Sukumar Margret Beaula Alocious, Peter Roshni Mary, Joseph Alex
Division of Epidemiology, SRM School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, India.
Department of Community Medicine, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, Chennai, Tamil Nadu, India.
BMC Oral Health. 2025 Feb 18;25(1):252. doi: 10.1186/s12903-025-05628-9.
Oral diseases are a major global health challenge, posing health and economic burdens that have profound impacts on the quality of life, disproportionately affecting marginalized populations such as tribal communities. Among scheduled tribes in India, the Irula community belongs to one of the tribes most vulnerable by poor access to health care and education. The elders in the population have increased incidence and prevalence rates of tooth morbidities-an increased incidence of caries, non-carious lesions, and periodontitis-related conditions that affect oral health related quality of life (OHQOL) dimensions.
This study aims to assess tooth morbidity and tooth loss among older Irula community members, identify risk factors, and evaluate how oral and physical comorbidities have been associated with OHRQoL.
A cross-sectional study was conducted on elderly persons aged 60 years and above in Thiruvallur district, Tamil Nadu, India. A multi-stage random sampling technique was employed in the study. Data were collected by semi-structured questionnaires covering demographics, medical history, oral health practices, and quality of life by clinical dental examination. The tools used included the International Caries Detection and Assessment System (ICDAS) the Smith and Knight Tooth wear index for non-carious lesions, and the Community Periodontal Index for Treatment Needs (CPITN) index for periodontal disease Furthermore, quality of life assessment was carried out utilizing the Geriatric Oral Health Assessment Index (GOHAI). Subsequently, Descriptive and multivariate logistic regression analyses were performed to determine the predictors of OHRQoL.
The prevalence of carious lesions was 38.5%, non-carious lesions 70%, periodontitis 70.8%, and tooth loss 53.6%. Only 2.3% of participants had restorative dental treatments. Multivariate analysis reveals that illiteracy (AOR = 0.163, p = 0.003), arthritis (AOR = 0.340, p = 0.001), carious lesions (AOR = 1.402, p = 0.031), periodontal disease (AOR = 1.663, p = 0.002), and tooth loss (AOR = 2.744, p = 0.001) affected OHRQoL significantly.
The results regarding the elderly community of Irula point towards the severe oral health disparities observed among them; thus, this raises an urgent need to develop a public health intervention for this eminent existing fact. Removing education and socioeconomic barriers, improving access to dental health care, and advocating culturally appropriate preventive programs could increase OHRQoL. Longitudinal study and policy-driven approaches should be carried out in future studies for sustainable health equity of the tribal population.
口腔疾病是一项重大的全球健康挑战，带来了对生活质量产生深远影响的健康和经济负担，对部落社区等边缘化人群的影响尤为严重。在印度的在册部落中，伊鲁拉社区是因难以获得医疗保健和教育而最脆弱的部落之一。该人群中的老年人牙齿发病率和患病率有所上升——龋齿、非龋性病变以及与牙周炎相关疾病的发病率增加，这些疾病影响了口腔健康相关生活质量（OHQOL）的各个方面。
本研究旨在评估伊鲁拉社区老年成员的牙齿发病率和牙齿缺失情况，确定风险因素，并评估口腔和身体合并症与口腔健康相关生活质量（OHRQoL）之间的关联。
在印度泰米尔纳德邦蒂鲁瓦勒尔区对60岁及以上的老年人进行了一项横断面研究。研究采用了多阶段随机抽样技术。通过半结构化问卷收集数据，问卷涵盖人口统计学、病史、口腔健康习惯以及通过临床牙科检查获取的生活质量。使用的工具包括国际龋病检测和评估系统（ICDAS）、用于非龋性病变的史密斯和奈特牙齿磨损指数，以及用于牙周疾病的社区牙周治疗需求指数（CPITN）。此外，利用老年口腔健康评估指数（GOHAI）进行生活质量评估。随后，进行描述性和多变量逻辑回归分析以确定OHRQoL的预测因素。
龋病病变的患病率为38.5%，非龋性病变为70%，牙周炎为70.8%，牙齿缺失为53.6%。只有2.3%的参与者接受了牙齿修复治疗。多变量分析显示，文盲（调整后比值比[AOR]=0.163，p=0.003）、关节炎（AOR=0.340，p=0.001）、龋病病变（AOR=1.402，p=0.031）、牙周疾病（AOR=1.663，p=0.002）和牙齿缺失（AOR=2.744，p=0.001）对OHRQoL有显著影响。
关于伊鲁拉老年社区的研究结果表明他们存在严重的口腔健康差异；因此，鉴于这一突出的现有事实，迫切需要制定公共卫生干预措施。消除教育和社会经济障碍、改善获得牙科保健的机会以及倡导符合文化背景的预防计划可以提高OHRQoL。未来的研究应采用纵向研究和政策驱动的方法，以实现部落人口可持续的健康公平。
