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Statement of Problem: Tooth loss is a critical indicator of oral health and negatively impacts oral health-related quality of life (OHRQoL) depending on the number and location of the missing teeth. Reports of oral rehabilitation have been conflicting depending on the tooth loss pattern and prostheses provided., Purpose: The purpose of this population-based study was to evaluate the association between the use of different dental prostheses according to different tooth loss patterns and OHRQoL., Material and Methods: A representative sample of 22 843 individuals aged between 15 and 75 years was recruited in Brazil. The dependent variable was the OHRQoL as measured by the score on the oral impact on daily performance (OIDP), and the main predictor was the pattern of tooth loss and prosthesis use. Covariates included sex, age, income, education, missing teeth, dental pain, and dental visits. The zero-inflated negative binomial regression was applied with sampling weights., Results: Participants with only anterior missing teeth had an OIDP mean ratio, MR) 1.49 times higher than those without tooth loss and not wearing a prosthesis (95% CI=1.12-1.98); those with a distal extension, with anterior tooth loss MR=1.68 (95%CI=1.17-2.43); and complete edentulism in one or both jaws MR=1.53 (95%CI=1.04-2.25). Participants wearing a removable partial denture (RPD) or a combination of an RPD and fixed prostheses with a few missing teeth reported worse OIDP (MR=3.57, 95% CI=2.11-6.04) than those with fixed prostheses only or without a prosthesis. Individuals with edentulism using complete dentures in both jaws had lower OIDP scores (MR=0.9, 95% CI=0.59-1.37) than those using or those who do not use other categories of prosthetic rehabilitation., Conclusions: Some types of prosthetic rehabilitation were not associated with better OHRQoL in individuals with tooth loss. The impact of prosthetic rehabilitation was associated with the pattern of tooth loss., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: Latin American and Carribean (LAC) are currently experiencing a rapid aging of their population, coupled with a significant burden of oral diseases. Despites this, there is a scarcity of evidence regarding the manner in wich geriatric dentistry is being taught in dental schools across LAC. So, the objective of this study is to investigate the current status of geriatric dentistry education at undergraduate and postgraduate levels in selected LAC dental schools., Methods: An electronic questionnaire was developed and emailed to all 539 dental schools in 19 LAC countries. The questionnaire recorded activity levels, contents and methodology of geriatric dentistry education as part of dental degree programmes. Reminders by email and telephone calls were used to encourage non-responders to complete the questionnaire., Results: In total, 317 schools from 17 countries responded to the questionnaire (response rate: 58.8%). Geriatric dentistry was taught in 54.6% of the schools at the undergraduate level and in 6.9% at the postgraduate level. Thirty two percent of the schools had a programme director trained in geriatric dentistry. Geriatric dentistry was taught as an independent course in 14.5% of the schools. Dry mouth, periodontal disease, denture-related conditions and prosthodontic management, oral mucosal disease and age-related changes of the orofacial complex were the most frequently covered topics. Clinical teaching of geriatric dentistry was reported by 26.5% of the schools, with 38.0% providing clinical training in outreach facilities., Conclusions: Geriatric dentistry education remains incipient in LAC, with only one in every four dental school offering it as a standalone course. There is an urgent need to further develop geriatric dentistry education in the continent, including further research to develop a minimum geriatric dentistry curriculum., (© 2023 Gerodontology Association and John Wiley & Sons Ltd.)

Objectives: To investigate the association between different types of dental prostheses (and residual dentition) and oral health-related quality of life (OHRQoL)., Methods: A population-based study with a representative sample of adults and older adults in Uruguay (2010-2011). The dependent variable was the score on the oral impact on daily performance (OIDP), and the main predictor was the pattern of tooth loss and prosthesis use. Covariates included sex, age, socioeconomic status, education, missing teeth, pain and decayed teeth. Negative binomial regression was used., Results: The sample comprised 762 participants. Those participants not wearing a prosthesis and with extensive tooth loss had a mean OIDP of 3.1 (95% CI = 1.6-6.2), while those wearing removable partial dentures (RPD) and having <12 missing teeth had a mean OIDP of 3.6 (95% CI = 1.3-10.0). Participants with a free-end saddle had the highest mean OIDP, at 4.9 (95% CI = 2.0-12.1). For participants with ≤12 missing teeth, any additional missing tooth was associated with an 11% higher OIDP score. Participants who wore RDPs reported fewer impacts on OHRQoL if they had extensive tooth loss or anterior tooth loss than those with a free-end saddle, or who had lost fewer teeth., Conclusions: The use of RPDs is associated with better OHRQoL. These findings may be valuable in clinical practice and prosthetic planning., (© 2022 Gerodontology Association and John Wiley & Sons Ltd.)

