Occluding Pairs Research Articles

Clinically estimated signs of hyposalivation in older adult residents of long-term care.

To assess whether the estimation of clinical signs of hyposalivation is applicable in recognising long-term care facility (LTCF) residents with poor oral health, and which individual characteristics are important in that respect. A common inconvenience among older adults, dry mouth, particularly hyposalivation, can cause many complications, such as greater susceptibility to root caries and oral infections, and it can lead to further deterioration of oral health. However, very little is known about the association of clinically assessed signs of hyposalivation with the oral health status of LTCF residents. The study sample comprised 362 individuals (dentate n = 266, edentate n = 96) aged 65 or older. The examinations included a questionnaire and clinical oral examination. Participants were categorised into three groups based on clinically assessed oral dryness: normal salivation (n = 83, 22.9%), lower salivation (n = 182, 50.3%) and dry mouth (n = 97, 26.8%). The association between signs of dry mouth with aspects to oral health was evaluated and further tested with logistic regression analysis. The signs of oral dryness were observed among females, those with dementia, and those with longer stays in the current facility. Root caries (odds ratio, OR 1.3) and diagnosis of periodontitis (OR 4.1), together with several individual periodontal parameters, as well as having less than ten occluding pairs of natural teeth (OR 3.5) were associated with dry mouth. Edentate participants showed an increased likelihood of having dry mouth with advancing age, and lesions on the lips were associated with dry mouth with OR 3.0. Clinical estimation of signs of oral dryness can be a useful adjunct in evaluating the oral health status of dentate LTCF residents. Poor oral health was a frequent finding, especially among dentate LTCF residents with signs of dry mouth.

Oral health-related quality of life and reasons for discontinuing partial removable dental prosthesis usage: a cross-sectional study with one to seven years of follow-up

BackgroundIn partial edentulous individuals, a partial removable dental prosthesis (PRDP) is a common dental replacement option to improve oral function and quality of life. However, some patients discontinue using their denture over time. The aim of this study was to determine the prevalence and characteristics of partial edentulous patients who no longer wear their dentures, explore their reasons, and assess their oral health-related quality of life (OHRQoL).MethodologyThis cross-sectional study, conducted at Chulalongkorn University Dental School from 2013 to 2019, involved patients who received PRDP treatment. They were contacted via phone calls and asked about their denture usage. Eligible participants were patients who had stopped or rarely used their PRDPs. Data on oral status, health insurance, and PRDP variables were collected from hospital records. Telephone interviews were conducted to collect the initial reasons for seeking PRDP treatment, reasons for discontinuation, desire for a new PRDP, and OHRQoL. The Oral Impacts on Daily Performances index was used to assess the OHRQoL. The score was dichotomized into the absence or presence of oral impacts. Chi-square tests and multivariable binary logistic regression were employed to determine the associations between oral impacts and various factors in the participants who discontinued PRDP usage.ResultsAmong the 975 contacted participants, 175 (17.9%) discontinued using their PRDPs. Most of these individuals had at least 20 remaining natural teeth and/or 4 posterior occluding pairs. The primary initial reason for seeking PRDP treatment was often based on a dentist’s suggestion. Although many participants reported no impact on OHRQoL and did not express the need for new PRDPs, those experiencing oral impacts were more likely to seek replacements.ConclusionsWith up to 7 years follow-up duration, individuals with partial edentulism and sufficient remaining functional dentition without oral impacts were more inclined to discontinue PRDP usage. Those with maxillary anterior teeth loss were less likely to discontinue using their PRDP. The primary initial reason for seeking PRDP treatment was often a dentists’ suggestion. However, the individuals reporting oral impacts expressed their needs for new denture replacements. This highlights the significance of incorporating patient needs and preferences in prosthodontic decision-making.

Dentition and weight status in community-dwelling older adults.

