Association between number of teeth, dental prostheses, and self-reported dysphagia in brazilian old people: a population-based study

Aquino, Marina de Macedo; Rech, Rafaela Soares; Baumgarten, Alexandre; Goulart, Bárbara Niegia Garcia de

doi:10.1590/2317-1782/20242023072en

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Original Article • CoDAS 36 (4) • 2024 • https://doi.org/10.1590/2317-1782/20242023072en copy

Association between number of teeth, dental prostheses, and self-reported dysphagia in brazilian old people: a population-based study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To investigate the association between the number of permanent teeth and the use of removable dental prostheses with self-reported dysphagia occurrence in individuals aged 60 years or older.

Methods

A population-based cross-sectional study was conducted with 5,432 old individuals who participated in the baseline of the Brazilian Longitudinal Study of Elderly Health (ELSI-Brazil). The outcome "dysphagia" was associated with the number of permanent teeth and the use of removable dental prostheses. Sociodemographic independent variables (age, sex, and race/ethnicity) and clinical history variables (no morbidity, one morbidity, or more than two morbidities) were analyzed using Poisson Regression with robust variance and their respective 95% confidence intervals (CI).

Results

The prevalence of self-reported dysphagia in non-institutionalized old individuals was 30%. The group of old individuals with 10 – 19 natural teeth showed a 52% increased risk of self-reported dysphagia complaint (PRadj 1,565 IC95% 1,34;1,826) compared to their counterparts with more teeth.

Conclusion

An association was found between a lower number of teeth and removable prostheses with the occurrence of dysphagia.

Keywords:
Dysphagia; Number of Teeth; Elderly; Swallowing; Permanent Teeth

Dysphagia
	Total		Yes		No		χ²
	n 5428	% 100	n 1641	% 30.2	n 3787	% 69.8
Age
60 to 69 years	2,875	53.0	960	58.5	1,915	50.6	<0.001
70 to79 years	1,778	32.8	493	30.0	1,285	33.9	-
> 80 years	775	14.3	188	11.5	587	15.5	3.3
Sex
Female	3,260	60,0	975	29,9	2,281	70.0	-
Male	2,172	40,0	666	30,7	1,506	69.3	0.319
Color/Race
White	2,152	42.8	607	39.8	1,545	44.2	-
Black	2,872	57.2	920	60.2	1,952	55.8	8.517
Multimorbidities
No disease	1,157	21.3	305	26.4	852	73.6	-
1 disease	1927	35.5	533	27.7	1,394	72.3	0.616
>2 disease	2,344	43.1	803	34.3	1,541	65.7	22.328

Dysphagia
	Total	(%)	Yes	(%)	No	(%)	χ²
Main reason for your last dentist appointment	5,205		1,586	30.5	3,619	69.5
Revision, prevention or check-up	1,056	20.3	253	24.0	803	76.0	<0.001
Pain	346	6.6	123	35.5	223	64.5	-
Extraction	1,576	30.3	528	33.5	1,047	66.4	0.471
Treatment	1,443	27.7	469	32.5	973	67.4	0.283
Other	784	15.1	213	27.2	570	72.7	0.005
How many permanent teeth do you have left	5,279		1,601	30.3	3,678	69.7
Over 20	878	16.6	234	26.7	644	73.3	-
10 to 19	710	13.4	265	37.3	445	62.7	<0.001
1 to 9	1,337	25.3	486	36.4	851	63.6	<0.001
None	2,354	44.6	616	26.2	1,736	73.7	0.791
How many permanent teeth are left in your upper jaw	5,245		1,590	30.3	3,655	69.7
Over 12 teeth	690	13.2	173	25.1	517	74.9	<0.001
6 to 11 teeth	503	9.6	188	37.4	315	62.6	-
0 to 5 teeth	4,052	77.2	1,229	30.3	2,821	69.6	0.001
How many permanent teeth are left in your upper jaw	5,351		1,593	29.8	3,758	70.2
Over 12 teeth	831	15,8	213	25.6	618	74.4	<0.001
6 to 11 teeth	1,189	22.6	438	36.8	751	63.2	-
0 to 5 teeth	3,231	61.5	942	29.2	2,287	70.8	<0.001
Use of some type of removable dental prosthesis in the lower jaw	5,429		1,641	30.2	3,788	69.8
Yes	2,526	46.5	690	27.3	1,835	72.6	-
No	2,903	53.5	951	32.8	1,949	67.10	<0.001
Use of some type of removable dental prosthesis in the upper jaw	5,430		1,640	30.2	3,790	69.8
Yes	3,782	69.6	1,094	28.9	2,686	71.00	9.727
No	1,648	30.3	546	33.1	1,100	66.70	-

	Uses Dental Prosthesis
	Total	No		Yes
Permanent teeth left in the upper jaw	n 5,243	n 1,544	% 29.4	n 3,699	% 70.6
0 to 5 teeth	4,050	800	19.8	3,250	80.2
6 to 11 teeth	503	244	48.5	259	51.5
Over 12 teeth	690	500	72.5	190	27.5
Permanent teeth left in the lower jaw	n 5,248	n 2,755	% 52.5	n 2,493	% 47.5
0 to 5 teeth	3,230	1,258	38.9	1,972	61.1
6 to 11 teeth	1,189	812	68.3	377	31.7
Over 12 teeth	829	685	82.6	144	17.4

	Crude PR (95% CI)	p-value	χ²	Adjusted PR ^* (95% CI)	p-value
Age
>80	0.835 (0.687;1.014)	0.072	0.068	0.840 (0.717;0.983)	0.03
70 – 79	1	-	-	1	-
60 – 69	1.307 (1.148;1.487)	<0.001	<0.001	1.206 (1.095;1.328)	<0.001
Self-Reported Color/Race
White	1	-	-	1	-
Black	1.163 (1.062;1.273)	0.001	0.001	0.956 (0.878;1.041)	0.301
Sex
Female	1	-	-	1	-
Male	1.035 (0.919;1.164)	0.587	0.572	1.017 (0.93;1.112)	0.717
Multimorbidity
None	1	-	-	1	-
1 disease	1.068 (0.906;1.259)	0.550	0.433	1.069 (0.94;1.216)	0.307
> 2 diseases	1.456 (1.245;1.702)	0.229	< 0.001	1.409 (1.25;1.589)	<0.001
Removable Prosthesis
No	1	-	-	1	-
Yes	1.272 (1.120;1.445)	< 0.001	<0.001	0.811 (0.735;0.896)	<0.001
No. of permanent teeth
> 20	1	-	-	1	-
10 to 19	1.639 (1.324;2.029)	< 0.001	< 0.001	1.565 (1.34;1.826)	<0.001
1 to 9	1.572 (1.304;1.894)	< 0.001	< 0.001	1.547 (1.338;1.788)	<0.001
None	0.977 (0.819;1.164)	0.788	0.791	1.182 (1.018;1.373)	0.028
*Adjusted for sociodemographic variables (gender, age, color/race) and clinical history

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[1] Conflict of interests: nothing to declare.