Abstract
BackgroundOral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional judgment about restorative treatments and prosthetic replacement in patients who had reduced dentitions. The aim was to compare the OHRQoL among adults (35–44 years) categorized according to different definitions of reduced dentition and considering the use (or non-use) of dental prosthesis.MethodsThis study used data from a probabilistic sample of adults in Sao Paulo, Brazil, 2015. OHRQoL was based on none items of Oral Impacts on Daily Performance (OIDP) index, as prevalence (at least one impact) and extent (the number of items with non-zero score). We used different criteria to assess dentition status: (1) Shortened Dental Arch (SDA): having 3–5 natural occlusal units (OUs) in posterior teeth and intact anterior region; (2) hierarchical functional classification system: a five-level stepwise classification of dentition; and (3) presence of ≥21 teeth. The use or nonuse of dental prosthesis was recorded. Negative binomial regression models involved the adjustment for social determinants of health.ResultsNearly half (53.1%) of the 5753 participating adults had at least one oral health issue impacting OHRQoL. OIDP prevalence in adults with SDA did not differ from those with more OUs (PR = 1.02; 95%CI 0.91–1.13). Individuals with non-functional dentition had worse OHRQoL regardless of their use of a dental prosthesis. Adults with fewer than 21 remaining teeth, ranked significantly higher in OIDP extent, regardless of dental prosthesis use (PR = 1.38; 95%CI 1.16–1.63 with prosthesis; PR = 1.62; 95%CI 1.19–2.20 without dental prosthesis).ConclusionsIndividuals with more missing teeth reported worse OHRQoL regardless of using a dental prosthesis. Preserving a functional dentition, even with missing teeth, is compatible with OHRQoL.
Highlights
Oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional judgment about restorative treatments and prosthetic replacement in patients who had reduced dentitions
The FDI World Dental Federation launched a new definition of “oral health” in 2016, as part of the organization’s strategic plan (Vision 2020): “Oral health is a fundamental component of health”, and “is influenced by the person’s changing experiences, perceptions, expectations, and ability to adapt to circumstances” [1]
For the assessment of Shortened Dental Arch (SDA), we find the highest adjusted prevalence of Oral Impacts on Daily Performance (OIDP) among individuals with < 5 Occlusal Unit (OU) using dental prosthesis, compared to the reference group of those with > 5 OUs/ no prosthesis
Summary
Oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional judgment about restorative treatments and prosthetic replacement in patients who had reduced dentitions. The concept of the oral health-related quality of life (OHRQoL) is in line with this new definition because it is a multidimensional construct representing subjective assessments of how much oral conditions affect a person’s daily life [2]. The impact of dental disease and its treatment on quality of life has been increasingly considered when assessing health status [3]. Retaining a reduced dentition can be compatible with OHRQoL when dental status preserves some characteristics that are required for performing oral functions and esthetics (i.e., presence of anterior teeth and occlusal pairs) [13]. The loss of posterior teeth seems to have a lower negative impact on OHRQoL than the loss of anterior teeth when some occluding pairs remain [14]
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