Tooth loss is common among older adults and can affect dietary intake and weight status. This study investigated associations between dentition status and body mass index (BMI) in older adults. This was a cross-sectional study of data from a convenience sample of older adults (65-89 years) treated at an urban U.S. dental school clinic. Clinical and demographic data were obtained from electronic health records. Dentition status was determined based on data from odontograms. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of having a non-normal weight status for each measure of dentition status, after adjusting for covariates. Patients (n = 1765) were 54.1% female, 51.5% White, 41.6% African American and 22.5% Hispanic/Latino. The median (interquartile range [IQR]) age was 71 (67.0-75.0) years; the mean (±SD) BMI was 28.5 (±5.7) kg/m2 ; 72.5% were overweight or obese. The median (IQR) number of remaining teeth was 20.0 (13.0-24.0); the median numbers of anterior and posterior occluding pairs of teeth were 5.0 (2.0-6.0) and 2.0 (0.0-5.0), respectively; and 44.9% had a functional dentition (≥21 teeth). Having a higher number of remaining teeth and more posterior occluding pairs were associated with lower odds of obesity (OR = 0.980, 95% CI = 0.964, 0.997, p = .022 and OR = 0.931, 95% CI = 0.885, 0.980, p = .006, respectively). Lack of a functional dentition was associated with higher odds of obesity (OR = 1.400, 95% CI = 1.078, 1.818, p = .012), after controlling for covariates. Older adults with tooth loss - especially loss of posterior occlusion and lack of a functional dentition - were more likely to be obese than of normal weight.

Association between shortened dental configurations and health outcomes: a scoping review

This study mapped definitions of shortened dental configurations and health outcomes employed in association studies. A scoping review was conducted using the PubMed/Medline, Scopus, Web of Science, SciELO and Cochrane databases. Two trained researchers selected studies and extracted data. Studies that investigated the association between shortened dental configurations (exposure) and person-centered outcomes (general and oral health) related to health behavior (dietary patterns). Clinical outcomes were classified according to the International Classification of Functioning, Disability and Health and the International Classification of Diseases of the World Health Organization (WHO). Shortened dental configurations were defined as at least 20/21 teeth or the position of the teeth, including esthetics, dental occlusion and periodontal status (Eichner Index, Shortened Dental Arches, Functional Dentition Classification System, Posterior Occluding Pairs, Functional Tooth Units). The initial search resulted in 12,525 records in English, Portuguese and Spanish, 432 of which addressed the association of interest. General health (n = 203) and oral health (n = 201) were addressed in a similar number of studies. Most outcomes were related to general health (n = 184), the most frequent of which were endocrine, nutritional or metabolic diseases (n = 57) and mental functions (n = 26). Person-centered measures were addressed in 153 studies, most of which were about oral health and oral health-related quality of life (n = 62). Oral health outcomes were predominantly related to intake functions (n = 44) and diseases or disorders of the orofacial complex (n = 24). Dietary patterns (n = 43) and mortality (n = 38) were also studied. The cross-sectional design (n = 257) and non-probabilistic sampling (n = 218) were more frequent. The shortened dental configurations defined by the WHO were the most frequent in the studies (n = 206). The effects of shortened dental configurations have been investigated mainly in relation to endocrine, nutritional or metabolic diseases and measures of oral health-related quality of life. The findings point to a diversity of health outcomes assessed and substantial methodological variability.

Validation of pairs of antagonist teeth for the evaluation of shortened dental arch in epidemiological studies.

The aim of this study was to evaluate the accuracy of pairs of antagonist teeth (epidemiological criterion) for defining pairs of teeth in occlusal contact (clinical criterion) and to estimate the agreement between the prevalence of "shortened dental arch" (SDA) and "functional dentition" (FD) when occlusal units (OUs) or posterior occluding pairs (POPs) are defined by the epidemiological or clinical criterion. Data were collected in an epidemiological oral health survey conducted in a municipality in Minas Gerais, Brazil. OUs and POPs were defined by the epidemiological criterion (dental crown status) or clinical criterion "gold standard" (carbon paper record of occlusal contacts during habitual maximum intercuspation). SDA corresponded to the presence of an intact anterior region and three to five OUs. FD was based on the concomitant presence of ≥ 1 tooth in each arch, 10 teeth in each arch, 12 anterior teeth, ≥ 3 premolar POPs, and ≥ 1 molar POP bilaterally. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the epidemiological criterion were calculated. The study included 197 adults. Sensitivity, specificity, PPV, and NPV were 88.5, 87.9, 92.5, and 81.9%, respectively, and accuracy was 88.3%. The epidemiological criterion proved to be valid and could be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs. The assessment of oral functionality is an aspect that should be included in the diagnosis of the clinical condition of patients, contributing to a more effective individual and collective oral health care plan.