Objective: To investigate the risk factors for tooth loss after 8 years among community-dwelling older adults in a southern Brazilian city., Methods: In 2004, 388 dentate community-dwelling older adults from Carlos Barbosa, southern Brazil, were selected using simple random sampling. In 2012, the follow-up consisted of 199 (51.3%) participants. Data collection comprised an interview with data about socio-demographic, behavioural and access to services and an oral examination. The outcome variable of this study is the ratio between the sum of the teeth lost during the 8-year period of follow-up, and the sum of the teeth present in 2004, per person, modelled through binomial regression analysis., Results: Being older (IOR = 1.03, 95% CI: 1.00-1.06), living in a rural area (IOR = 1.56, 95% CI: 1.17-2.07), earning two or more monthly minimum wages (IOR = 1.46, 95% CI: 1.09-1.96), living alone (single, widowed or divorced; IOR = 1.36, 95% CI: 1.00-1.85), having more gingival bleeding sites (IOR = 1.01, 95% CI: 1.00-1.02) and wearing partial removable prosthesis (IOR = 2.82, 95% CI: 2.15-3.71) were risk factors for tooth loss. Approximately 48% of the participants lost one or more teeth over the 8-year follow-up period., Conclusion: Socio-demographic, economic and clinical variables were associated with the risk for tooth loss. This might be a result of social determinants of health influencing people's access to oral health care, oral health behaviours and oral health status. Public policy aimed at older adults living in rural areas, living alone and using removable dentures may contribute to reducing the risk of tooth loss., (© 2022 Gerodontology Association and John Wiley & Sons Ltd.)

Objectives: Obesity is an important risk factor for chronic diseases and can also result in greater mortality. The aim of this longitudinal study was to investigate whether poor oral health acts as a risk factor for obesity as indicated by body mass index (BMI) and waist circumference (WC)., Methods: We included in this analysis all participants who volunteered in a cohort study entitled 'Carlos Barbosa Cohort Study-CBCS' in the city of Carlos Barbosa, Southern Brazil. The interview questionnaire comprised socio-demographic information, behavioural questions and medical history. Oral examinations and anthropometric assessments were carried out. The outcome was obesity measured by both BMI (≥30 kg/m 2 ) and WC (>0.80 for women and >0.94 for men). Variables were collected longitudinally. Those associated with the outcome and epidemiologically relevant to the conceptual framework participated in the analysis and were adjusted for socio-demographic, behavioural, general and oral health conditions., Results: Six hundred and thirty-three independently living elders participated. The baseline mean age was 67.5 ± 6.1 years. Individuals who never visited a dentist (OR = 3.02, 95% CI: 1.25-7.26) as well as participants who needed a dental prosthesis in the lower arch (OR = 4.38, 95% CI: 1.34-14.32) were more likely to be obese, through BMI and WC measures, respectively. Edentulous participants with complete dentures in both arches (OR = 0.23, 95% CI: 0.06-0.84) and those who perceived their oral health as unsatisfactory (OR = 0.41, 95% CI: 0.19-0.88) had a lower likelihood of being obese, according to BMI and WC measures., Conclusions: Older persons with poor oral health may be at risk for general and central obesity, a relationship that may have important clinical implications., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To explore the sociocultural context in which patients and dentists in urban and rural communities in Southern Brazil interpret dental problems., Method: Beliefs and experiences related to dental problems were explored in eight focus groups involving a total of 41 older patients, and in direct interviews with two dentists and two dental assistants. The interactions were audio recorded and transcribed for thematic analysis., Results: The beliefs and experiences of the participants focused on four main themes: cultural beliefs; dental services; decisions to extract teeth; and expectations for change. A culture of pre-nuptial tooth loss and complete dentures was considered beneficial to young women. Although dental services at the time were scarce in the region, demands for relief of pain were extensive despite the fear and anxiety of the participants. Extraction of teeth and fabrication of complete dentures were the usual dental treatments available, although some participants felt that dentists withheld other treatment options. Participants were hopeful that dental services would improve for their children., Conclusions: Patients and dental professionals in urban and rural communities of Southern Brazil managed dental problems within a culture of limited access and availability of services that favoured dental extractions and complete dentures., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Knowledge Transfer Statement: This article provides an overview of the oral health status of older people from Latin American countries and the emergence of recent gerodontology research initiatives within the region.

