Dental and prosthodontic status of adults in Bulgaria: socio-demographic and functional aspects

The general discussion presents some methodological issues and the main findings of the papers constituting the present thesis. In addition, implications for oral health care for the adult population in Bulgaria are discussed and recommendations are made for future research. A detailed discussion of the results can be found in the individual papers included in this thesis. Based on the findings of the studies presented in this thesis, it was concluded that: (1) predominantly fixed restorations were provided to restore reduced dentitions to a functional level and not necessarily to complete dentitions; (2) age, female gender, having low education, and less frequent toothbrushing were identified as risk indicators for having “missing” teeth and should be considered in prevention program planning if reduction of tooth loss is to be achieved; (3) number of present teeth, age, regularity of dental visits, and frequency of toothbrushing were relevant factors with respect to tooth replacement. The cutoff value of 20 teeth did not discriminate high-risk from low-risk subjects with respect to tooth replacement; (4) satisfaction was strongly associated with dental functional status. Dental configurations comprising both natural and artificial teeth were less likely to provide the same level of satisfaction as equivalent dental configurations comprising natural teeth only. The present findings suggest that strategies aiming at retention of a natural functional dentition not requiring recourse to prostheses, as proposed by the WHO, may be appropriate in Bulgaria. Applying more functionally oriented approaches, however, requires revision of the role of prosthodontic care in a collective effort to maintain functional den¬titions for life. Before putting these recommendations into practice, further research on perceived oral health-related quality of life, nutritional status, and cost-effectiveness of conventional and functionally oriented tooth replacement strategies in relation to reduced dentitions is needed

Dental laboratory production of prosthetic restorations in a population in sofia, bulgaria: a descriptive study.

Contains fulltext : 88297.pdf (publisher's version ) (Open Access)Objective. To describe prosthodontic production related to mutilated dentitions in Sofia, Bulgaria. Methods. Prosthodontic production from 5 dental laboratories was recorded during a 14-day period. Production was related to dentitions as noted from casts. Dentitions were classified as edentulous, interrupted/reduced, slightly interrupted, shortened, and complete. The representativeness of the laboratory sample was verified trough comparison with a Sofia population sample using proportions of crowned or replaced teeth per dental region. Results. The total production consisted of 243 crowns, 16 post and cores, 82 fixed dental prostheses, and 41 removable dentures. Proportions of crowned teeth were significantly different between the samples; proportions of replaced teeth were not. Of the 58 incomplete dentitions analyzed, 19 were restored to the level of completeness, 15 resulted in slightly interrupted, and 24 in shortened dentitions. Conclusions. Predominantly fixed restorations were provided to restore mutilated dentitions to a functional level and not necessarily to complete dentitions

Dental status and associated factors in a dentate adult population in bulgaria: a cross-sectional survey.

This study aimed to determine variations in the dental status of a dentate adult population in terms of "decayed," "missing," and "filled" teeth in relation to several sociodemographic and behavioral factors. Quota sampling was used to draw 2531 subjects aged 20 years and over. Data were collected by means of a questionnaire and an oral examination. Multiple logistic regression analyses were performed to observe associations between "decayed," "missing," and "filled" teeth and the factors of interest. The mean numbers of "decayed," "missing," and "filled" teeth were 2.2, 6.7, and 4.9, respectively. Molar teeth were significantly more often "missing" than premolar and anterior teeth. Age, gender, education, and tooth brushing revealed most noticeable associations. Increasing age was associated with a lower chance of having "decayed" and "filled" teeth, but with a higher chance of having "missing" teeth. Females were more likely to have "missing" and "filled" teeth. Higher education was associated with a lower chance of having "missing" teeth. More frequent tooth brushing was associated with a lower chance of having "decayed" and "missing" teeth, but with a higher chance of having "filled" teeth. These risk indicators should be considered in prevention program planning if reduction of tooth loss is to be achieved

Tooth replacement related to number of natural teeth in a dentate adult population in Bulgaria: a cross-sectional study

PURPOSE: This study aimed to explore the relationships among tooth replacement, number of present natural teeth, and sociodemographic and behavioral factors in an adult population in Bulgaria. MATERIALS AND METHODS: Quota sampling was used to recruit 2,531 dentate subjects aged 20 years and over from the capital city and four main urban centers, four towns, and seven small towns and villages of Bulgaria. Potential candidates for tooth replacement were classified as having functional dentitions (26 to 27 or 20 to 25 natural teeth present) or subfunctional dentitions (16 to 19 or 2 to 15 natural teeth present), not including third molars. Multiple logistic regression analyses were performed to determine the associations between tooth replacement and the factors of interest. RESULTS: Of the included subjects, 37% presented with tooth replacement, while 19% presented with fewer than 20 natural teeth. Molars were replaced significantly less often (P </= .017) than premolars and anterior teeth. The presence of tooth replacement was more likely in subjects with 2 to 15 teeth (odds ratio: 1.62) and less likely in subjects with 26 to 27 teeth (odds ratio: 0.29), but no significant difference was detected between subjects with 16 to 19 and 20 to 25 teeth. Tooth replacement was associated with age, occupational status, frequency of dental visits, and toothbrushing habits. CONCLUSIONS: In this Bulgarian population, the variables number of present teeth, age, dental visits, and toothbrushing were relevant factors with respect to tooth replacement. The cutoff value of 20 teeth did not discriminate high-risk from low-risk subjects

Satisfaction with the dentition related to dental functional status and tooth replacement in an adult Bulgarian population: a cross-sectional study

Item does not contain fulltextOBJECTIVES: The purpose of this study is to assess satisfaction with the dentition in general, dental esthetics, and chewing function related to dental functional status and tooth replacement in subjects, dentate in both jaws. MATERIALS AND METHODS: Dentitions of subjects (n = 2,437) aged >/=20 years were categorized in a hierarchical functional classification system, with and without tooth replacements, according to four dental conditions: '>/=10 teeth in each jaw', 'complete anterior regions', 'sufficient premolar regions' (>/=3 occluding pairs), and 'sufficient molar regions' (bilaterally >/=1 occluding pair). Likelihood ratios (LR) were used to express the ability of these conditions to discriminate between satisfied and not satisfied subjects. Odds ratios (OR) were calculated to evaluate associations between satisfaction, the four dental conditions separately, and tooth replacement. RESULTS: In the hierarchical system, subjects having '/=10 teeth' was significantly associated only with satisfaction with chewing. The conditions 'complete anterior regions' and 'sufficient' premolar and molar regions' were associated with all satisfaction variables (ORs 1.47-2.96, p values </=0.012). When dental conditions were determined on the basis of natural teeth only, having teeth replaced was positively correlated with satisfaction; when determined on the basis of natural plus replaced teeth, subjects having teeth replaced tended to be less satisfied than their counterparts with natural teeth only. CONCLUSIONS: Satisfaction was strongly associated with dental functional status. CLINICAL RELEVANCE: Dental configurations comprising both natural and artificial teeth were less likely to provide the same level of satisfaction as equivalent dental configurations comprising natural teeth only