Oral Conditions as Risk Factors for Low Oral Health-Related Quality of Life Among the Elderly Population in Yogyakarta, Indonesia.

Approximately 70% of the elderly population living in Yogyakarta, Indonesia, has a low oral health-related quality of life (OHRQoL). This study aimed to identify the risk factors for low OHRQoL in the elderly population of Yogyakarta. Oral Hygiene Index Simplified (OHI-S), Community Periodontal Index, Decayed, Missing, and Filled Teeth (DMFT) Index, and the number of natural occluding pairs (NOP) were assessed for 153 participants aged ≥ 60 years. Xerostomia, hyposalivation, and OHRQoL were also examined using Xerostomia Inventory (XI), unstimulated spitting whole saliva collecting method, and Geriatric Oral Health Assessment Index (GOHAI) questionnaire, respectively. OHRQoL was categorized as low, moderate, and high. Bivariate and multivariate tests were conducted to identify the risk factors for low OHRQoL. Initial analysis of characteristics of participants revealed that hyposalivation, xerostomia, periodontal pocket, high DMFT, NOP ≤ 5, poor OHI-S, and low OHRQoL were experienced by 40 (26.1%), 92 (60.1%), 39 (25.5%), 110 (71.9%), 112 (73.2%), 44 (28.8%), and 108 (70.6%) participants, respectively. Relative risk (RR) and p values for hyposalivation, xerostomia, periodontal pocket, high DMFT, NOP ≤5, and poor OHI-S were found to be at 1.573 (CI 0.681-3.637) and 0.225; 2.532 (CI 1.255-5.108) and 0.006; 0.846 (CI 0.391-1.830) and 0.606; 1.759 (CI 0.843-3.670) and 0.110; 1.133 (CI 0.522-2.461) and 0.008; and 2.723 (CI 1.293-5.734) and 0.632, respectively. Multivariate tests showed that xerostomia and NOP ≤5 had RR of 2.519 (CI 1.221-5.195) and 2.536 (CI 1.175-5.477), respectively. Overall, elders with xerostomia or NOP ≤ 5 had 2.5 times higher risk of having a low OHRQoL.

Oral impacts of number of natural teeth and posterior occluding pairs on daily performance of geriatric population of Bareilly city: A cross-sectional study

Background: Poor oral health among the elderly has been measured in terms of tooth loss, dental caries, high prevalence rates of periodontal disease, xerostomia, and oral precancer/cancer around the world. Aim: The study's goal is to see how posterior occluding pairs and the total number of natural teeth in the mouth affect everyday activity in the elderly. Materials and methods: It was cross-sectional research with 300 participants drawn from a physiotherapy hospital by convenience sampling. The participants were asked about their age, gender, cigarette usage, oral hygiene practices, regularity of use, type of materials utilized, quality of life dental health and other xerostomia symptoms. The oral influences on the daily performance index were used to measure the effects on daily performance. The number of NT and POPs was counted during a clinical evaluation. Results: The studied population's general average age was 63.81 4.50, with no statistically significant differences between men and women. Overall, the research sample had a mean number of NT of 24.76 7.21, with men having 25.90 6.29 and women having 23.32 8.03. Conclusion: The number of NT and POPs was discovered to be important determinants of daily performance among the geriatric population.

The association between oral health and nutritional status in older adults: a cross-sectional study

ObjectivesThis work aimed to describe the nutritional status of French older adults (age ≥ 90 years) and studied the association between oral health and nutritional status.MethodsA cross-sectional study was carried out in 2014 among the participants of a cohort on cerebral and functional aging in France at their 25-year follow up (the PAQUID cohort). Nutritional status (Mini Nutritional Assessment [MNA]) and oral health status (number of decayed, missing, and filled teeth [DMFT], number of posterior occluding pairs, xerostomia [Xerostomia Inventory], and prosthetic rehabilitation) were recorded at the participants’ living places by two dentists. Univariate and multivariate logistic regressions were used to explore the association between oral health and nutritional status, with adjustments for potential confounders. Odds ratios (OR) were estimated with their 95% confidence interval (CI).Results87 participants were included in the analyses: 74.7% were females and the mean age was 94.1 years (± 3.0). Malnutrition or risk of malnutrition (MNA < 24) was present in 23 participants (26.4%), with only one having malnutrition. The mean DMFT score was 26.5 (± 5.3). The mean number of posterior occluding pairs was 1.5 (± 2.3). Twenty-one participants had xerostomia (24.1%). Only 8.1% of the participants had all their teeth or adequate dentures; 47.1% had inadequate dentures, while 44.8% had no dentures despite tooth loss. After adjustment, xerostomia (OR = 8.79; 95% CI = 2.38–39.10; p = 0.002) was found to be associated with malnutrition or risk of malnutrition.ConclusionBeing at risk of malnutrition was common among people ≥ 90 years old and was associated with xerostomia. NCT04065828.