Objective: The purpose of this review was to gather information and discuss oral health status of older people in the Latin American and Caribbean region (LAC)., Background: Scarce data are available to portrait the oral situation of older people in the region., Material and Methods: This review paper is the result of a meeting of the IADR's Latin American Geriatric Oral Research Group held in Porto Alegre, Brazil, in November of 2016, part of the activities of an IADR Regional Development Programme (RDP). A group of researchers from 8 countries of LAC held a discussion using 5 questions related to the oral health situation of older Latin Americans, the most appropriate strategies to face the problem and the challenges for the future, with an open discussion format. In a second step, a group of 6 experts refined the answers and reviewed the existent literature., Results: The review of the evidence revealed that only a few LAC countries have information, which suggests the need for multinational efforts to understand the oral health status and programmes in place. Of the few studies available, it is possible to observe poor oral health as a common feature of older adults in the region., Conclusion: There is a need for the development of national surveys and standardised tools for the assessment of oral health in older adults. Also, intense advocacy to modify and influence public health policies in the different countries of the LAC is strongly recommended., (© 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.)

Objective: This study aimed to assess the incidence density (ID) of new root caries lesions and restorations among community-living south Brazilian older adults and to assess its association with predictor variables., Methods: We conducted a prospective cohort with a random sample of elders from the municipality of Carlos Barbosa, in south Brazil. Trained dentists performed interviews and oral examinations in 388 individuals at baseline, of which 273 were retained at follow-up 4 years later. Our outcome was root caries ID, with 100 root-years as its unit of measure. Demographic, biological and lifestyle predictors were tested with Poisson regression., Results: The mean number of roots at baseline among participants was 7.0 (SD ± 4.9) and the incidence rate per 100 root-year 4.9 (SD ± 8.9). Incidence of root caries among these older Brazilians was of 47.3%. The associated factors with the incidence of root caries were age, geographic location of residence, frequency of tooth brushing and stimulated saliva flow rate., Conclusion: Age, external environment, personal practices and oral status were predictors of the incidence of root caries. Preventive strategies including the use of fluorides and instruction to improve the attitude and behaviour towards oral hygiene are needed., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To identify socioeconomic, demographic, behavioural and clinical predictors of the 8-year incidence of edentulism in south Brazilian older adults., Methods: Cohort of a representative sample of older persons in Carlos Barbosa, a south Brazil city. A cohort study was conducted using a simple random sample of 392 older people evaluated in 2004, with follow-ups in 2008 and 2012, when 199 participants were evaluated. Interviews and oral examinations were conducted. The baseline assessment was carried out in 2004, with follow-ups in 2008 and 2012. To evaluate the predictors of edentulism, Poisson regression models with robust variance were carried out. The outcome was modelled through the use of a hierarchical approach based on the conceptual framework proposed by Andersen and Davidson., Results: Some 11.5% of the participants had become edentulous after 8 years. Higher income, use of partial removable dentures and low salivary flow were associated with the incidence of edentulism., Conclusions: Maintaining a good salivary function may be essential for the prevention of the incidence of edentulism in this age group. Furthermore, our findings suggest that rehabilitations with partial removable dentures may be detrimental to long-term oral health., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: The aim of the present study was to develop and validate an ultra-short Spanish version of the Oral Health Impact Profile (OHIP) in an elderly Chilean population., Methods: The OHIP-49Sp was applied to 490 older adults, and the seven questions with the higher impact on oral health-related quality of life were selected through linear regression. These items were applied to 85 older adults to test internal consistency (Cronbach's alpha). A discriminative validity analysis was carried out along with the assessment of sociodemographic and clinical variables. Data were analyzed using the Mann-Whitney U-test, Student's t-test and one-way anova tests with a 95% confidence level., Results: High internal consistency values were obtained for the OHIP-7Sp instrument (0.93). There was an association between the OHIP-7Sp scores and the presence of caries, need for complex periodontal treatment, prosthetic needs, and age younger than 70 years., Conclusion: The OHIP-7Sp proved to be a consistent and valid tool to assess oral health-related quality of life in Chilean older adults, and can be incorporated in epidemiological studies that include several other targets. Geriatr Gerontol Int 2017; 17: 277-285., (© 2016 Japan Geriatrics Society.)

