The burden of tooth loss in Italian elderly population living in nursing homes

Abstract

BackgroundThis survey aims to evaluate the prevalence and severity of tooth loss in the Italian elderly population living in nursing homes and to associate the oral data with demographic, socioeconomic factors, the Mini-Mental State Examination (MMSE), the Body Mass Index (BMI) and the Mini Nutritional Assessment (MNA) scores.MethodsA cluster sample method was performed using each nursing home as a cluster. Twenty-three nursing homes located in the five areas of the Italy (North-West, North-East, Centre, South and Islands) were selected. An informed consent to participate was distributed by the personnel of the selected nursing homes and signed directly by subjects/caregivers; 2114 forms were distributed, 1998 forms signed and finally 1976 subjects were examined. Chewing ability was scored as good (≥10 functional units (FUs)), sufficient (7–10 FUs), and insufficient (< 7 FUs). The presence of prosthetic dental restorations was summarized as: absent of prosthesis, fixed prosthesis, removable prosthesis, combined prosthesis. Age, gender, socioeconomic status, MMSE, BMI and MNA were obtained from medical charts.ResultsAlmost three quarters of the subjects were ≥ 80 years old (74.37%) and women (74.04%). The prevalence of edentulism was 42.10% with a large variation among the five areas of Italy (from 34.43% in Centre to 53.46% in North-West). Insufficient presence of FUs was preeminent in each age group (prevalence 42.10%) and statistically associated to age and to female gender (p < 0.01). Overweight/obese (7.47%) subjects showed the highest FUs. Area of living, MMSE (both < 0.01), BMI (p = 0.01) were statistically significant associated to the type of prosthetic dental restorations in the oldest group. Subjects with no mental impairment showed the highest percentage of prosthetic dental restorations (32.36%).ConclusionsMore than half of the sample has an insufficient number of functional units for chewing and this is more pronounced in females. The presence and the type of prosthetic dental restorations are linked to cognitive impairment: the higher is the mental impairment the higher is the number of subjects with absence of prosthetic restorations. The findings of this national survey highlight the need for public health policy, aiming to increase awareness regarding oral health though health education.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0760-0) contains supplementary material, which is available to authorized users.

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

“…Twenty-two of the included studies used a cross-sectional design [21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42] and three [43,44,45] used a case-control design or incorporated some sort of reference group. The JBI critical appraisal checklists for cross-sectional studies and case-control studies were applied to evaluate the methodological quality.…”

“…Among the 25 studies/series ( n = 10,958), the following were found: eight from Asia ( n = 1851), three from India [21,22,23,46],two from Iran [24,25],one each from South Korea [43], Hong Kong [26] and Japan [27,47];two from the Eurasian trans-continent ( n = 460), Turkey [28,29,48];eleven from Europe ( n = 5899), one each from Belgium [32,49], Finland [33,50], Italy [34], Lithuania [44], Malta [35,51], the Netherlands [45,52], Spain [36] and the United Kingdom [37];two from Germany [30,31,53,54,55,56,57],two from Australia ( n = 715) [38,39,58,59];two from North America ( n = 841), one each from Canada [40,60] and the USA [41];one ( n = 1192) from South America, Brazil [42,61]; butnone from Africa. …”

“…eleven from Europe ( n = 5899), one each from Belgium [32,49], Finland [33,50], Italy [34], Lithuania [44], Malta [35,51], the Netherlands [45,52], Spain [36] and the United Kingdom [37];two from Germany [30,31,53,54,55,56,57],…”

“…The mean age of the surveyed residents in these investigations was not reported. Nineteen studies [21,25,26,27,29,30,31,32,33,34,35,37,39,40,41,42,43,44,45] reported the mean age of their surveyed cohorts, which was 72.2 to 85.5 years. Two studies [28,38] reported the mean age of their surveyed cohorts with reference to their gender: 79.1 to 85.7 years for females and 75.2 to 77.8 years for males.…”

“…Four studies [27,31,33,34] reported the body mass index (BMI) of their residents. Briefly, a Finish study [33] following 1369 residents reported that the mean BMI was approximately 25.…”