriptive statistics, chi-square tests, correlation analyses and logistic regressions were used to investigate associations between independent variables and dental care-seeking behaviour.

RESULTS

In the total sample, 15.1% of respondents reported refraining from seeking dental care. Having no emotional social support or having no instrumental social support was separately associated with reporting refraining from seeking dental care in adjusted multivariate models (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.18-1.34 and OR: 1.89, 95% CI: 1.67-2.13, respectively). Having a long-term illness was associated with refraining from seeking dental care in adjusted models (adjusted OR: 1.43, 95% CI: 1.35-1.51). Furthermore, being an informal caregiver was associated with refraining from seeking dental care (adjusted OR: 1.15, 95% CI: 1.07-1.23). Low SES was associated with higher refraining from seeking dental care; the strongest association was with having financial problems (adjusted OR: 3.57, 95% CI: 3.19-4.00). Interaction effects were found between education level and SES, and between social support and long-term illness, and the outcome.

CONCLUSIONS

The findings in this study imply that having no social support, having long-term illness, being informal caregiver or having financial problems are factors associated with reporting refraining from seeking dental care, on a population basis.

Oral health-related quality of life in socially endangered persons in Copenhagen, Denmark

OBJECTIVE

The aims of this study were to investigate and describe the Oral Health Related Quality of Life (OHRQoL) in a socially endangered group of people and to compare the OHRQoL to other patient groups.

MATERIAL AND METHODS

About 294 socially endangered persons attending a volunteer clinic in Copenhagen Denmark filled in the OHIP-14 questionnaire. The group was compared in mean score and reported problems to a group of patients with tooth loss and about to have a removable dental prosthesis (RDP), a group with tooth loss about to have a fixed dental prosthesis (FDP) and a control group without tooth loss.

RESULTS

Significantly higher OHIP-14 score was seen in the socially endangered group (15.5 (SD 12.6)) compared with the control (1.9 (SD 2.7)) and the FDP group (9.4 (SD 8.2)) but not the RDP group (13.1 (SD 10.5)). This difference was not changed after stratifying in age groups. Problems related to psychological disability, social disability, and handicap were more frequent in the social endangered group than for the other groups. The items pain, tense, diet, relax, life, and function stand out as problems in the socially endangered group compared to the other groups.

CONCLUSION

The OHRQoL is highly impaired in the socially endangered persons and at least to the level of persons with great tooth loss about to have an RDP. The problems seem to be more handicapping in the socially endangered compared with other patient groups known to have high impairment.

Discontinued dental attendance among elderly people in Sweden

Aim:

Our objective was to study the loss of dental attendance and a possible age trend among patients aged ≥65 years in Sweden. Regular dental check-ups are considered to be an important factor in maintaining oral health. Approximately 80% of the adult population in Sweden are enrolled in a regular check-up system; however, dental practitioners often find that older patients attend fewer check-ups. Old people may naturally lose contact with dental services as they move to special housing or die. In this systematic study, these factors were investigated and used as exclusion criteria.

Materials and Methods:

Data were collected for all patients (n = 4759) aged 65 or older from the electronic journal system in 3 large public dental clinics in 3 communities. Their dental records for the years 2004–2009 were studied longitudinally by 1 person at each clinic; 1111 patients were excluded (patients died during study period, wanted emergency care only, obtained special dental care allowance, moved from the community or moved to special housing, or left the clinic for another caregiver). The statistical analyses were performed using the Statistical Package for the Social Sciences version 21 (IBM).

Results:

Of the 3648 patients (1690 men and 1958 women) included in the study, 13% lost contact with their dental service over the course of the study (10% of those were aged 65–79 and 21% ≥80). The decrease in regular dental contact had a statistically significant association with increasing age (P < 0.001).

Conclusion:

A considerable number of older people living independently or with moderate supportive care in their own homes lost contact with dental service despite enrolment in a recall system.

Edentulism and quality of life among older Ghanaian adults

Background

Edentulism affects the quality of life and general health of an individual. But in ageing individuals, it has been observed to have greater impact, manifesting in functional, psychological and social limitations. With an increasing older adult population in Ghana, its burden is likely to increase. This study was thus carried out to explore the association between edentulism and quality of life among older Ghanaian adults.

Methods

Secondary analysis of WHO’s Study on global AGEing and adult health (SAGE) Wave 1 in Ghana was conducted using self-reported edentulism as the dependent variable. Participants included a nationally representative sample of adult’s aged 50 years and older living in Ghana. Quality of life was measured using the 8 item WHOQOL measure and a single item measure which was a question “How would you rate your overall quality of life?”. To assess the association between edentulism and the independent variables, a bivariate analysis was carried out. A Poisson regression model was then performed, adjusting for age, sex, income, education and the diagnosis of a chronic disease condition. A Spearman’s correlation analysis was also carried out between the single and multi item measure of quality of life to assess how well they correlate.