Objectives: To determine the incidence and predictors of coronal caries among community-dwelling elderly in a southern Brazilian city., Methods: A cohort study was conducted using a simple random sample of persons aged 60 years or older in Carlos Barbosa city, southern Brazil. Interviews and oral examinations were conducted among 388 dentate individuals at baseline and among 273 at 4-year follow-up. The incidence of coronal caries was modeled by means of negative binomial regression., Results: Some 184 (76.7%) participants presented with new coronal caries lesions or restorations, whose mean number was 2.2 ± 2.1, whereas the 4-year mean coronal caries incidence rate was 0.28 ± 0.29. In the multivariate model that controlled for baseline predictors, older age, male gender, living in a rural area, current smoking, and negative self-perception of oral health were associated with coronal caries incidence. Among clinical variables, the use of partial dentures was a predictor, whereas higher saliva flow rate was a protective factor for the outcome., Conclusions: Demographic factors, primary determinants of health, behavioral, and clinical variables were predictors of the incidence of coronal caries. As people enter old age, even stronger emphasis should be put on preventive strategies., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To describe changes in oral health-related quality of life and to evaluate the associations of these changes in community-dwelling older people., Materials and Methods: In this longitudinal study a representative sample of 872 older people, living in Brazil, was evaluated during 2004. The follow-up was carried out during 2008, with 587 older persons evaluated. A questionnaire assessing socio-demographic information, health history, oral health-impact profile and number of natural teeth was used. Changes in oral health-related quality of life were categorized as improvement or deterioration. Data analysis was performed using a hierarchical approach based in a conceptual framework. A hierarchal approach was carried out using Poisson regressions., Results: Older persons living in rural areas, those who reported brushing once a day or less and older persons with fewer natural teeth had an increased chance of reporting deterioration in oral health-related quality of life. Women and participants who received a minimum wage of less than US $219.50 were more likely to report improvement in oral health-related quality of life., Conclusion: The results of this study suggest that changes in the oral health-related quality of life are influenced by many of the variables that were included in the conceptual framework., (© 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.)

Abuse of the elderly is a form of violence to come to the public's attention. Dental professionals are in an ideal position to identify physical abuse. The aim of this study was to assess the prevalence of elderly abuse and analyze the database of injury reports that can be identified by dental teams. A documentary analysis study developed by the Elderly Protection Police Station of Porto Alegre, Rio Grande do Sul, was carried out. The information used came from 2,304 complaints filed at the aforementioned institution between the years of 2004 and 2006. The records of abuse are categorized as injury, neglect, mistreatment, theft, financial abuse, threat, disturbing the peace, atypical fact, and others. The injuries that could be identified by the dental team were classified according to the injury's location in the area of the head, face, mouth and neck. Descriptive analysis was performed, and chi-square tests were used to evaluate the distributions of the types of elder abuse in relation to sex and age. The most frequent of the different types of abuse was theft, with a prevalence of 17.8%, followed by disturbing the peace at 11.8%. Disturbing the peace, threat, and bodily injury were significantly associated with women. Elder abuse among women and men declines with age. The prevalence of head injury was 25% of the total injuries, most often in females, and in those aged < 70 years. Based on these results, it is necessary that the dental team observe the elderly person's appearance for suspicious physical signs.