The impact of poor dental status and removable dental prosthesis quality on body composition, masticatory performance and oral health-related quality of life: a cross-sectional study in older adults

BackgroundTo determine the impact of dental status, types, and quality of dental prostheses on body composition, masticatory performance and oral health-related quality of life (OHRQoL). Potential associations between body composition, masticatory performance and OHRQoL were also investigated.MethodsThis cross-sectional study included 110 older adults who received prosthodontic treatment at the Dental Faculty Clinics at Chulalongkorn University. Participants were categorized according to their dental prostheses: complete denture (CD), removable partial denture (RPD) and fixed partial denture (FPD). Retention and stability of the RPD and CD were evaluated using the CU-modified Kapur and the modified NHANES III criteria to classify denture quality into acceptable and unacceptable. Dental status including posterior occluding pairs and number of remaining natural teeth were assessed intraorally. Dependent variables were body composition, masticatory performance and OHRQoL. Body composition, including muscle mass (kg), bone mass (kg), basal metabolic rate (kcal) and visceral fat (%) were determined through a bioelectrical impedance analysis. Masticatory performance was assessed using a multiple sieve method of peanut mastication. OHRQoL was assessed using the validated Thai version of Oral Impacts on Daily Performances (Thai-OIDP) index. After adjusting for covariates, including age and sex, the associations between oral and dental prosthesis status and body composition, masticatory performance as well as OIDP score were analyzed using multivariable linear and negative binomial regression analyses. Spearman’s correlation was used to determine the potential associations between body composition, masticatory performance and OHRQoL.ResultsThe presence of fewer natural teeth or wearing an unacceptable removable denture were factors associated with lower bone mass, muscle mass and basal metabolic rate, and with a higher visceral fat. Similar dental and removable denture status were also associated with larger peanut particle size and higher OIDP score. Masticatory performance and OHRQoL variables were moderately correlated (Spearman's rho = 0.44). However, body composition was not correlated with masticatory performance or OHRQoL.ConclusionsIn individuals wearing dental prostheses, factors such as severity of tooth loss, types, and quality of dental prostheses, particularly retention and stability, negatively impacted not only masticatory function and OHRQoL, but also their overall body composition and health.

Memory decline in older individuals predicts an objective indicator of oral health: findings from the Sydney Memory and Ageing Study

BackgroundGrowing evidence suggests that there is an association between poor oral health and cognitive function in late adulthood. However, most studies to date have relied on cross-sectional research methods that do not permit inferences about the temporality of any association. Moreover, the few longitudinal studies that do exist have typically relied on small samples and quite limited cognitive or oral health assessments. The aim of the present study was therefore designed to provide the first direct evaluation of whether cognitive function is predictive of poor oral health in older adults.MethodsThis longitudinal research included data from 339 participants aged 70 years or older from The Sydney Memory and Ageing Study (MAS), a large cohort of healthy community-dwelling older adults. Cognitive function was assessed using a battery of tests at baseline (Wave 1) in 2005 and six years later (Wave 4) in 2011. In 2015 (Wave 6), participants were assessed for oral health using the Oral Health Assessment Tool (OHAT), number of functional occluding pairs of natural teeth and sublingual resting saliva pH (SRSpH). Ordinal least squares regression analysis was used to model the effect of cognitive function on total OHAT score, and binomial logistic regression used for SRSpH and occluding pairs of functional teeth.ResultsTwo models were tested. In the partially adjusted model, age, gender and years of education were included. The fully adjusted model additionally included medical conditions, general health, depression, smoking, alcohol consumption, functionality, and dental care utilization. The key finding to emerge was that a six-year change in memory (from Wave 1 to Wave 4) was associated with lower sublingual resting saliva pH at Wave 6 in partially (Odds Ratio (OR) = 0.65) and fully adjusted model (OR = 0.63).ConclusionsThis longitudinal study provides further evidence that a relationship between cognitive function and oral health exists, and also points to this relationship potentially being bi-directional, as previous evidence suggests. The findings from the study also suggest that older adults who present with greater than normal memory decline at an earlier point in life were more likely to experience poor oral health when this was evaluated at a later time-point, four years later.