Results

Edentulism was observed to be associated with significantly lower levels of SWB among older adults using both the single-item and multiple-item measure (WHOQOL). It, however, showed no association with happiness. Among edentulous respondents, females and those with no formal education reported significantly lower quality of life. The WHOQOL correlated positively and strongly with the single-item measure.

Conclusion

Edentulism may not be life threatening and yet it has been shown to have a negative effect on the quality of life of older adult Ghanaians. More emphasis may thus need to be placed on the oral health of the aging population in Ghana to avoid it.

Prevalence of loss of all teeth (edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa

Little information exists about the loss of all one’s teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO’s) Study on global AGEing and adult health (SAGE) Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367), Ghana (N = 4724), India (N = 7150), Mexico (N = 2315), Russian Federation (N = 3938) and South Africa (N = 3840). Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%–21.7%) than China, Ghana, and South Africa (3.0%–9.0%). In multivariate logistic analysis sociodemographic factors (older age, lower education), chronic conditions (arthritis, asthma), health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption) and other health related variables (functional disability and low social cohesion) were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention.

Influence of negative affectivity and self-esteem on the oral health related quality of life in patients receiving oral rehabilitation

Background

The aim of this study was to investigate if and how the personality traits Negative Affectivity (NA) and self-esteem influenced the Oral Health Related Quality of Life (OHRQoL) in patients receiving oral rehabilitation.

Methods

OHRQoL was measured by the Oral Health Impact Profile 49 (OHIP-49), NA with a short form of the Eysenck Personality Inventory Questionnaire (EPI-Q), and self-esteem with Rosenbergs Self-Esteem Scale (RSES) in 66 patients treated with removable dental prosthesis (RDP). The minimally important difference (MID), effect size (ES), and standard error of the measurement (SEM) were used to clinically interpret the patient-reported effect.

Results

The OHIP-49 score was significantly higher and exceeded the MID pre- and post-treatment in participants with high EPI-Q and low RSES score compared to participants with low EPI-Q and high RSES score. The improvement in OHIP-49 score was significant and not limited by high EPI-Q and low RSES score. High EPI-Q score was associated high improvement in OHIP-49 score and the ES of the improvement in participants with high EPI-Q was large and exceeded the MID and SEM.

Conclusion

Treatment with RDP improves the OHRQoL regardless of level of NA and self-esteem. High NA is associated with a large effect, but both high NA and low self-esteem is associated with poorer OHRQoL both before and after treatment.

Social relationships and oral health among adults aged 60 years or older

OBJECTIVE

This study assessed associations between social relationships and oral health outcomes and whether these associations were explained by demographic, socioeconomic, and behavioral factors, and physical health.

METHODS

We used the National Health and Nutrition Examination Survey (1999-2004) data on 4014 adults aged 60 years or older. Oral health outcomes were edentulism, number of decayed teeth, root decay, number of sound or filled teeth, and self-rated oral health. Social relationships referred to social networks (marital status, number of close friends) and social support (emotional support need, provision of financial support). Analyses consisted of regression models sequentially adjusting for demographic, socioeconomic, behavioral, and physical health confounders.

RESULTS

In fully adjusted models, widowed or divorced/separated individuals had fewer sound or filled teeth than those married or living with a partner: rate ratio (95% confidence interval)=0.89 (0.82 to 0.97) and 0.90 (0.83 to 0.97), respectively. People with four to six close friends had fewer decayed teeth and lower probability for root decay than those with fewer friends. Emotional support need was associated with 1.41 (1.05 to 1.90) higher odds for root decay and 1.18 (1.04 to 1.35) higher odds for poorer self-rated oral health. Lack of financial support was associated with more decayed teeth. Edentulism was not related to any social network and social support markers.

CONCLUSIONS

Social relationships are associated with clinical measures of current disease, markers of good oral function, and subjective oral health, but not with clinical measures of a lifetime history of oral disease among older Americans.

Oral health-related quality-of-life in patients to be treated with fixed or removable partial dental prostheses

OBJECTIVES

The aims of this study were to measure and describe the Oral Health-Related Quality-of-Life (OHRQoL) in a population about to receive removable dental prostheses (RDP) or fixed dental prostheses (FDP).

MATERIALS AND METHODS

The Oral Health Impact Profile 49 (OHIP-49) was completed by 410 patients about to receive treatment with either RDP or FDP. Objective variables were: gender, age, number of teeth, type of replacement planned (FDP/RDP) and location (one jaw or both) and zone (aesthetic/masticatory/both) of missing teeth to be replaced.

