Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy.
WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.
BMC Geriatr. 2018 Mar 20;18(1):76. doi: 10.1186/s12877-018-0760-0.
This 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.
A 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.
Almost 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%).
More 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.
本研究旨在评估居住在意大利养老院的老年人群的缺牙率和严重程度，并将口腔数据与人口统计学、社会经济学因素、简易精神状态检查（MMSE）、体重指数（BMI）和微型营养评估（MNA）评分相关联。
采用以养老院为单位的聚类抽样方法。从意大利五个地区（西北部、东北部、中部、南部和岛屿）选择了 23 家养老院。所选养老院的工作人员分发了知情同意书，并由受试者/护理人员直接签署；共分发了 2114 份表格，有 1998 份表格签署，最终有 1976 名受试者接受了检查。咀嚼能力评分标准为：好（≥10 个功能单位（FU））、充足（7-10 FU）和不足（＜7 FU）。义齿修复情况概括为：无义齿、固定义齿、可摘义齿、联合义齿。年龄、性别、社会经济地位、MMSE、BMI 和 MNA 均从病历中获得。
近四分之三的受试者年龄≥80 岁（74.37%），女性占 74.04%。无牙颌的患病率为 42.10%，意大利五个地区之间差异较大（从中心地区的 34.43%到西北部的 53.46%）。每个年龄组的咀嚼能力不足都很突出（患病率为 42.10%），且与年龄和女性性别呈统计学相关（p＜0.01）。超重/肥胖（7.47%）受试者的咀嚼能力最强。居住地区、MMSE（均＜0.01）和 BMI（p=0.01）与最年长组的义齿修复类型呈统计学相关。无精神障碍的受试者的义齿修复比例最高（32.36%）。
超过一半的样本咀嚼功能单位不足，女性更为明显。义齿修复的存在和类型与认知障碍有关：精神障碍越严重，无义齿修复的受试者比例越高。这项全国性调查的结果强调了制定公共卫生政策的必要性，旨在通过健康教育提高人们对口腔健康的认识。