Background: Tooth loss is still prevalent among older adults and may negatively affect their health and well-being. Previous evidence has shown that oral disease-related factors are the more consistent predictors of tooth loss. Although certain models have considered oral health behaviour as a key construct in explaining oral health inequalities, others have favoured the role of social structure and the social environment in determining oral health outcomes., Objective: To determine the tooth loss incidence and its predictors among community-living older adults in a southern Brazilian city., Methods: A cohort study was conducted using a simple random sample of 388 older people evaluated in 2004. The follow-up was carried out during 2008, with 273 older persons examined. Interviews and oral examinations were conducted. The incidence of tooth loss was modelled through a conceptual framework with the use of negative binomial regression., Results: Some 67.8% of people lost one or more teeth, whereas 12.5% became edentulous during the follow-up period. In the multivariate model that controlled for baseline predictors, older age; male gender; living in a rural area; being married; less schooling; current smoking; and dissatisfaction with the access to health services were associated with tooth loss. Among the clinical variables, the use of partial dentures and gingival bleeding index were predictors, whereas higher saliva flow rate was a protective factor for the outcome., Discussion: As proposed in the conceptual framework, demographic factors; primary determinants of health; behavioural; and clinical variables were predictors of tooth loss. These results are important, because understanding the causal association between lifestyle practices such as oral hygiene or smoking with tooth loss does not elucidate why individuals and communities engage in such practices., Conclusion: Interventions aiming to reduce tooth loss and edentulism in the elderly should account for social and environmental factors, in combination with clinical and behavioural components., (© 2012 John Wiley & Sons A/S.)

Extensive tooth loss and edentulism can have a negative impact on the general health and quality of life of older adults. The extent to which psychological and social factors affect an individual's decision to undergo tooth extraction and mouth clearance (extraction of all teeth), and the theoretical relationships between social structure, social life and oral health can be unraveled through qualitative research. This study aimed to explore the social and psychological factors involved in tooth extraction and mouth clearance within a historical perspective among rural Southern Brazilian older adults. It is based on qualitative data gathered via a series of eight focus groups among 41 older adults. Underlying the focus group discussions of different levels of health risks and resources for prevention of disease was the concept of vulnerability. Participants' responses illustrated that tooth loss and mouth clearance were related to a lack of public dental health policies and programs, were influenced by social norms (including values pertaining to gender), and were associated with a low level of oral health knowledge. The social and program-dependent contexts of vulnerability were shown to have played a major role in the development of norms and values towards tooth extraction and mouth clearance. Vulnerability must be reduced in order to prevent disease particularly among rural populations. The influence of fatalistic beliefs about the inevitable loss of teeth with age may negatively influence the acceptance of dental treatment and predilection for oral health self-care.

Objective: To evaluate if poor oral status was associated with percentage body fat in a representative sample of south Brazilian community-dwelling elderly., Background: Evidence suggests that elders with extensive tooth loss and edentulism present with compromised chewing function, which results in dietary changes. However, few studies have assessed whether poor oral status is associated with percentage body fat in community-dwelling elderly., Materials and Methods: A random sample of 471 south Brazilians =>60 years of age was evaluated. Measurements included a questionnaire to assess socio-demographic, behavioural, general, and oral health data. Percentage body fat was measured with a Tanita TBF 612 digital scale, which measures foot-to-foot bioelectrical impedance; and oral status assessment, by means of oral examinations assessing the number of teeth and use of dental prostheses. Correlates of risk of inadequate percentage body fat were assessed by means of multinomial logistic regression., Results: Edentulous participants were more likely to be underfat [OR: 3.11 (1.27-7.61)] or overfat/obese [OR: 1.82 (1.05-3.16)]., Conclusion: The present study shows that edentulous older people had higher odds for inadequate percentage body fat. The maintenance of teeth had a crucial role in increasing the chance of having an adequate body fat percentage in the study population., (© 2010 The Gerodontology Society and John Wiley & Sons A/S.)