RESULTS

Women had a worse OHRQoL than men in the RDP group. Higher age was significantly correlated with a better OHRQoL independent of treatment modality. Participants about to receive FDP in one jaw in the masticatory zone only had a better OHRQoL than RDP participants in the same group. The most frequently reported problems in all groups concerned functional limitations, discomfort and physical disabilities. Little variance in reported items was seen between the sub-groups and social handicap was not frequently reported.

CONCLUSIONS

The difference in OHRQoL between participants about to receive RDP and FDP was limited. The most frequently reported problems concerned functional limitations, discomfort and physical disabilities. Social handicap was not frequently reported.

Influence of self-esteem and negative affectivity on oral health-related quality of life in patients with partial tooth loss

To meaningfully interpret oral health-related quality of life (OHRQoL) measures, the influence of personality traits must be investigated.

OBJECTIVES

To investigate and quantify the influence of self-esteem and negative affectivity (NA) on OHRQoL. It was hypothesized that low self-esteem and high NA would be associated with worse OHRQoL.

METHODS

OHRQoL measured by the Oral Health Impact Profile 49 (OHIP-49), self-esteem measured by the Rosenberg Self-Esteem Scale (RSES), NA measured by the Eysenck Personality Inventory Questionnaire (EPI-Q), global oral rating of oral comfort and controlling variables (gender, age, number of teeth, experience of wearing removable dental prostheses (RDP), location of missing teeth and zone of missing teeth) were collected from 81 patients with partial tooth loss, signed in for treatment with RDP.

RESULTS

Bivariate analyses showed that the EPI-Q score had the highest correlation with OHIP-49 score (R = 0.5). Both EPI-Q and RSES score had a stronger correlation with psychosocial items than physical/functional items of the OHIP-49. In the multivariate analyses, the controlling variables alone explained 17.75% of the variance in OHIP-49 score, while addition of EPI-Q score, RSES score and both EPI-Q and RSES score explained additionally 11.64%, 6.07% and 14.12%, respectively. For each unit increase in EPI-Q score, the OHIP-49 score increased 5.1 units and for each unit increase in RSES score, the OHIP-49 score decreased 1.1. NA was statistically and clinically significantly higher and self-esteem was statistically significantly lower in patients reporting worse oral comfort.

CONCLUSION

NA had the strongest and most clinically meaningful influence, but both NA and self-esteem was found to influence OHRQoL; low self-esteem and high NA was associated with worse OHRQoL. This indicates the possibility to explain some of the impact of tooth loss on OHRQoL based on personality traits.

Social Relationships and Dental Care Service Utilization Among Older Adults

Objectives: This study described the association between dental care service utilization and two domains of social relationships (social integration and social support) among older adults. Methods: The study employed data from the 2008 Health and Retirement Study, examining regression models for whether a person visited a dentist in the past 2 years, including adjustments for demographic, socioeconomic, and health characteristics. Results: Social interaction, social participation, neighborhood cohesion, and marital status were related to an increased likelihood of having visited a dentist. Older persons exhibiting loneliness and having received financial aid from network members demonstrated a decreased likelihood of visiting a dentist. The increased likelihood of visiting a dentist when a child lives nearby only occurred after introducing health covariates. Discussion: The article discusses the implications of the study findings as they relate to social relationships and oral health and recommends some additional research directions to explore the etiology of dental care use.

Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks

Background

Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks.

Methods

A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group - employed women with paid work, and, 2. home-based social network group - women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class.

Results

There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥4 [OR 1.73 (95% CI: 1.23-2.42)].

Conclusions

Pregnant and post-partum Brazilian women in paid employment outside the home and having social supports had better OHRQoL than those with home-based social networks.

The relationship between social network, social support and periodontal disease among older Americans

AIM

The objectives of this study were to examine the relationship between social network, social support and periodontal disease among older American adults and to test whether social network and support mediates socioeconomic inequality in periodontal disease.

MATERIALS AND METHODS

Data pertaining to participants aged 60 years and over from the National Health and Nutrition Examination Survey 2001-2004 were used. Periodontal disease variables were extent loss of periodontal attachment ≥3 mm and moderate periodontitis. Social support and networks were indicated by the need for emotional support, number of close friends and marital status.

RESULTS

Widowed and those with lowest number of friends had higher rates of the extent of loss of periodontal attachment (1.27, 95% CI: 1.03, 1.58) and (1.22, 95% CI: 1.03, 1.45), respectively. Marital status and number of friends were not significantly associated with moderate periodontitis after adjusting for behavioural factors. The need for more emotional support was not related to periodontal disease in this analysis. Social networks and support had no impact on socioeconomic inequality in periodontal disease.

