Abstract
BackgroundLittle is known about the presence of two or more chronic conditions (multimorbidity) on tooth loss between adults and older adults. Understanding the mechanisms of multimorbidity on tooth loss is essential to inform policy development. This study aims to investigate the association between multimorbidity and severity of tooth loss in Brazilian adults and older adults.MethodsWe analysed data from a nationally representative sample of 88,531 Brazilian individuals aged 18 and over who participated in the 2019 Brazilian Health Survey. Tooth loss was the outcome by two different classifications: functional dentition (lost 1–12 teeth) and severe tooth loss (lost 23–32 teeth). The presence of multimorbidity was the main exposure and based on 13 self-reported doctor-diagnosed chronic diseases that were further categorised into two groups, i.e., ≥2 or ≥ 3 comorbidities. Sociodemographic covariates included sex, age, race, income, level of education and tobacco smoking and geographic region of residency. Multivariate logistic regression models estimated the OR (Odds Ratios) and 95%CI of the associations between multimorbidity and tooth loss.ResultsFor 65,803 adults (aged 18 to 59), the presence of multimorbidity (≥2) was associated with 32% higher odds of having severe tooth loss (95% CI, 1.17; 1.49) and 33% lower odds of having functional dentition (95% CI, 0.60; 0.75). For the 22,728 older adults (aged 60 and older), multimorbidity (≥2) was associated with a 17% higher odds of severe tooth loss (95% CI, 1.06; 1.29) and 23% lower odds of having functional dentition (95% CI 0.70; 0.85). The sensitivity analysis, excluding hypertension, confirmed our findings.ConclusionsBrazilian adults and older adults with multimorbidity are more likely to have severe tooth loss and less likely to have functional dentition.
Highlights
Little is known about the presence of two or more chronic conditions on tooth loss between adults and older adults
The oral microbiota may change with systemic diseases [17], which may contribute to tooth loss
Out of the 90,846 selected households, the analytical sample comprised of 65,803 participants aged 18–59 and 22,728 older adults who had information on all variables included in the study
Summary
Little is known about the presence of two or more chronic conditions (multimorbidity) on tooth loss between adults and older adults. This study aims to investigate the association between multimorbidity and severity of tooth loss in Brazilian adults and older adults. The World Health Organization (WHO) defines 20 as the minimum number of permanent teeth required for individuals to take part in social activities and achieve an adequate masticatory function [14] This number is known as a functional dentition [15]. Severe tooth loss, defined by fewer than 10 remaining teeth in the oral cavity [16], could impact one’s quality of life in a more extensive way.
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