Unlabelled: Evidence suggests that older adults with extensive tooth loss may present dietetic restrictions and frequently choose softer and more processed foods, which consequently may lead to obesity., Objective: To evaluate whether there was an association between dental status and central obesity in community-dwelling elderly., Basic Research Design: A simple random sample of 471 community-dwelling Brazilian elderly ranging from 60 to 89 years old was evaluated in 2006. A questionnaire on socio-demographic, behaviour, general and oral health variables was applied. The number of natural teeth and the use of dental prostheses, following the World Health Organization (WHO) criteria, were assessed., Main Outcome Measures: The circumferences of the waist and the hip were measured in order to provide the waist circumference (WC) and the waist-hip ratio (WHR) measures. For both measures, participants were categorised as non-obese or obese according to the WHO-established cut-off points., Results: Participants with more than 8 teeth were less likely to have central obesity, as measured by WHR [OR = 0.49 (0.32 to 0.87)], while participants with only 1-8 natural teeth were more likely to have central obesity when evaluated by WC [OR = 3.28 (CI 1.43 to 7.52)]., Conclusions: Tooth loss was associated with central obesity, even when controlled for confounders, suggesting a relationship between oral health status and nutritional status in this sample of community-dwelling Brazilian elderly. Preserving natural teeth may have a positive impact on the nutritional status of older adults and on obesity-related morbidity.

Objective: The objective of this study was to assess factors associated with the diet quality of brazilian older adults., Design: Cross-sectional study., Setting: City of Carlos Barbosa, Brazil., Participants: 228 participants aged 60 and older., Measurements: A questionnaire with questions on socioeconomic and behavioral variables and health characteristics was used. The body mass index was calculated and the waist circumference was measured to provide information in respect to abdominal fat accumulation. Dietary data were collected via 24-hour recall and the diet quality was assessed using the Healthy Eating Index, an instrument that attributes scores to the diet according to the adequacy of intake of the main food and nutrient groups. Participants were divided into three categories, according to the Healthy Eating Index scores: under 51--poor diet; between 51 and 80--diet that needs improvement; over 80--good diet. The evaluation employed the analysis of variance, t test and non-conditional logistic regression to assess the association between the Healthy Eating Index and the other variables., Results: Most participants (80.9%) presented diet that needs improvement and the marital status showed an independent association with the Healthy Eating Index--married individuals showed higher odds of presenting good diet., Conclusion: The results of this study suggest that, in general, the diet quality of this group needs improvement and that the marital status is a factor that can be considered for the development of activities to promote health and healthy food intake habits.

There is evidence suggesting that edentulous older persons modify their diet, avoiding foods that are difficult to chew, such as fruit and vegetables; meanwhile, the consumption of these foods is associated with prevention of chronic diseases. However, few studies evaluated whether a poor oral status without prosthetic rehabilitation is associated with a reduction in the consumption of fruit and vegetables in community-dwelling older persons. We evaluated the association of oral status with emphasis on complete dentures use with the daily consumption of at least 400 g of fruit and vegetables, following the recommendations of the WHO. A random sample of 282 south Brazilians ≥60 years of age was evaluated. Measurements included a questionnaire to assess sociodemographic, behaviour, and health data; consume of fruit and vegetables by means of a 24-h diet recall, and oral status assessment, by means of oral examinations assessing the number of teeth and use of dental prosthesis. Multivariate Poisson regression showed that the only variable significantly associated with inadequate consumption of fruit and vegetables was edentulism with the use of only one denture [PR=1·75 (1·11-2·74)]. Edentulous participants wearing only one denture were less likely to consume at least 400 g day(-1) of fruit and vegetables. These results indicate that, in edentulous community-dwelling elderly, oral health rehabilitation might play an important role in the maintenance of consumption of adequate amounts of fruit and vegetables, which is an important component of a healthy diet and also in the prevention of chronic diseases., (© 2010 Blackwell Publishing Ltd.)