Tooth loss and cognitive decline in community dwelling older Irish adults: A cross-sectional cohort study

ObjectivesTo investigate whether tooth loss and related loss of occluding tooth pairs, were associated with cognitive decline in a group of community dwelling older men and women from Ireland. MethodsA group of 2508 men and women, aged 50–93 years, underwent a dental examination as part of The Irish Longitudinal Study of ageing (TILDA). Global cognitive function was assessed using the mini-mental state examination (MMSE). Analysis included multiple logistic regression with adjustment for various confounders. ResultsThe mean age of participants was 65.5 years (SD 8.1) and 55.3% of the group were female. Three hundred and twenty-nine (13.1%) of the cohort were classified as having a low MMSE with a score ≤ 27. After adjustment for confounding variables, compared to subjects with ≥ 20 teeth, the odds ratio for a low MMSE amongst edentulous was 1.55 (95% CI 1.03–2.34) p = 0.03, and for those with 1–19 teeth was 1.38 (95% CI 1.03–1.84) p = 0.04. Having < 10 natural occluding pairs and < 4 posterior occluding pairs also associated with a low MMSE. ConclusionsIn this cross-sectional cohort study, tooth loss and related loss of occluding tooth pairs were associated with a low MMSE in a group of older adults from Ireland, independent of various known confounders. Clinical SignificanceDentists should be aware of the potential systemic health implications of patients presenting with tooth loss. Tooth loss may be an important risk indicator for cognitive decline.

Maximal Bite Force Measured via Digital Bite Force Transducer in Subjects with or without Dental Implants—A Pilot Study

The aims of the current study were as following: (1) to evaluate the maximal bite forces in patients with dental implants versus patients without dental implants, as measured by a digital bite force transducer (GM10); (2) to evaluate the influences of sex, age, and sleep/awake bruxism on the maximal bite forces of the two groups. Forty patients recruited to the study were divided into two groups: test group (“implant”) if they had one or more posterior restored implants and control group (“no-implant”) without the presence of posterior dental implants. A digital bite fork (GM10) was used to measure the bite forces from three posterior occluding pairs in all participants. Differences in the mean values between the test and control groups and between different sexes were evaluated using one-way and two-way ANOVA tests. A cross-tabulation analysis was conducted to identify a trend line between the groups. There was no significant difference in the maximal bite force between the test and control groups (p = 0.422), but the cross-tabulation analysis revealed a clear trend of a stronger representation of the “no-implant” group at higher occlusal forces. A significant difference was detected between the maximal biting forces of male and female subjects (p = 0.030 in the implant group, p = 0.010 in the no-implant group), regardless of the experimental group. The presence of bruxism and clenching did not influence the bite force values (p = 0.953), and a significant difference was not found between the age groups (p = 0.393). Within the limitations of this study, it may be assumed that there was no significant difference between the maximal bite forces between patients with and without dental implants but that there was a trend line implicating a stronger representation of the “no-implant” group at higher forces. In addition, the results revealed a significant sex-related difference in the maximal occlusal force. Further studies with larger sample sizes are warranted.

Effect of rehabilitation by using the shortened dental arch concept on the thickness of the masseter muscle and occlusal force: A pilot study

