Oral Mucosal Conditions and Risk Factors among Elderly in a Turkish School of Dentistry

Abstract

Background: Prevalence studies are important to determine the oral health status and treatment needs of elderly people. Our aim was to obtain data for the prevalence of oral mucosal conditions (OMC) in a Turkish elderly sample and to compare our results with different geographic regions. Objective: The purpose of this clinical-based study was to determine the prevalence of OMC and associated risk factors in a clinical-based Turkish elderly sample. Methods: The study sample consisted of 700 patients >60 years old. The clinical examination of patients was performed by both authors. All participants were questioned about their general health status, medication use, oral hygiene habits, tobacco or alcohol use, use of dentures, and the length of denture use. χ² Pearson’s test with Fisher’s exact probability test was used to analyze the data. Logistic regression models were used to assess the influence of independent variables; odds ratios were calculated with 95% confidence intervals. Statistical significance was defined as p <0.05. Results: OMC were recorded in 40.7% of the study sample. The logistic regression model revealed that male gender, length of denture use, smoking habit, and being a former smoker increased the probability of having an OMC. Smoking habit also increased the risk of having leukoplakia. The denture-related lesions accounted for 36.4% with the length of denture use and diabetes mellitus being significant risk factors for denture stomatitis and denture hyperplasia. The model for traumatic ulcer included medication use as a significant risk factor. Conclusions: Our results regarding an elderly Turkish sample support the studies of other populations where the prevalence of OMC was related to length of denture use, smoking, and gender. We also observed some important associations between denture-related lesions, systemic diseases, and medication use which require further investigation.

Prevalence of oral and maxillofacial diseases diagnosed in an Oral Medicine service during a 7-year period

“…Several studies have been conducted with population-based samples [1][2][3][4][5]8 and these will probably show different results when compared to studies conducted at universities and centers of specialized health care, with individuals searching for assistance (convenience samples) 6,[9][10][11][12][13] . Studies conducted in dental schools, both with patients in routine dental treatment or referred for stomatological evaluation, in spite of probably showing a different picture from the general population, may better represent a model of what occurs in daily practice of the profession 6,[11][12][13][14] . In contrast, studies with samples derived from oral surgical pathology laboratories do not evaluate the frequency of clinically diagnosed lesions, basing their results on diseases diagnosed and/or treated by surgical procedures 15,16 .…”

Predictors of oral mucosal lesions among removable prosthesis wearers

“…prosthesis type, a higher prevalence of DROMLs was found in complete denture prosthesis wearers than in partial denture prosthesis wearers (10,13,26). In this matter, Jainkittivong et al (26) found a higher prevalence of denture-related lesions among complete denture prosthesis wearers (46.3%) than in those wearing partial denture prostheses (40.8%).…”

“…The most often-listed local causes are: denture trauma, wearing a prosthesis at night, wearing a complete prosthesis, inadequate prosthesis stability and retention, poor prosthesis hygiene, candida infection, low salivary flow rate, low salivary pH and smoking (7,10,16,18,19). The systemic factors linked to these lesions are age and diabetes mellitus (10,13,18). Some studies report higher incidence of DROMLs among women (19), others in men (15,16).…”

“…The immune system's defence is also weakened due to age and systemic diseases (like diabetes mellitus), and as a result, denturerelated oral mucosal lesions (DROMLs) caused by opportunistic pathogens (most commonly, Candida albicans) occur (7,(11)(12)(13). When patients wear dentures not only during the day but also at night, they additionally increase the potential incidence of DROMLs, due to the lack of the protective action of saliva on oral mucosa (14).…”

“…As a result of years of wearing them, prosthesis retention weakens along with their stability and DROMLs occur (denture stomatitis, angular cheilitis, traumatic ulcer and inflammatory fibrous hyperplasia). The likely reason for this occurring is patient negligence, but also bad education on the part of therapists (7,8,10,13,17,18). The literature also presents findings noting that the prevalence of DROMLs is higher in the case of total rather than partial dentures, particularly in the upper jaw (19).…”