Objectives: To determine whether positive self-perceived oral health is associated with sociodemographic health variables, with an emphasis on resilience, in community-dwelling older adults in southern Brazil., Design: Cross-sectional study nested within a cohort study., Setting: Carlos Barbosa in southern Brazil., Participants: Four hundred ninety-six community-dwelling adults aged 64 and older., Measurements: Sociodemographic information, a health history, and health perceptions were assessed using a structured questionnaire. Resilience was assessed using a resilience scale. For each participant, a brief oral examination was performed to assess number of teeth. Positive self-perceived oral health was the outcome of interest., Results: A final, fully adjusted Poisson regression model showed that high resilience potential (prevalence ratio (PR)=1.18, 95% confidence interval (CI)=1.06-1.32), income (PR=1.18, 95% CI=1.07-1.30), and no reported change in diet because of dental problems (PR=1.34, 95% CI=1.13-1.60) were associated with positive self-perceived oral health. Participants living in rural areas were less likely to report positive self-perceived oral health (PR=0.83, 95% CI=0.75-0.93)., Conclusion: Using a hierarchical approach, positive self-perceived oral health was found to be associated with several variables included in the conceptual framework of oral health outcomes, such as resilience. Resilience may act as a potentiating agent in the positive adaptation to tooth loss., (© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.)

Objective: Evidence suggests that older people with partial tooth loss and edentulism change their diet and lack specific nutrients, but few studies have assessed whether poor oral status is associated with risk of malnutrition and malnutrition in independent-living older people. We evaluated if poor oral status was associated with risk of malnutrition and malnutrition in this population., Methods: A random sample of 471 south Brazilians > or =60 y of age was evaluated. Measurements included a questionnaire to assess sociodemographic, behavioral, general, and oral health data; nutritional status assessment, according to the Mini-Nutritional Assessment (MNA); and oral status assessment, by means of oral examinations assessing the number of teeth and use of dental prostheses. Correlates of risk of malnutrition/malnutrition according to the MNA were assessed by means of multivariate logistic regression., Results: Participants who reported dissatisfaction with their gingival health and edentulous persons wearing only one denture were more likely to be at risk of malnutrition, according to the screening MNA. Dissatisfaction with gingival health was a risk indicator, whereas having one to eight natural teeth was protective against the risk of malnutrition/malnutrition according to the full MNA., Conclusion: In the present study, older people with a compromised oral status had higher odds for risk of malnutrition. The maintenance of a few teeth had a crucial role in increasing the chance of maintaining an adequate nutritional status in the studied population. In cases where edentulism was present, complete dental prosthetic use was associated with better nutritional status.

Objective: To evaluate the oral health care provided to subjects with Alzheimer's disease (AD) as reported by their family caregivers., Method: Structured interviews were performed with 56 Alzheimer caregivers from the Group of relatives and friends of subjects with AD of the Hospital de Clínicas de Porto Alegre. Spearman and Pearson correlations were performed., Results: The mean age of the subjects with AD was 76.09 (+/-7.76) years, 53.6% were female and 58.9% were in the advanced stage of AD. The mean number of teeth present was 11.66 (+/-10.94), and oral hygiene was performed 2.21 (+/-1.04) times/day. The provision of oral health care to subjects with AD was carried out by caregivers in 85.7%. Oral hygiene was provided by the caregivers to the subjects with AD with the aid of a toothbrush and/or gauze embedded with non-fluoridated mouthwash in the majority of the cases. Complete dental prostheses were cleaned with the aid of mouthwashes instead of denture brushes by 44% of the subjects/caregivers. There was a significant association between the number of teeth in the subjects with AD and the number of oral hygiene procedures performed per day and current smoking., Conclusion: Oral health care planning for subjects with AD should take into account caregivers' perceptions and knowledge about oral health and hygiene as caregivers represent the primary providers to these patients when the disease progresses from early to more advanced stages.