Statement of problemKnowledge of the effect of a shortened dental arch on masseter muscle thickness and occlusal force is sparse but could help clinicians understand how a shortened dental arch might affect the stomatognathic system. PurposeThe purpose of this pilot clinical study was to evaluate and compare the masseter muscle thickness and occlusal force of participants rehabilitated by using a shortened dental arch with matched completely dentate individuals. Material and methodsTwelve partially edentulous participants with a minimum of 1 posterior occluding pair on each side of the arch were enrolled in the study. The mandibular arch of these participants was rehabilitated by using a single posterior mandibular implant crown (group S). The maxillary arch of all participants in group S was intact. Masseter muscle thickness (cm) and occlusal force (N) were recorded before (T1) and 6 months after implant rehabilitation (T2) for each participant. Twelve participants were selected as controls (group C). They were matched for age, sex, height, and weight with group S and evaluated for masseter muscle thickness and occlusal force. Masseter muscle thickness was evaluated by using ultrasonography during the rest position and maximum volumetric clenching. Occlusal force was measured with an occlusal force measuring appliance. All recordings were done for the left and right sides of the arch. Descriptive analysis was followed by comparison between groups and within group S by using the paired t test (α=.05). ResultsHigher masseter muscle thickness and higher occlusal force were observed in group C than in group S before and after rehabilitation. An increase in masseter muscle thickness in the rest position and in maximum volumetric clenching was observed within group S after rehabilitation. Before rehabilitation, a difference in the masseter muscle thickness between group S and group C was statistically significant for the left side at the rest position (P=.017) and during maximum volumetric clenching (P=.016). After rehabilitation, the difference between group S and group C was not statistically significant for masseter muscle thickness at the rest position (P=.890 for right side and P=.555 for left side) and during maximum volumetric clenching (P=.109 for right side and P=.755 for left side). The difference in occlusal force between group S and group C was statistically significant for the right side and left side (P<.001) before rehabilitation and statistically not significant after rehabilitation (P=.161 for the right side and P=.134 for the left side). ConclusionsRehabilitation following the concept of a shortened dental arch increased masseter muscle thickness and occlusal force in partially edentulous individuals, making the masseter muscle thickness and occlusal force comparable with those of a completely dentate arch.

Associations between Dentition Status and Nutritional Status in Community-Dwelling Older Adults.

Older adults are at higher risk of malnutrition. The aim of this study was to explore associations between nutritional status and dentition status among older adults seeking care in a dental clinic. This was a cross-sectional study of data from older adults (65-89 y) who received care at a northeastern US urban dental school clinic between June 2015 and June 2020 (N = 305). Clinical and demographic data were obtained from the electronic health record; nutritional status was determined using the Self-Mini Nutritional Assessment (Self-MNA), and odontograms and digital radiography were used to determine dental data. Adjusted multivariable models were used to explore associations between variables. The sample was 53.8% female with a median age of 72.0 y. The median Self-MNA score was 13, reflective of normal nutritional status; 29.5% were at risk of or had malnutrition. Median numbers of teeth and posterior and anterior occluding pairs of teeth (POP, AOP) were 18.0, 2.0, and 5.0, respectively. Those with normal nutritional status had significantly more teeth, POPs, and AOPs than those at risk of or with malnutrition (P = 0.015, P = 0.015, and P = 0.039, respectively). Every additional unit increase in the number of natural or restored teeth or POP was associated with significantly lower odds of being at risk of or with malnutrition (3% and 13%, respectively). Having functional dentition was associated with 46% lower odds of being at risk of or with malnutrition. This study demonstrated that older adults who had more teeth, better occlusion, and functional dentition were more likely to be of normal nutritional status than those who had less teeth, had poorer occlusion, and lacked functional dentition. Further research with larger, more diverse samples and varied measures of dentition are needed to better understand the associations between nutritional status and dentition status. The findings from this study suggest that older adults with fewer teeth and therefore less efficient occlusion are at higher risk for malnutrition than those with more teeth and better occlusion. Health care professionals should include screening for dentition and malnutrition as part of their routine practice to identify patients who may have tooth loss and be at risk of malnutrition and refer them accordingly for interventions to optimize oral health and nutritional status.

Oral impacts of number of natural teeth and posterior occluding pairs on daily performance of an elderly population

Background: Globally, poor oral health among older people has been assessed in terms of high levels of tooth loss, dental caries experience, high prevalence rates of periodontal disease, xerostomia, and oral precancer/cancer. Aim: The aim of the study is to compare impacts of total number of natural teeth (NT) and posterior occluding pairs (POPs) present in the oral cavity on daily performances among elderly population. Materials and Methods: It was a cross-sectional study which included 300 subjects recruited through convenience sampling from a physiotherapy center. The included subjects were asked in a face-to-face interview about their demographic information (i.e., age and gender), tobacco habits (type and frequency), oral hygiene habits (frequency and material used), oral health-related quality of life, and various symptoms of xerostomia. Impacts on daily performances were measured by the use of oral impacts on daily performances index. Clinical examination was done to measure number of NT and POPs. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 21, IBM Inc., and for inferential statistics, Mann–Whitney U-test and Chi-square tests were used. Level of statistical significance was set at P < 0.05. Results: The overall mean age of the study population was found to be 63.81 ± 4.50 with gender wise no statistically significant difference (males = 63.82 ± 4.13, females = 63.79 ± 4.94; P ≤ 0.05). Overall, mean number of NT present in the study population was found to be 24.76 ± 7.21 with 25.90 ± 6.29 among males and 23.32 ± 8.03 among females. Mean number of NT present was significantly more among males as compared to females (Mann–Whitney U-test, P = 0.003). Conclusion: Number of NT and POPs were found to be the significant predictors of daily performances among elderly population.