CONCLUSION

Certain aspects of social network, namely being widowed and having fewer friends, were linked to the extent of loss of periodontal attachment but not to the definition of moderate periodontitis, in older adults.

Gender-dependent associations between socioeconomic status and tooth loss in working age people in the Study of Health in Pomerania (SHIP), Germany

OBJECTIVES

Individual impact and the effect magnitude of socioeconomic key indicators (income, education and occupation) and of gender on oral health are ambiguous. In primary analyses of cross-sectional data among participants of the Study of Health in Pomerania (north-east Germany), women with low school education and low income were at highest risk for missing teeth, whereas being single was a risk indicator for missing teeth in men. Using the 5-year follow-up of this study, we aimed at verifying these findings and at investigating the gender-dependent impact of key socioeconomic indicators on tooth loss.

METHODS

The longitudinal data originate from 1971 subjects (1062 women) aged 25-59 enrolled from 1997 to 2001 and again from 2002 to 2006. The effects of marital status, household income, school education and occupational prestige for tooth loss were examined by gender using negative binomial regression analyses.

RESULTS

Low education and low income were moderately [relative risks (RR) between 1.6 and 2.0] associated with tooth loss among both women and men, whereas occupational prestige was not. After multiple imputations of missing data, less-educated women with lower income exhibited the highest risk of tooth loss [RR=3.1; 95% confidence interval (CI)=1.7-5.5 for <10 years of school education and the lowest income tertile] and tooth loss was more likely in single men (RR=1.5; 95% CI=1.0-2.2) than in single women (RR=0.9; 95% CI=0.6-1.3).

CONCLUSIONS

The primary cross-sectional results were partly confirmed. Socioeconomic factors help to explain differences in tooth loss, although the causal pathways are speculative. To improve dental health, the policies should target not only the individual, e.g. oral health promotion, but also an entire population by better education and higher wage employment.

Differences in self-reported oral health among community-dwelling black, Hispanic, and white elders

OBJECTIVE

To compare differences in self-rated oral health among community-dwelling Black, Hispanic, and White adults aged 60 and older.

METHOD

A total of 4,859 participants in the National Health and Nutrition Examination Survey (1999-2004) provided self-report information on oral health.

RESULTS

Blacks and Hispanics reported poorer self-rated oral health than Whites. In separate dentate and edentulous groups, socioeconomic status, social support, physical health, clinical oral health outcomes, and dental checkups accounted for much of the difference in self-rated oral health in Blacks, but significant differences remained for Hispanics.

DISCUSSION

The study findings may have important implications for health policy and program development. Programs and services designed for minority populations should target treatments for dental diseases and include components that take into account subjective evaluations of oral health conditions and perceived dental needs of the individuals.

Why do some people lose teeth across their lifespan whereas others retain a functional dentition into very old age?

OBJECTIVES

To analyse the importance of caries, periodontitis, and medical and psychosocial factors for risk of becoming edentulous across their lifespan and to examine factors critical for retaining functional dentition into very old age.

METHODS

From the longitudinal population-based Octogenarian Twin study which analysed psychosocial and health variables, 357 individuals aged 82 + in 1995-1998 were collected. Information about number of teeth, decayed and filled surfaces percentage and periodontal disease experience were drawn from dental records. Reasons for and time of edentulousness were recorded.

RESULTS

Outcome varied - depending on perspective and factors for losing or retaining teeth. Significant factors for losing teeth varied over the lifespan. Losing teeth early in life was related to lower social class; in middle age, to lower education; and in old age, to poor lifestyle factors and low social class. Caries constituted the main reason for tooth loss (about 55%). This increased substantially in the >80 year age-group (75%). Maintaining a functional dentition into old age was significantly associated with non-smoking, more education, being married and good periodontal health.

CONCLUSION

It is important to apply life-span and cohort perspectives to oral health and disease. In our sample of persons born before World War I, caries was the main reason for losing all teeth, with substantially increased prevalence by age. Lifestyle factors were significant for losing and for retaining teeth. Periodontal condition had a significant influence on the likelihood of retaining functional dentition, and also when taking psychosocial variables into account.

Socioeconomic indicators and prosthetic replacement of missing teeth in a working-age population--results of the Study of Health in Pomerania (SHIP)

OBJECTIVES

To analyse the possible effects of the socioeconomic status (SES) on the prosthetic replacement of missing teeth in working-age people and to explore the role of potential confounders.

METHODS

Cross-sectional data were collected from 2310 German adults aged 30-59 years. The relationship between each of the three SES indicators (education, income, and occupational status) and dental prostheses were examined by multinomial logistic regression analyses. For that, partially dentate participants with suboptimal and no replacement of missing teeth were compared with partially dentate participants having optimal replacement. Potential confounders (age, sex, dental status, social network and social support) were entered if their inclusion in the model led to >or= 10% change in the coefficient of interest.

