Determinants of masticatory performance in dentate adults

Masticatory performance results fi om a complex interplay of direct and indirect effects, yet most studies employ univariate models. This study tested a multivariate model of masticatory performance for dentate subjects. Explanatory variables included number of functional tooth units, bite force, sex, age, masseter cross-sectional area, presence of temporomandibular disorders. and presence of diabetes mellitus. The population-based sample consisted of 631 dentate subjects aged 37-80 years. Convariance structure analysis showed that 68%, of the variability in masticatory performance could be explained by the combined effects of the explanatory variables. Age and sex did not show a strong effect on masticatory performance, either directly or indirectly through masseter cross-sectional area, temporomandibular disorders. and bite force. Number of functional tooth units and bite force were confirmed as the key determinants of masticatory performance, which suggests that their maintenance may be of major importance for promoting healthful functional status. (C) 2001 Elsevier Science Ltd. All rights reserved.46764164

Dietary intake in edentulous subjects with good and poor quality complete dentures

Statement of problem. previous studies in complete denture wearers evaluated the relationship betweene diet and measures of chewing, yet only isolated nutrient intake was considered. This limited information makes the assessment of overall diet quality, and the planning of interventions difficult. Purpose. This study investigated the relationship of complete denture quality to masticatory perfor mance, perceived ability to chew, and diet quality as measured by the Healthy Hating Index (HEI), an overall diet quality index. Material and methods. The study population comprised 54 complete denture wearers. Data were obtained from clinical examinations, masticatory performance measurements, and 2 non-consecutive 24-hour dietary recalls, (Masticatory performance data were not collected for 9 subjects because of time constraints, patient fatigue, or patient refusal. Statistical analysis showed no significant effect of their absence on the reported findings.) Based on a composite rating scale, subjects were divided into 3 denture quality groups described as good, medium, and poor. The outcome variables were the HEI and its components, plus selected nutrient and non-nutrient intake. Explanatory variables were quality of complete dentures, masticatory performance, and reported chewing ability. Data were analyzed with Kruskal-Wallis tests, Mann-Whitney U-tests, and Fisher exact tests. Because a large number of dietary components were examined, results were considered significant at alpha = .01. Results. Masticatory performance and perceived ability to chew were unrelated to diet quality. The good quality denture group had significantly better masticatory performance than the medium and poor quality groups, but the median HEI scores and dietary intakes were not significantly different among these 3 groups. Milk, vegetable, fruit, and grain intake scores were mainly responsible for the low overall HEI scores. Conclusion. In the population evaluated, complete denture quality, food comminution capacity, and perceived chewing ability were not related to diet quality. The majority of subjects had deficient diets regardless of the technical quality of their dentures.87549049

Saúde bucal em adultos e idosos na cidade de Rio Claro, São Paulo, Brasil Oral health in adults and the elderly in Rio Claro, São Paulo, Brazil

O objetivo deste trabalho foi verificar prevalência de cárie, edentulismo, uso e necessidade de próteses totais em idosos e adultos no Município de Rio Claro, São Paulo, Brasil. A amostra foi de 202 indivíduos, sendo 101 idosos (65 a 74 anos) e 101 adultos (35 a 44 anos). Os exames foram realizados por quatro examinadores, calibrados de acordo com critérios da Organização Mundial da Saúde. A porcentagem de edêntulos foi de 74,25% para os idosos e 8,91% para os adultos, sendo a média de dentes presentes de 3,19 e 22,10, respectivamente. O CPOD foi de 31,09 e 22,86 para os idosos e adultos, respectivamente. O maior componente do índice CPOD no grupo de idosos foi dentes perdidos (92,64%); para os adultos, foi dentes restaurados (57%), seguido de dentes perdidos (40,54%). Somente 1% dos adultos necessitava de próteses totais superiores e inferiores, já para os idosos estas necessidades foram de 48,5% e 45,5%, respectivamente. Mediante tais resultados, há necessidade de programas preventivos e educativos tanto para idosos como para adultos, a fim de que estes adultos cheguem à terceira idade com uma condição de saúde bucal melhor que a relatada atualmente.<br>The aim of this study was to verify the prevalence of dental caries, edentulism, and use of and need for complete dental prostheses in adults and the elderly in Rio Claro, São Paulo State, Brazil. The total sample included 202 subjects, 101 elderly (64 to 75 year-olds) and 101 adults (35 to 44 year-olds), who were examined by four examiners according to who criteria. Edentulism was 74.25% in the elderly and 8.91% in adults, and present teeth rates were 3.19 and 22.10, respectively. In the elderly and adults, DMFT was 31.09 and 22.86, respectively. MT was the major component of the DMFT index in the elderly group (92.64%), as compared to FT in the adult group (57%), followed by MT (40.54%). complete upper and lower dental prostheses were needed by only 1% of the adults; however, 48.5% of the elderly required complete upper prostheses and 45.5% complete lower prostheses. the data suggest that preventive and educational programs are needed for both the elderly group and adults in order for adults to enjoy good oral health when they reach old age

Diagnósticos de enfermagem de idosas carentes de um programa de saúde da família (PSF) Diagnósticos de enfermería de ancianas carentes de un programa de salud de la familia (PSF) Nursing diagnoses of pauper elderly women of a family health program (FHP)