Assessment of the Effects of Occluding Pairs of Teeth on Oral Health-related Quality of Life among Dialysis Patients

To determine oral health-related quality of life (OHRQoL) in hemodialysis patients and assess if location and distribution of teeth had perceived oral impacts. Face-to-face interviews and oral examinations were conducted among 96 patients in southwest Florida. Sociodemographic data in addition to self-reported medical conditions were collected. OHRQoL was determined using the Geriatric Oral Health Assessment Index (GOHAI-12). Presence of decayed teeth, missing teeth, anterior occluding pairs (AOPs) and posterior occluding pairs (POPs), and community periodontal index were ascertained through oral examinations. Mean age was 64.81 ± 12.9 years. Mean number of teeth present was 20.12 ± 10.8. Nearly half (48%) of the participants had ≥1 decayed teeth. Among those examined for periodontal health, 86% had some form of periodontal disease. Mean AOP was 4.4 ± 2.3 and mean POP was 4.2 ± 3.1. Median GOHAI-12 score was 52. Limiting the kinds or amounts of food (p = 0.040), trouble biting or chewing (p = 0.010), feeling uncomfortable eating in front of people (p = 0.024), and pleased with looks (p = 0.038) were statistically significant for AOP groups. Only trouble biting or chewing (p = 0.044) and pleased with looks showed significant association with POP groups (p = 0.038). In adjusted regression analyses, participants with AOPs 0 to 2 had 86% lower odds of reporting GOHAI-12 scores above 40 (25th percentile) than the group with AOPs 3 to 6 (odds ratio = 0.14; 95% confidence interval = 0.04-0.58). The study highlights fewer AOP to have a larger effect than POP not only in the psychosocial dimension but also in the functional abilities. Lower GOHAI-12 scores were associated with AOP 2 or less than 2 in the study sample. While treatment and management of oral health problems in dialysis patients are complicated by the presence of co-morbidities, age-related changes in the mouth, and issues of access to dental care, identification, repair, or replacement of strategically important teeth using the "shortened dental arch principle" to maintain oral function among hemodialysis patients are recommended.

Functional tooth units and masticatory ability in elderly population

Introduction: The elders are the ones that most often experience tooth loss which affects masticatory function. Masticatory function can be evaluated subjectively through masticatory ability assessment. The masticatory function is influenced by the number of posterior occluding pairs; this also may be called as functional tooth units (FTUs). The purpose of this study was to describe FTUs and masticatory ability in the elderly. Methods: This research was a descriptive study with a cross-sectional study design. Subjects were taken by purposive sampling technique. The study was conducted in the Lebakgede Sub-district, Bandung City. Data mentioned were obtained by conducting interviews regarding data on subject characteristics and questionnaires of masticatory ability, as well as examining the oral cavity to obtain FTUs data. Results: Subjects obtained were 74 people consisting of 63 women (85.14%) and 11 men (14.86%). Based on the results, the average age of the research subjects was 68.49 years, and those with good masticatory ability status were 26 elderly (35.14%) with an average FTU value of 5.9 while 48 elderly (64.86%) had poor masticatory ability status with an average FTU score of 1.5, even 31 subjects (41.89%) had a zero FTU score. Conclusion: The majority of the elderly in this research mostly had a low total FTUs score which means that the masticatory ability status in the elderly tended to be poor.

How Do Changes in Oral Health and Chewing Efficiency Affect the Changes of Oral-Health-Related Quality of Life of Nursing-Home Residents in the Short Term?