RESULTS

Social network and social support did not meet the criterion for confounding. In the maxilla, having no replacement was positively associated with lower categories for each of the three SES indicators [Odds ratios (OR) between 1.6 and 2.1; 95% confidence intervals (CI) between 1.1 and 3.4]. Low occupational status was the single predictor for suboptimal dental prostheses (OR=3.2; 95% CI: 1.6-6.2). In the mandible, occupational status showed no association with the prosthetic status, whereas low educational level and low household income were determinants for having no replacement (OR=1.9 and 1.9, 95% CI: 1.0-3.5 and 1.1-3.0, respectively). Low household income was the single determinant for suboptimal replacement of missing teeth (OR=2.4, 95% CI=1.1-5.2).

CONCLUSION

The findings may indicate the relevance of the financing of prosthodontic treatment. The strong association between various forms of upper dentures and occupational prestige can be seen as key contributing concept to how individuals' characteristics affect the outcome in prosthodontic care.

Tooth loss and subsequent disability and mortality in old age

OBJECTIVES

To examine whether tooth loss at age 70 is associated with onset of disability at 5-, 10-, 15-, and 20-year follow-up and to mortality at 21-year follow-up.

SETTING

Community-based population in Copenhagen.

DESIGN

A baseline study of a random sample of 70-year-old people born in 1914 and follow-up 5, 10, 15, and 20 years later.

PARTICIPANTS

A total of 573 nondisabled individuals participated in the study of 70-year-olds in 1984, 460 participated in the 5-year follow-up, 292 in the 10-year follow-up, 150 in the 15-year follow-up, and 78 in the 20-year follow-up.

MEASUREMENTS

Data from interviews and a medical and oral examination. Oral health was measured according to number of teeth (0, 1-9, 10-19, > or = 20). Disability was measured using the Avlund Mob-H scale at age 75, 80, 85, and 90. Mortality data were obtained from the National Death Register.

RESULTS

Being edentulous or having one to nine teeth was associated with onset of disability at age 75 and 80. Health-related variables and education attenuated the associations between edentulism and onset of disability, although they remained marginally significant, whereas the association between having one to nine teeth and onset of disability remained unchanged and statistically significant at 10-year follow-up (odds ratio=3.02, 95% confidence interval (CI)=1.26-7.24). Persons who were edentulous at age 70 were at significantly higher risk of mortality 21 years later, also in the adjusted analysis (hazard ratio=1.26, 95% CI=1.03-1.55).

CONCLUSION

Tooth loss is independently associated with onset of disability and mortality in old age. The findings indicate that tooth loss may be an early indicator of accelerated aging.

Inequity in access to dental care services explains current socioeconomic disparities in oral health: the Swedish National Surveys of Public Health 2004-2005

OBJECTIVE

To analyse the effects of socioeconomic disadvantage on access to dental care services and on oral health. Design, setting and outcomes: Cross-sectional data from the Swedish National Surveys of Public Health 2004 and 2005. Outcomes were poor oral health (self-rated oral health and symptoms of periodontal disease) and lack of access to dental care services. A socioeconomic disadvantage index (SDI) was developed, consisting of social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves.

PARTICIPANTS

Swedish population-based sample of 17 362 men and 20 037 women.

RESULTS

Every instance of increasing levels of socioeconomic disadvantage was associated with worsened oral health but, simultaneously, with decreased utilisation of dental care services. After adjusting for age, men with a mild SDI compared with those with no SDI had 2.7 (95% confidence interval (CI) 2.5 to 3.0) times the odds for self-rated poor oral health, whereas odds related to severe SDI were 6.8 (95% CI 6.2 to 7.5). The corresponding values among women were 2.3 (95% CI 2.1 to 2.5) and 6.8 (95% CI 6.3 to 7.5). Nevertheless, people with severe socioeconomic disparities were 7-9 times as likely to refrain from seeking the required dental treatment. These associations persisted even after controlling for living alone, education, occupational status and lifestyle factors. Lifestyle factors explained only 29% of the socioeconomic differences in poor oral health among men and women, whereas lack of access to dental care services explained about 60%. The results of the multilevel regression analysis indicated no additional effect of the administrative boundaries of counties or of municipalities in Sweden.

CONCLUSIONS

Results call for urgent public health interventions to increase equitable access to dental care services.

What is the prevalence of various types of prosthetic dental restorations in Europe?

OBJECTIVES

The aim of this review was to analyse the prevalence of prosthetic dental restorations in the adult population in Europe and to investigate factors influencing the frequencies of fixed restorations and removable dental prostheses (RDP).