Considerando que as mulheres idosas e pobres são propensas à maior vulnerabilidade nas condições de saúde, no presente estudo propôs-se a identificar os diagnósticos de enfermagem, segundo a taxonomia II de NANDA, sobre um grupo de idosas consideradas muito pobres. Foram selecionadas 69 idosas, a partir da aplicação do instrumento de Classificação Econômica Brasil (CCEB) em 301 idosos residentes na área de abrangência de um PSF. O estado de saúde das idosas foi avaliado utilizando-se a Avaliação Geriátrica Ampla (AGA), que envolve os aspectos funcionais, emocionais, sociais e ambientais. Foram identificadas 23 categorias diagnósticas nas idosas do estudo e uma média de 7,4 diagnósticos/ idosa. Entre os diagnósticos mais freqüentes destacam-se " Mobilidade física prejudicada","Dor crônica","Manutenção do lar prejudicada". Os diagnósticos revelaram-se impor tantes na caracterização das complexas necessidades apresentadas pelas idosas e no grande avanço no direcionamento da assistência.<br>Considerando que las mujeres ancianas pobres son propensas a mayor vulnerabilidad en las condiciones de salud, proponemos en este estudio identificar los diagnósticos de enfermería según la taxonomía II de NANDA de un grupo de ancianas consideradas muy pobres. Fueran seleccionadas 69 ancianas, a partir de la aplicación del instrumento de Clasificación Económica Brasil (CCEB) en 301 ancianos residentes en el área de alcance de un PSF. El estado de salud de las ancianas fue evaluado utilizándose de la Evaluación Geriátrica Amplia (AGA) que involucra los aspectos funcionales, emocionales, sociales y ambientales. Fueron encontradas 23 categorías diagnósticas en las ancianas del estudio y un promedio de 7,4 diagnósticos/anciana. Entre los diagnósticos más frecuentes se destacan: " Mobilidad física perjudicada"; "Dolor crónica"; "Manutención del hogar perjudicada". Los diagnósticos se han revelado importantes en la caracterización de las complexas necesidades presentadas por las ancianas y gran avanzo en lo direccionamiento de la asistencia.<br>Considering that the elderly and pauper women are disposed to a larger vulnerability in the health conditions, in the present study it was proposed to identify the nursing diagnosis, according to the taxonomy II of NANDA, about the elderly women group considered very pauper. Were selected 69 elderly women, from the application of the instrument of Brazilian Economic Classification (CCEB) in 301 elderly people that lives in the scope of the FHP. The health condition of the elderly women was evaluated using the Wide Geriatric Evaluation (WGE), that involves the functional, emotional social, and of the environment aspects. Were identified 23 categories of diagnosis in the elderly women of the study and an average of 7.4 diagnosis/elderly. Among the more frequent diagnosis was detached " Damaged Physical Mobility", " Chronicle Pain", " Damaged Maintanance of the Home". The diagnosis revealed to be important in the characterization of the complexity needs presented by the elderly women and in the large advance in the assistance orientation

Raça e o uso dos serviços de saúde bucal por idosos Race and the use of dental health services by the elderly

Analisamos se a raça pode ser considerada um fator limitante na utilização dos serviços odontológicos por idosos. O presente estudo é de caráter analítico, com a utilização de dados secundários coletados pela Pesquisa Nacional de Saúde Bucal em 2003. Foram incluídos os examinados que se declararam como brancos, pardos ou pretos, na faixa etária de 65 a 74 anos. O número amostral foi composto por 5.108 idosos sendo 2.575 brancos e 2.533 negros. Dos brancos 3,8% afirmaram nunca terem ido ao dentista enquanto que para os negros esse valor é de 7,8%. Mesmo após o ajuste com interceptação de necessidade de prótese e dor, a chance do idoso negro não ter utilizado o serviço odontológico pelo menos uma vez na vida é 0.62 OR menor que para um idoso branco. Dos que utilizaram os serviços, 21,2% dos idosos brancos visitaram o dentista no último ano, enquanto para os negros o valor foi de 14,2%, no modelo ajustado interceptado pela necessidade de prótese e dor o OR foi de 0.60. Todas as relações foram estatisticamente significantes (p < 0,001). A raça é um fator limitante na utilização dos serviços odontológicos por idosos e, mesmo após ajustes, os idosos negros permanecem com maior dificuldade na utilização dos serviços de saúde bucal.<br>We analyze if race can be considered a limiting factor in the use of dental services by the elderly. This study is of an analytical nature, with the use of secondary data collected by the National Survey of Oral Health in 2003. Those examined who declared themselves as being white, brown or black in the 65 to 74-year-old age bracket were included. The sample was composed of 5,108 elderly people: 2,575 whites and 2,533 blacks. Of the whites, 3.8% stated that they had never been to the dentist, while this figure was 7.8% for the blacks. Even after the adjustment for interception for prosthetics and dental pain, the chance of elderly blacks not having used dental services at least once in their life is 0.62 OR less than for elderly whites. Of those who used the services, 21.2% of the elderly whites visited the dentist in the last year, while for elderly blacks the figure was 14.2%, in the adjusted model for interception for prosthetics and dental pain the OR was 0.60. All the relations were statistically significant (p<0,001). Race is a limiting factor in the use of dental services by the elderly and even after the adjustments the elderly blacks continue to manifest greater resistance to the use of oral health services