ObjectiveTo evaluate how changes in oral health and chewing efficiency affect the changes in oral-health-related quality of life (OHRQoL) of nursing-home residents over six months.MethodsThe study was conducted in nine nursing homes. Sociodemographic and general data were collected for all eligible individuals (n = 150). Of these, 114 participants (mean age 82.0 [± 9.5] years, 77.2% women) were available for the following tests at baseline and six months later: a comprehensive examination of dental and general health, a two-colour mixing-ability test (to assess chewing efficiency), the Geriatric Oral Health Assessment Index (GOHAI; to evaluate the OHRQoL), and the Mini Mental State Examination (MMSE; to diagnose the presence and severity of dementia). Univariate and multivariate linear regression models were compiled to analyse possible factors affecting OHRQoL.ResultsFor the final analysis, 108 participants were available. For the study cohort as a whole, a decrease in the number of functional occluding pairs (C: 0.195; p = 0.034) and an increase in dental-treatment needs (C: −1.968; p = 0.056) had the greatest negative effects on OHRQoL as expressed by the GOHAI score. For denture wearers, a deterioration of denture condition (C: −2.946; p = 0.003) was the most important predictor for a decline in OHRQoL.ConclusionA short-term decline in oral health and function affects the OHRQoL of nursing-home residents. The most important dental variables in this regard are the number of functional occluding pairs and dental and denture-related treatment needs.

Masticatory coefficient and physical functioning in older frail patients admitted for a Comprehensive Gerontological Assessment

Background: Physical functioning may be limited in older, frail patients with missing teeth without prosthetic correction. This cross-sectional study examined the relationship between physical performance and the geriatric masticatory coefficient (GMC) in patients who underwent both a comprehensive gerontological assessment (CGA) to improve poly-pathology management and an intra-oral exam. Methods: All patients were evaluated based on the following: (corrected) GMC, number of posterior occluding pairs (POPs), short physical performance battery (SPPB) or timed up and go (TUG) test, and mini-nutritional assessment (MNA). Results: Of the 256 patients (mean age 83.76[SD 6.16], 148F), 75 (29.30%) were malnourished. The corrected GMC was lower in malnourished patients. When adjusted for age, gender, and MNA, the corrected GMC correlated with the TUG time (r=-0.198, p=0.005) and SPPB score (r=0.282, p=0.009). Correlations between GMC and POPs were determined for the SPPB (r=0.269, p=0.013; r=0.319, p=0.004, respectively) but not for the TUG (r=-0.108, p=0.128; r=-0.136, p=0.072). Conclusion: The correlation between physical performance and decreased masticatory capacity was not fully explained by malnutrition in mildly to severely frail and multi-morbid patients; posture may also be impaired by missing teeth. The study of dental care effects on physical performance will provide further insights.

Hyposalivation is the main risk factor for poor oral health status in Indonesian elderly

Aim: To analyze the effect of xerostomia and hyposalivation as risk factors for poor oral health status in Indonesian elderly. Materials and Methods: Oral health status of 158 elders in Yogyakarta, Indonesia was determined using Oral Hygiene Index-Simplified, Decayed, Missing, and Filled Teeth (DMFT) index, modified Community Periodontal Index, and number of natural occluding pairs (NOP). Xerostomia was determined by Xerostomia Inventory and hyposalivation was identified by measuring whole unstimulated saliva flow. Bivariate and multivariate analyses were done to analyze the possible correlation between the event of hyposalivation and xerostomia with each of the independent variables (oral health status) and to assess the simultaneous effect of hyposalivation and xerostomia for the event of poor oral hygiene (OH), respectively. Results: Periodontal pocket, high DMFT index, poor OH, ≤5 NOP, xerostomia, and hyposalivation were experienced by 41, 113, 44, 116, 94, and 40 of 158 participants, respectively. Based on the bivariate analysis between the event of xerostomia and oral health status indicators, it was found that there was a significantly different proportion of OH condition between the group of participants with and without xerostomia (P = 0.035). Conversely, the proportions of periodontal pocket and OH condition were significantly different between the group of participants with and without hyposalivation with P values of <0.001. The multivariate analysis demonstrated that the participants with hyposalivation and xerostomia have a 5.68 and 2.49 times higher risk of experiencing poor OH condition, respectively, accounted for 20% of the total model. Conclusion: Hyposalivation is the main risk factor for poor oral health status in Indonesian elderly.