MATERIAL AND METHODS

A search for literature up to 31 October 2006 on dental restorations was performed in Medline via PubMed and in an additional hand search using several keywords related to epidemiology and dental restorations. Out of approximately 6000 titles listed, 136 articles were identified, which were related to 13 different European countries. 43 articles fulfilled the inclusion criteria and were included in this review.

RESULTS

Approximately half of the adult population in most European countries have had some type of prosthetic dental restoration. The frequency of RDPs among adults varied between 13 and 29%, with 3-13% edentulous subjects wearing complete dentures in both jaws. The frequency of fixed restorations including crowns and fixed dental prostheses (FDPs, bridges) was the highest in Sweden with 45% and Switzerland (34%). In the recent decades, there has been a slight decrease in RDP use reflecting a decline in edentulism, while more subjects had maintained a residual dentition and were wearing removable partial dentures or fixed restorations. The latter are less prevalent in countries with lower prosperity. If only a few teeth are absent, these are generally replaced with FDPs or have no replacement. If more teeth are missing, the likelihood of a removable restoration increases with the number of teeth to be replaced. A higher frequency of removable restorations is present in older age groups, in subjects living in rural areas, in those from a lower socio-economic status and in subjects with less education and lower incomes.

CONCLUSIONS

All types of fixed and removable restorations are highly prevalent, especially among older age groups, in most European countries. There is a trend towards higher frequencies of fixed restorations, more removable partial dentures and a reduction in complete dentures.

What are the longevities of teeth and oral implants?

OBJECTIVE

To analyse tooth loss and to evaluate the longevity of healthy teeth and teeth compromised by diseases and influenced by therapy as well as that of oral implants.

MATERIAL AND METHODS

On the basis of an electronic and manual search using key words for survival, success, longevity of teeth, longevity of implants, epidemiology, periodontally compromised, endodontically compromised, risk for tooth extraction 49 full-text articles were identified to construct a traditional review. Among these, six systematic reviews addressing longevity were found.

RESULTS

Tooth loss is a complex outcome, it is influenced by the extent of dental caries and its sequelae and/or the presence or absence of periodontitis as well as the decisions taken by dentists when evaluating possible risk factors for rendering successful therapy. In addition, tooth loss is related to behavioural and socio-economic factors and associated morbidity and cultural priorities. Generally, teeth surrounded by healthy periodontal tissues yield a very high longevity (up to 99.5% over 50 years). If periodontally compromised, but treated and maintained regularly, the survival of such teeth is still very high (92-93%). Likewise, endodontically compromised, but successfully treated devital teeth yield high survival and success rates. The survival of oral implants after 10 years varies between 82% and 94%.

CONCLUSIONS

Teeth will last for life, unless they are affected by oral diseases or service interventions. Many retained teeth thus may be an indicator of positive oral health behaviour throughout the life course. Tooth longevity is largely dependent on the health status of the periodontium, the pulp or periapical region and the extent of reconstructions. Multiple risks lead to a critical appraisal of the value of a tooth. Oral implants when evaluated after 10 years of service do not surpass the longevity of even compromised but successfully treated natural teeth.

'Inadequate' dietary habits and mastication in elderly men

OBJECTIVE

The aim of this study was to re-evaluate data about oral status, mastication and nutrition in elderly men in Malmö, Sweden, recorded in 1985-1987, to assess associations between inadequate dietary habits, oral conditions and masticatory function.

MATERIALS AND METHODS

Four hundred and eighty-one men, aged 67-68, participated in a comprehensive health examination, including tooth and denture status and masticatory tests. A separate study of dietary habits and nutritional status was made. Ninety-five men had inadequate dietary habits. The databases of dental/denture status, mastication, nutritional status and social network factors were re-evaluated for assessment of associations.

RESULTS

No significant differences between those with adequate or inadequate nutrition were found with regard to the number of teeth, occlusal contacts or removable dentures. Also self-assessed chewing did not show any differences.

CONCLUSION

Inadequate dietary habits were independent of teeth and denture status. Some correlations to social network conditions could be identified. Overweight, obesity, low physical activity and high alcohol intake were more common among those with inadequate nutritional intake.

The relationship between sociodemographic factors and oral health-related quality of life in dentate and edentulous community-dwelling older adults

OBJECTIVES

To quantify the associations between sociodemographic factors and oral health-related quality of life (OHRQoL) in dentate and edentulous community-dwelling older adults.

DESIGN

Cross-sectional study using a 54-item OHRQoL questionnaire.

SETTING

Five counties in central Alabama: Jefferson and Tuscaloosa (urban), and Hale, Bibb, and Pickens (rural).

PARTICIPANTS

Two hundred eighty-eight participants (Dental Study subjects) aged 65 and older were recruited from participants in the University of Alabama at Birmingham Study of Aging, a longitudinal study of mobility in older African Americans and non-Hispanic whites.

