Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
J Am Dent Assoc. 2012 May;143(5):488-95. doi: 10.14219/jada.archive.2012.0209.
Identifying changes in the oral health status of older populations, and their predictors and explanations, is necessary for public health planning. The authors assessed patterns of change in oral health-related quality of life in a large cohort of older adults in Brazil during a five-year period and evaluated associations between baseline characteristics and those changes.
The sample consisted of 747 older people enrolled in a Brazilian cohort study called the Health, Well-Being and Aging (Saúde, Bem-estar e Envelhecimento [SABE]) Study. Trained examiners measured participants' self-perceived oral health by using the General Oral Health Assessment Index (GOHAI). The authors calculated changes in the overall GOHAI score and in the scores for each of the GOHAI's three dimensions individually by subtracting the baseline score from the score at follow-up. A positive difference indicated improvement in oral health, a negative difference indicated a decline and a difference of zero indicated no change.
The authors found that 48.56 percent of the participants experienced a decline in oral health and 33.48 percent experienced an improvement. Participants with 16 or more missing teeth and eight or more years of education were more likely to have an improvement in total GOHAI score. Deterioration was more likely to occur among those with two or more diseases. Improvement and decline in GOHAI functional scores were related to the number of missing teeth. The authors found no significant model for the change in the psychosocial score, and self-rated general health was the only variable related to both improvement and decline in pain or discomfort scores.
The authors observed a bidirectional change in self-perceived oral health, with deterioration predominating. The strongest predictor of improvement in the total GOHAI score was the number of missing teeth, whereas the number of diseases was the strongest predictor of deterioration.
Dental professionals and policymakers need to know the directions of change in older adults' oral health to establish treatment priorities and evaluate the impact of services directed at this population.
了解老年人群口腔健康状况的变化及其预测因素和解释，对于公共卫生规划至关重要。作者评估了巴西一个大型老年人群队列在五年期间口腔健康相关生活质量变化的模式，并评估了基线特征与这些变化之间的关联。
该样本由参加巴西队列研究健康、幸福和老龄化（Saúde，Bem-estar e Envelhecimento [SABE]）研究的 747 名老年人组成。经过培训的检查人员使用一般口腔健康评估指数（GOHAI）来衡量参与者的自我感知口腔健康。作者通过从基线评分中减去随访评分来计算整体 GOHAI 评分和每个 GOHAI 三个维度的评分的变化。正差值表示口腔健康改善，负差值表示下降，差值为零表示无变化。
作者发现，48.56%的参与者口腔健康状况下降，33.48%的参与者口腔健康状况改善。有 16 颗或更多缺失牙齿和 8 年或以上教育的参与者更有可能提高总体 GOHAI 评分。有两种或更多种疾病的人更有可能出现恶化。GOHAI 功能评分的改善和下降与缺失牙齿的数量有关。作者发现，心理社会评分变化的模型没有显著意义，自我评估的一般健康状况是与疼痛或不适评分改善和下降都相关的唯一变量。
作者观察到自我感知口腔健康呈双向变化，恶化占主导地位。改善总体 GOHAI 评分的最强预测因素是缺失牙齿的数量，而疾病数量是恶化的最强预测因素。
牙科专业人员和政策制定者需要了解老年人口口腔健康变化的方向，以便确定治疗重点并评估针对这一人群的服务的影响。
