Within weeks of the emergence of the novel coronavirus COVID-19 in China, misleading rumours and conspiracy theories about the origin circulated the globe paired with fearmongering, racism and mass purchase of face masks, all closely linked to the new "infomedia" ecosystems of the 21 st century marked by social media. A striking particularity of this crisis is the coincidence of virology and virality: not only did the virus itself spread very rapidly, but so did the information -and misinformation -about the outbreak, and thus the panic that it created among the public. 1,2 The social media panic traveled faster than the COVID-19 spread. 3 In many ways, we could identify here a

Little information exists about the loss of all one’s teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO’s) Study on global AGEing and adult health (SAGE) Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367), Ghana (N = 4724), India (N = 7150), Mexico (N = 2315), Russian Federation (N = 3938) and South Africa (N = 3840). Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%–21.7%) than China, Ghana, and South Africa (3.0%–9.0%). In multivariate logistic analysis sociodemographic factors (older age, lower education), chronic conditions (arthritis, asthma), health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption) and other health related variables (functional disability and low social cohesion) were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention.

BackgroundEdentulism (loss of all teeth) is a final marker of disease burden for oral health common among older adults and poorer populations. Yet most evidence is from high-income countries. Oral health has many of the same social and behavioural risk factors as other non-communicable diseases (NCDs) which are increasing rapidly in low- and middle-income countries with ageing populations. The “common risk factor approach” (CRFA) for oral health addresses risk factors shared with NCDs within the broader social and economic environment.MethodsThe aim is to improve understanding of edentulism prevalence, and association between common risk factors and edentulism in adults aged 50 years and above using nationally representative samples from China (N = 11,692), Ghana (N = 4093), India (N = 6409) and South Africa (N = 2985). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007–2010). Multivariable logistic regression describes association between edentulism and common risk factors reported in the literature.ResultsPrevalence of edentulism: in China 8.9 %, Ghana 2.9 %, India 15.3 %, and South Africa 8.7 %. Multivariable analysis: in China, rural residents were more likely to be edentulous (OR 1.36; 95 % CI 1.09–1.69) but less likely to be edentulous in Ghana (OR 0.53; 95 % CI 0.31–0.91) and South Africa (OR 0.52; 95 % CI 0.30–0.90). Respondents with university education (OR 0.31; 95 % CI 0.18–0.53) and in the highest wealth quintile (OR 0.68; 95 % CI 0.52–0.90) in China were less likely to be edentulous. In South Africa respondents with secondary education were more likely to be edentulous (OR 2.82; 95 % CI 1.52–5.21) as were those in the highest wealth quintile (OR 2.78; 95 % CI 1.16–6.70). Edentulism was associated with former smokers in China (OR 1.57; 95 % CI 1.10–2.25) non-drinkers in India (OR 1.65; 95 % CI 1.11–2.46), angina in Ghana (OR 2.86; 95 % CI 1.19–6.84) and hypertension in South Africa (OR 2.75; 95 % CI 1.72–4.38). Edentulism was less likely in respondents with adequate nutrition in China (OR 0.68; 95 % CI 0.53–0.87). Adjusting for all other factors, compared with China, respondents in India were 50 % more likely to be edentulous.ConclusionsStrengthening the CRFA should include addressing common determinants of health to reduce health inequalities and improve both oral and overall health.