Relation between oral health and nutritional condition in the elderly

Oral health is a prerequisite for a good chewing function, which may have an impact on food choices and nutritional well-being. OBJECTIVE: This study was designed to evaluate the relationship between oral health status and nutritional status in the elderly. MATERIAL AND METHODS: In this cross-sectional study, 33 elderly people from the Group for the Elderly Interdisciplinary Geriatrics and Gerontology Program, at Fluminense Federal University, Niteroi, RJ, Brazil, completed a questionnaire to collect information on socioeconomic status, eating habits, physical activity and health habits, undertook a clinical oral examination, blood test, and anthropometric measurements, and were allocated into groups according to age. The oral health status was assessed using the index for decayed, missing and filled teeth (DMFT). The nutritional status was assessed using hemoglobin, hematocrit and albumin concentrations in blood, anthropometric values and the body mass index. RESULTS: Tooth loss was the biggest nuisance to the elderly subjects (57.6%), followed by the use of dentures (30.3%) and ill-fitting dentures (33.3%). 66.6% of patients had difficulty in chewing, and 54.5% reported this to be due to prostheses and 13.6% to the absence of teeth. A significant correlation was found between DMFT and the value of suprailiac skinfold thickness (rho=0.380, p=0.029). CONCLUSION: The results support the temporal association between tooth loss and detrimental changes in anthropometry, which could contribute to increased risk of developing chronic diseases

The origin and composition of carbonatite-derived carbonate-bearing fluorapatite deposits

Carbonate-bearing fluorapatite rocks occur at over 30 globally distributed carbonatite complexes and represent a substantial potential supply of phosphorus for the fertiliser industry. However, the process(es) involved in forming carbonate-bearing fluorapatite at some carbonatites remain equivocal, with both hydrothermal and weathering mechanisms inferred. In this contribution, we compare the paragenesis and trace element contents of carbonate-bearing fluorapatite rocks from the Kovdor, Sokli, Bukusu, Catalão I and Glenover carbonatites in order to further understand their origin, as well as to comment upon the concentration of elements that may be deleterious to fertiliser production. The paragenesis of apatite from each deposit is broadly equivalent, comprising residual magmatic grains overgrown by several different stages of carbonate-bearing fluorapatite. The first forms epitactic overgrowths on residual magmatic grains, followed by the formation of massive apatite which, in turn, is cross-cut by late euhedral and colloform apatite generations. Compositionally, the paragenetic sequence corresponds to a substantial decrease in the concentration of rare earth elements (REE), Sr, Na and Th, with an increase in U and Cd. The carbonate-bearing fluorapatite exhibits a negative Ce anomaly, attributed to oxic conditions in a surficial environment and, in combination with the textural and compositional commonality, supports a weathering origin for these rocks. Carbonate-bearing fluorapatite has Th contents which are several orders of magnitude lower than magmatic apatite grains, potentially making such apatite a more environmentally attractive feedstock for the fertiliser industry. Uranium and cadmium contents are higher in carbonate-bearing fluorapatite than magmatic carbonatite apatite, but are much lower than most marine phosphorites

Dental fluorosis in Brazil: a systematic review from 1993 to 2004 Fluorose dentária no Brasil: uma revisão sistemática do período 1993/2004

The current article proposes a reflection on several aspect pertaining to dental fluorosis in Brazil, based on a systematic review of epidemiological surveys. The authors assess the prevalence and degrees of severity found in different studies and show that in methodological terms, there is a need for progress in procedures for population-based studies on fluorosis. Despite the different data collection approaches, there is some consensus among the different studies as to the limited severity of fluorosis in Brazil, as well as its association with the independent variables age and socioeconomic status. The authors also highlight the importance of adding subjective aspects to the normative diagnosis as a contribution to public health policy decisions, since the use of exclusively clinical criteria gives dental fluorosis more space than society ascribes to it. There is a lack of empirical evidence to reassess the fluoride content in public water supplies, a method that is known to be necessary to improve dental caries epidemiological indicators.<br>O presente trabalho propõe uma reflexão sobre alguns aspectos relativos à fluorose dentária no Brasil, a partir de uma revisão sistemática de estudos e inquéritos epidemiológicos. A prevalência e os níveis de severidade encontrados nos diferentes estudos são avaliados, verificando-se que, quanto aos aspectos metodológicos, há necessidade de avançar no que diz respeito aos procedimentos para estudo da fluorose em âmbito populacional. Apesar das diferentes abordagens para coleta de dados, há algum consenso, entre os diferentes estudos, quanto à baixa severidade da fluorose no Brasil e a sua associação com as variáveis independentes idade e condição sócio-econômica. Destaca-se também a importância de incluir aspectos subjetivos ao diagnóstico normativo, como uma contribuição às decisões que envolvem o planejamento de políticas públicas de saúde, uma vez que o uso de critérios exclusivamente clínicos oferece à fluorose dentária um espaço maior que aquele que lhe confere a sociedade. Nota-se a ausência de evidência empírica para a reavaliação dos teores de flúor nas águas de abastecimento público, um método reconhecidamente necessário no contexto brasileiro para a melhoria dos indicadores epidemiológicos de cárie

Perda dentária e expectativa da reposição protética: estudo qualitativo Dental loss and prosthetic replacement expectation: qualitative study

Esse estudo qualitativo analisou as repercussões da perda dentária total de usuários do serviço público. Aplicou-se o Oral Health Impact Profile simplificado(OHIP14) a cinquenta voluntários e, após a apuração dos resultados, foram selecionados treze pacientes para entrevistas individuais baseadas em um roteiro com questões abertas. A seleção das pessoas foi de acordo com o grau de percepção do impacto da condição bucal na qualidade de vida, medida pela pontuação OHIP, de forma a incluir a maior variedade de perfis da amostra inicial. Da análise do conteúdo dos depoimentos, verificou-se que a perda dentária total tem forte impacto na vida das pessoas e implica consequências negativas como vergonha, dificuldade em se alimentar, prejuízo ao relacionamento social e sentimento de incompletude. A possibilidade de reposição protética dos dentes gera ansiedade nas pessoas e, embora elas saibam que a utilização das próteses possa representar sacrifícios, a expectativa de retorno ao padrão social geralmente aceito e de recuperação de sua própria imagem rejuvenescida faz valer a pena quaisquer sacrifícios.<br>This qualitative research analyses the repercussions of total dental loss on people's quality of life. The Oral Health Impact Profile short-form (OHIP14) was applied to 50 volunteers, and after analyzing the results, 13 out of those 50, were selected to be individually interviewed in an opened questions script. The criteria to select these 13 people were: perception of the impact of mouth condition on quality of life measured by the score reached on OHIP. We tried to comprise the sample with a good variety, according to the profile of the initial sample. After analyzing people's statements, it was possible to verify that dental loss had strong negative consequences on people's life, like shame, difficulty to eat, impact on social relationship and feeling of not being complete. The possibility of having their teeth replaced generates some anxiety. Although being aware that wearing total prosthesis represents some sacrifices, people considered it worthwhile because the possibility of regaining the social pattern and the self-image is renewed