Prevalence and factors associated with alterations of the temporomandibular joint in institutionalized elderly

Abstract

Prevalence and factors associated with alterations of the temporomandibular joint in institutionalized elderlyPrevalência e fatores associados a alterações na articulação temporomandibular em idosos institucionalizados Resumo O objetivo deste artigo é avaliar a prevalência e os fatores associados a alterações na ATM em idosos institucionalizados. Estudo observacional e transversal, conduzido em 1.192 idosos brasileiros. Foram realizados exames intra e extraoral, baseados na Ficha de Avaliação da OMS (1997). Dados demográficos e nível de dependência também foram coletados. A autopercepção do idoso quanto à saúde bucal foi obtida através do GOHAI (Geriatric Oral Health Assessment Index). Na análise dos dados foram usados o teste do Qui-quadrado e a Regressão robusta de Poisson (nível de significância de 5%). A presença de alguma alteração na ATM foi pouco prevalente quando comparada a dos adultos, e esteve associada à condição de dependência do idoso (os independentes tiveram 45,4% mais alterações do que os dependentes), ao sexo (mulheres tiveram 47,4% mais alterações), à autopercepção de saúde bucal (quem avaliou negativamente teve 65,6% mais alterações) e à necessidade de prótese (PT) superior (quem necessita de algum tipo de PT superior teve 45,8%). Apesar de ter sido baixa, a presença de alterações na ATM esteve mais frequente em idosos independentes, do sexo feminino, que avaliaram negativamente a saúde bucal e que necessitam de algum tipo de PT superior. Abstract This article aims to analyze the prevalence and associated factors of TMJ alterations in elderly institutionalized. An cross-sectional study of 1192 elderly institutionalized in Brazil was undertaken. Intra and extra-oral exams were performed and the TMJ was evaluated based on the Oral Health Assessment Form of the WHO (1997). Demographic data and elderly dependence were also collected. The self-perception of the elderly regarding oral health was measured using the Geriatric Oral Health Assessment Index -GOHAI. Data analysis was performed using the Chi-squared test and robust Poisson regression (level of significance of 5%). The prevalence of TMJ alteration was low compared to adults and was only associated with the state of dependence of the elderly individual (independent had 45.4% more alterations than dependent individuals), gender (women had 47.4% more alterations), self-perception of oral health (who evaluated negatively had 65.6% more alterations) and the need of upper dentures (who needed some kind of upper dentures had 45.8% more alterations than those who did not). Despite being low, the presence of alterations in the TMJ was more frequent in elderly independent, women, who evaluated negatively oral health and need some kind of upper dentures.

Oral Health and Its Associated Factors Among Older Institutionalized Residents—A Systematic Review

“…Two study series reported on periodontal problems for various ages. A Brazilian study series [42,61,65] indicated that the prevalence of periodontitis was 20.6% in residents older than 64 years, whereas the prevalence was 45.7% for residents who were 75 to 84 years old. A lower prevalence of 14.3% was observed for residents who were 95 years old or older.…”

“…Regarding gender, 11 studies [21,22,24,30,32,33,34,36,38,42,45] explored the association between gender and oral problems or a poor OHRQoL. Three study series [32,38,42,49,58,61,65] reported that the male gender was associated with dental/periodontal problems. Janssens et al [32,49] reported that male Belgian dentate residents had a higher proportion of decayed teeth according to a mixed-effect logistic regression analysis.…”

“…Hopcraft et al [38,58] indicated that Australian male residents were associated with a CPI score of 3 or above, indicating possibly poor periodontal conditions detectable by logistic regression analysis. A Brazilian study [42,61,65] used an adjusted multivariate data analysis and reported that males appeared to be associated with higher rehabilitation needs.…”

“…Rabiei et al [31] indicated that female Iranian denture wearers were at a higher risk of denture complications, such as denture stomatitis and overall, these Iranian institutionalized females had a significantly higher prevalence of oral mucosal disorders. A Brazilian study series [42,61,65] reported that females were associated with more TMJ alterations.…”

“…They also found that assistance with tooth brushing and the frequency of tooth brushing were significantly associated with better oral hygiene. Piuvezam et al [42,61,65] showed that Brazilian residents whose last dental visit was longer than 1 year past were significantly associated with higher rehabilitation needs based on an adjusted multivariate analysis.…”