Satisfação com saúde bucal de idosos brasileiros: um estudo de gênero com modelo hierárquico

Influence of oral health literacy on dissatisfaction with oral health among older people

OBJECTIVE

To investigate the influence of oral health literacy (OHL) and associated factors on dissatisfaction with oral health (DOH) among older people.

BACKGROUND

Oral health literacy is a recent field of research that has been considered an important mediator between socioeconomic variables and oral health outcomes. However, there are few studies with older people.

MATERIALS AND METHODS

A cross-sectional study was conducted with 535 non-institutionalised older people aged 60-100 years from Brazil. Individuals completed a questionnaire on general health, sociodemographic information and usual reason for dental visit. OHL was assessed using the Health Literacy in Dentistry questionnaire (HeLD-14), validated in Brazil. DOH was the outcome of interest. Poisson regression with robust standard errors was applied as a statistical model to estimate bivariate and multivariable relationships of DOH with OHL after adjusting for sex, age, social characteristics and general health using the P-value of ≤ .05.

RESULTS

The overall prevalence of DOH was 21.1%. Multivariable regression analysis showed that older people with low OHL (HeLD-14 score ≤35) had 1.28 times the odds of having DOH than those with high OHL (HeLD14 score >46), after adjusting for sociodemographic, economic and health outcomes.

CONCLUSIONS

Dissatisfaction with oral health in older people is a complex issue associated with OHL, social and behavioural factors. Health services should give greater attention to developing health literacy competences in older adults in order to empower them to achieve optimal oral health.

Tooth loss experiences in adult and elderly users of Primary Health Care

From the theoretical perspective of phenomenology, this article seeks to understand the experiences of tooth loss in adult and elderly users of Primary Health Care in Porto Alegre, Rio Grande do Sul. Tooth loss was identified by the analysis of dental records of users that attended the oral health service at the Health Unit under study. Following this identification, individual household interviews were carried out. The sample was intentional. Data were interpreted by content analysis using the software ATLAS.ti (Visual Qualitative Data Analysis). The study had ethical approval. Losing teeth was an experience that expresses subjectivities, showing plural narratives and highlighting the social function of the mouth. Besides the number of missing teeth, the understanding of how people perceived themselves without their teeth determined how much tooth loss affected their lives. Wearing prostheses adds significance to individuals' perceptions of their body, restoring the balance between their body and the world. Qualitative approach studies in health services should be considered in order to plan interventions which prioritize people's individual needs in their own territories, thus reducing stigmas and social inequalities.

Gender differences in predictors of self-rated health among older adults in Brazil and Chile

Background

The determinants of self-rated health (SRH) have been widely investigated to explain social differences and gender differences in health. This study aimed to investigate the gender differences in predictors of SRH among Brazilian and Chilean older adults.

Methods

We used two samples of older people: 2052 Brazilian community-dwelling participants (1226 women and 862 men) and 1301 Chilean community-dwelling participants (855 women and 446 men). Sequential logistic regression analysis was used to examine the relationships between SRH and potential predictors in a hierarchical model.

Results

Overall, 35.5% and 52.1% of individuals in Chile and Brazil, respectively, reported good SRH. There was a gradient association between good SRH and chronic diseases in both countries. Chilean men without chronic disease or with one had a higher chance of good SRH, compared to two or more diseases. For Brazilian men, no or one chronic disease was associated with good SRH. For women, the set of independent predictors for good SRH included no chronic diseases or one chronic disease, and no activities of daily living limitation. For men, the set also included instrumental activities limitation. For Brazilian adults of both genders, depression demonstrated the strongest independent association with good SRH.

Conclusions

We conclude that when examining gender differences in predictors of SRH, the similarities are greater than the differences between Brazilian and Chilean older adults. In both countries, physical health was the most important predictor of SRH. In addition, absence of depression was the strongest predictor of good health in older Brazilian adults.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-1666-9) contains supplementary material, which is available to authorized users.