Tooth loss in the elderly and its association with nutritional status, socio-economic and lifestyle factors.
OBJECTIVE
Tooth loss impacts on general health and is a risk factor for malnutrition, disability, loss of self-sufficiency, and deterioration in quality of life. The present study was carried out to evaluate the prevalence of edentulism and its association with social and lifestyle factors in a population of elderly Italians.


METHODS
Dental, social, and disease conditions were evaluated in a large community-based cohort (3054) of elderly subjects (> or =65 years) of both sexes in northern Italy. Logistic regression analyses with stepwise forward selection were performed to estimate the independent contribution of nutritional, socio-economic, and lifestyle variables to dental status. Adjusted ORs and 95% CI were estimated for variables significantly associated with edentulism.


RESULTS
The prevalence of edentulism was about 44.0%. It was more pronounced in females and it was twice as prevalent in the 90+ years age group. Among edentulous subjects, 17.5% wore no prostheses. Difficulties in chewing and in swallowing were reported by 47.6% and 13.7% of the subjects, respectively. Multivariate analysis indicates that edentulism was associated with age in both sexes. For women, independently associated risk factors were: years since menopause >23 (OR = 1.81; 95% CI: 1.37-2.40), number of children >3 (OR = 1.95; 95% CI: 1.36-2.80), and living alone (OR = 1.47; 95% CI: 1.15-1.88). For men, these were serum albumin <40 g/l (OR = 1.79; 95% CI: 1.22-2.63), current smoking (OR = 4.01; 95% CI: 2.59-6.20), and former smoking (OR = 3.42; 95% CI: 2.42-4.82).


CONCLUSIONS
The prevalence of edentulism among the elderly Italian population studied was at the high end among Western countries, and higher in women than in men. In women, tooth loss correlated with aging, female events (pregnancies, menopausal status), and living alone. In men, aging and smoking are important determinants of edentulism, which is associated with the risk condition of hypoalbuminemia. Difficulty in chewing was associated with dentition type. In our study, the high prevalence of edentulous subjects without prostheses suggests a need for educational and social measures to improve patients' attitudes to dental care and to encourage the use of prostheses among the elderly.
Musacchio
Estella
E
Department of Medical and Surgical Sciences, University of Padova, Padova, Italy. estella.musacchio@unipd.it
Perissinotto
Egle
E
Binotto
Pierluigi
P
Sartori
Leonardo
L
Silva-Netto
Fatima
F
Zambon
Sabina
S
Manzato
Enzo
E
Corti
Maria Chiara
MC
Baggio
Giovannella
G
Crepaldi
Gaetano
G
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications; D009066:Mouth, Edentulous / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D016388:Tooth Loss / Q000453:epidemiology* / Q000209:etiology