MEASUREMENTS

Dental Study subjects were queried on their OHRQoL and sociodemographic status and classified into two categories: dentate and edentulous. Bivariate analyses were used to quantify associations between sociodemographic variables and OHRQoL after excluding participants with severe depression. Variables included age, sex, race, marital status, veteran status, residence, income, education, and transportation difficulties.

RESULTS

Dentate and edentulous subjects had similar OHRQoL across age, sex, marital status, veteran status, and residence. Analyses suggested a strong association between OHRQoL and race, education, income, and transportation difficulties in dentate subjects. Sociodemographic factors were less strongly associated with OHRQoL in edentulous participants.

CONCLUSION

OHRQoL decrements were prevalent in dentate and edentulous subjects. Of dentate persons, African Americans and those with a 6th-grade education or less, with income less than 16,000 dollars/year, and with transportation difficulties were more likely to have decrements in OHRQoL. In edentulous persons, these associations were not statistically significant or were weaker. These findings suggest differential associations between sociodemographic factors and OHRQoL when stratified according to dentate status.

Suporte social, promoção de saúde e saúde bucal na população idosa no Brasil

O crescente envelhecimento da população mundial, inclusive no Brasil, ressalta a importância de medidas para se lidar com esta situação. No Brasil, a maioria dos idosos é do sexo feminino; vive em domicílios multigeracionais; é referência econômica nos mesmos; possui baixo nível socioeconômico; portadora de, pelo menos, uma doença crônica; independente para realização das atividades da vida diária; não possui dentes, e busca atenção em saúde no SUS. Os idosos brasileiros expostos a situações de vulnerabilidade social estão sujeitos à interferência direta dos determinantes sociais no processo saúde-doença. O Suporte Social inclui políticas e redes de apoio social, que atuam como agente de integração do idoso na sociedade, minimizando os riscos de exclusão social e, conseqüentemente, de danos à sua saúde por meio de medidas de Promoção de Saúde. Este artigo aborda o Suporte Social e alguns de seus aspectos, tais como: tipo e local de residência, transporte e suporte financeiro; em idosos brasileiros e sua relação com a Promoção de Saúde.

Tooth loss and caries prevalence in very old Swedish people: the relationship to cognitive function and functional ability

OBJECTIVE

To analyse whether cognitive function and functional ability are related to oral health among community-dwelling older people over the age of 80 years.

BACKGROUND

This cross-sectional study is based on the Kungsholmen Elders Oral Health Survey (KEOHS). The study included oral examinations carried out in two local clinics by standardised examiners and interviews using structured questionnaires.

MATERIALS AND METHODS

Altogether 159 individuals were included in this study. Coronal caries and root caries were assessed using the National Institute of Dental and Craniofacial Research (NIDCR) diagnostic criteria. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) index and functional ability was assessed by a global measure of self-reported changes.

RESULTS

Older adults with a low MMSE score (< or = 23) tended to have a higher risk of coronal caries than those with higher scores. Participants with mild cognitive decline (MMSE = 24-26) and with a decrease in functional ability had a significantly higher risk of root caries. These associations changed little when adjusted by the covariates. In addition, people with a low MMSE (0-23) had a four times higher risk of not using dental services regularly. This result was unchanged after adjusting for the variables studied.

CONCLUSIONS

This study revealed associations between the cognitive and functional status of the individual and aspects of oral health, that may contribute to a deeper understanding of the background of oral health status in older adults.

Social relations as determinants of oral health among persons over the age of 80 years

OBJECTIVE

To analyze whether social relations during a 7-year follow-up influence oral health among generally healthy, community-dwelling persons over the age of 80 years.

METHOD

The present investigation is based on a subsample of 129 dentate community-dwelling individuals from The Kungsholmen Elders Oral Health Study (KEOHS), which included data from interviews and oral examinations. Social relations were measured in terms of marital status, living alone, frequency of contacts, number of confidants, and satisfaction with social contacts and with the frequency of contacts. Oral health was measured in terms of coronal caries and root caries.

RESULTS

The primary findings of the adjusted multivariate logistic regression analysis were that persons who lived alone or who became alone during the 7 years prior to the dental examination had greater odds of having coronal caries (odds ratio (OR): 2.4, 95% CI: 1.0-5.7) than those who continually lived with others, and that persons who were continuously dissatisfied with the frequency of their social contacts were more likely to have root caries than those who reported a sustained satisfaction with the frequency of their social contacts (OR: 2.9, 95% CI: 1.2-7.2).

CONCLUSION

This study suggests that social relations are related to the oral health status of old-old individuals. From a psychosocial perspective, our findings contribute to a deeper understanding of the background of oral health status in older adults.

Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children

This ecological study investigated the associations between social deprivation, income inequality and social cohesion and dental caries levels in school children of the Distrito Federal, Brazil. Three sources of data were used: (1) area-based data from a 1997 social survey carried out on 13,000 families, (2) 1995 census data collected for the Government of the Distrito Federal (GDF), and (3) dental caries data from a 1997 oral health survey on 7296 6-12-year-old school children. Results of simple linear regression showed that percent with less than eight years of education (P = 0.03) and percent who did not have a maid (P = 0.009), were negatively statistically significantly associated with the percent of children free of caries. None of the deprivation measures were statistically significantly associated with mean DMF-T scores (P > 0.05). GINI coefficient, an indicator of social inequalities, was negatively statistically significantly associated with both measures of dental caries experience, percent of caries free (P = 0.003) and mean DMF-T scores (P = 0.01). Per thousand number of homicides or attempted homicides, an indicator of social cohesion was of marginal statistical significance associated with caries experience. Results of multiple linear regression analyses showed that only the Gini coefficient remained statistically significantly associated with both dental clinical measures used, after adjusting for potential confounding. In conclusion, relative rather than absolute levels of income were stronger determinants of the onset of caries in this study.

Functional ability and oral health among older people: a longitudinal study from age 75 to 80

OBJECTIVE

To examine whether functional ability at age 75 and age 80 is associated with oral health and use of dental services cross-sectionally and whether changes in functional ability from age 75 to age 80 are associated with oral health and regular use of dental services at age 80.

DESIGN

The study included a random sample of 75-year-olds at baseline and a follow-up study 5 years later. The data are treated as two cross-sectional studies at age 75 and 80, respectively, and as a longitudinal study from age 75 to 80.

SETTING

The western part of Copenhagen County.

PARTICIPANTS

The two cross-sectional studies of 75- and 80-year-old people included 411 and 321 persons, respectively. The longitudinal study from age 75 to 80 included the 326 persons who participated in both surveys.

MEASUREMENTS

Oral health status was measured roughly by number of teeth and chewing ability. Use of dental services was measured by frequency of visits to a dentist or denturist. Functional ability was measured by two scales on mobility in relation to tiredness and need of help. Changes in mobility from age 75 to 80 is described as (1) improved or sustained good, (2) decreased, and (3) sustained poor. Gender, chronic diseases, self-rated health, socio-demographic factors, living alone, and social relations were included as possible confounders.

RESULTS

The odds ratio of having no or few teeth was 1.7 (1.1-2.6) in 75-year-old individuals who felt tired in mobility, 1.7 (1.0-2.9) in 80-year-old persons who needed help with mobility, and 2.7 (0.94-7.5) in persons with sustained need of help with mobility from age 75 to 80. The odds ratio of chewing difficulties was 1.7 (1.1-2.8) in 80-year-old people in need of help, and 1.8 (1.1-3.0) in persons age 75 to 80 needing sustained help. Dentate 80-year-old persons who felt tired in mobility had an odds ratio of 2.0 (0.94-4.2) of not using dental services.

CONCLUSIONS

The results indicate that oral impairment (e.g., having no or few teeth), oral functional limitations (e.g., chewing problems), and general functional limitations (e.g., mobility problems) are interrelated and that prevention of disabilities should be aimed at both functional limitations and oral health problems if the intention is to promote a good life in old age. In addition, the results point to the importance of taking problems in mobility seriously in delivering preventive services to old people because people who are tired or dependent on help seem to be at a higher risk of not using dental services regularly.

Prosthodontic profiles relating to economic status, social network, and social support in an elderly population living independently in Canada

STATEMENT OF PROBLEM

Previous evaluations of life satisfaction and health have not completely explained the impact of social network, social support, and economics on the oral health-related behavior of elderly patients, particularly in relation to missing teeth.

PURPOSE

This study measured the strength of associations between social network/support/class and the use of complete and removable partial dentures in elderly patients living independently.

MATERIAL AND METHODS

A multiple stepwise logistic regression was used to contrast data from previous studies relating to the subject and to explore the influence of these social variables.

RESULTS

The results substantiated the links observed in a previous study between some social features and oral fitness. More frequent use of complete dentures was identified among participants who reported higher incomes and among those who thought their incomes were sufficient for their needs. Unreplaced missing anterior teeth were associated more commonly with subjects less willing or able to leave their homes.

CONCLUSIONS

Some salient features of prosthodontic care and oral health status were common to 2, comparable social environments. A minority within the elderly population may not see a need to make use of clinical dental services, regardless of how accessible these services are to them. Social network and social support issues may be important determinants in this perceived need to use clinical services.