School of Dentistry, Federal University of Minas Gerais, 6627 Antonio Carlos Avenue, Belo Horizonte, MG, 31270-901, Brazil.
Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, USA.
Health Qual Life Outcomes. 2019 May 3;17(1):79. doi: 10.1186/s12955-019-1149-2.
Oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional judgment about restorative treatments and prosthetic replacement in patients who had reduced dentitions. The aim was to compare the OHRQoL among adults (35-44 years) categorized according to different definitions of reduced dentition and considering the use (or non-use) of dental prosthesis.
This study used data from a probabilistic sample of adults in Sao Paulo, Brazil, 2015. OHRQoL was based on none items of Oral Impacts on Daily Performance (OIDP) index, as prevalence (at least one impact) and extent (the number of items with non-zero score). We used different criteria to assess dentition status: (1) Shortened Dental Arch (SDA): having 3-5 natural occlusal units (OUs) in posterior teeth and intact anterior region; (2) hierarchical functional classification system: a five-level stepwise classification of dentition; and (3) presence of ≥21 teeth. The use or nonuse of dental prosthesis was recorded. Negative binomial regression models involved the adjustment for social determinants of health.
Nearly half (53.1%) of the 5753 participating adults had at least one oral health issue impacting OHRQoL. OIDP prevalence in adults with SDA did not differ from those with more OUs (PR = 1.02; 95%CI 0.91-1.13). Individuals with non-functional dentition had worse OHRQoL regardless of their use of a dental prosthesis. Adults with fewer than 21 remaining teeth, ranked significantly higher in OIDP extent, regardless of dental prosthesis use (PR = 1.38; 95%CI 1.16-1.63 with prosthesis; PR = 1.62; 95%CI 1.19-2.20 without dental prosthesis).
Individuals with more missing teeth reported worse OHRQoL regardless of using a dental prosthesis. Preserving a functional dentition, even with missing teeth, is compatible with OHRQoL.
口腔健康相关生活质量（OHRQoL）对牙科临床实践和牙科研究具有重要意义，应有助于专业判断修复治疗和义齿修复对缺牙患者的影响。本研究旨在比较不同缺牙定义分类的成年人（35-44 岁）的 OHRQoL，并考虑是否使用（或未使用）义齿。
本研究使用了来自巴西圣保罗的概率抽样成年人的数据，2015 年。OHRQoL 基于 Oral Impacts on Daily Performance（OIDP）指数的无项目，即患病率（至少有一个影响）和程度（有非零分数的项目数）。我们使用不同的标准来评估牙列状况：（1）缩短牙弓（SDA）：后牙有 3-5 个天然咬合单位（OUs），前牙完整；（2）等级功能分类系统：牙列的五级逐步分类；（3）存在≥21 颗牙齿。记录义齿的使用或未使用情况。社会健康决定因素调整后的负二项回归模型。
近一半（53.1%）的 5753 名参与成年人至少有一个影响 OHRQoL 的口腔健康问题。SDA 成人的 OIDP 患病率与 OUs 较多的成人无差异（PR=1.02；95%CI 0.91-1.13）。无论是否使用义齿，非功能性牙列的个体 OHRQoL 较差。剩余牙齿少于 21 颗的成年人，无论是否使用义齿，OIDP 程度都显著较高（使用义齿时 PR=1.38；95%CI 1.16-1.63；不使用义齿时 PR=1.62；95%CI 1.19-2.20）。
无论是否使用义齿，缺失牙齿较多的个体报告的 OHRQoL 较差。保留有功能的牙列，即使缺失牙齿，也与 OHRQoL 兼容。
