Multimorbidity and tooth loss: the Brazilian National Health Survey, 2019

Abstract

Background Little is known about the presence of two or more chronic conditions (multimorbidity) on tooth loss between adults and older adults. Understanding the mechanisms of multimorbidity on tooth loss is essential to inform policy development. This study aims to investigate the association between multimorbidity and severity of tooth loss in Brazilian adults and older adults. Methods We analysed data from a nationally representative sample of 88,531 Brazilian individuals aged 18 and over who participated in the 2019 Brazilian Health Survey. Tooth loss was the outcome by two different classifications: functional dentition (lost 1–12 teeth) and severe tooth loss (lost 23–32 teeth). The presence of multimorbidity was the main exposure and based on 13 self-reported doctor-diagnosed chronic diseases that were further categorised into two groups, i.e., ≥2 or ≥ 3 comorbidities. Sociodemographic covariates included sex, age, race, income, level of education and tobacco smoking and geographic region of residency. Multivariate logistic regression models estimated the OR (Odds Ratios) and 95%CI of the associations between multimorbidity and tooth loss. Results For 65,803 adults (aged 18 to 59), the presence of multimorbidity (≥2) was associated with 32% higher odds of having severe tooth loss (95% CI, 1.17; 1.49) and 33% lower odds of having functional dentition (95% CI, 0.60; 0.75). For the 22,728 older adults (aged 60 and older), multimorbidity (≥2) was associated with a 17% higher odds of severe tooth loss (95% CI, 1.06; 1.29) and 23% lower odds of having functional dentition (95% CI 0.70; 0.85). The sensitivity analysis, excluding hypertension, confirmed our findings. Conclusions Brazilian adults and older adults with multimorbidity are more likely to have severe tooth loss and less likely to have functional dentition.

Multiple Chronic Diseases Associated With Tooth Loss Among the US Adult Population

“…Using a process mining technique, Larvin et al (2021) suggested that tooth loss might contribute to the developmental trajectories of multimorbid diseases. However, to the best of our knowledge, only one study has examined the association between multimorbidity and tooth loss in a large-scale population study; using data from the Brazilian national health survey, Bomfim et al (2021) reported older adults (≥60 years) with multimorbidity were 17% more likely to lose functional dentition (i.e., lost more than 23 teeth or be edentulous) compared to those without multimorbidity. Notably, the association was even stronger among young adults (18-59 years); those with multimorbidity were 32% more likely to lose functional dentition than their counterparts with one or no chronic disease.…”

Oral health in emerging countries and suggestions for adjusted care strategies

“…Also, the high DMFT figures in 35/44-year-old Brazilians and Filipinos (15.8, 12.9 respectively) are on par with the high number of missing teeth in seniors (20.5, 17 respectively). Severe tooth loss defined by <10 remaining teeth occurs in almost half of 60-79-year-old Brazilians, 54 indicating the somewhat low effectiveness of the comparatively advanced Brazilian dental system. However, what is hard to explain is the huge difference among Indonesian citizens, with a low DMFT in adults aged 35/44 (4.5) followed by a high MT value in seniors of 16.3 (Table 3) later in life.…”

Salivary Proteome, Inflammatory, and NETosis Biomarkers in Older Adult Practitioners and Nonpractitioners of Physical Exercise

“…This leads us to infer that any difference between groups regarding inflammatory and NETosis biomarkers, if detected, would not be attributed to intraoral sources. It is possible to state that the study participants had an oral health condition similar to the Brazilian elderly population [ 53 , 54 ]. Furthermore, there was no difference in salivary flow rates between the groups.…”