Sosyodemografik, Medikal ve Kognitif Faktörlerin Bir Türk Geriatrik Popülasyonunun Periodontal Sağlık Durumuyla İlişkisi

Abstract

Amaç: Yaşamın süresinin uzaması, yaşam kalitesini artırmak için yönetilmesi gereken ağız sağlığı sorunlarını da beraberinde getirir. Bu bağlamda geriatrik bireyler için ağız sağlığı durumunu ve belirleyicilerini tanımlamak gereklidir. Bu çalışmanın amacı, geriatrik bir popülasyonda sosyodemografik, antropometrik, tıbbi ve dental faktörlerin ve bilişsel durumun, geriatrik popülasyonda “periodontitis olup olmaması” ile olan ilişkileri ile ilgili olarak araştırılmasıdır. Materyal-Metot: Örneklem Nisan 2017-Aralık 2018 tarihleri arasında Süleyman Demirel Üniversitesi Diş Hekimliği Fakültesi'ne başvuran 200 yaşlı bireyden oluştu. Periodontal parametreler (plak indeksi (Pİ), sondlamada kanama, klinik ataçman kaybı ve sondlamada cep derinliği, periodontal iltihaplı yüzey alanı (PİYA)) ile antropometrik, sosyodemografik parametreler ve bilişsel durum (Schulman skoru) kaydedildi. Bulgular: Periodontitisi olan geriatrik bireyler çalışma popülasyonunun %58’ ini oluşturmaktaydı. Bilişsel durum minör görsel-uzamsal düzensizlik olarak belirlendi (2,69±1,34). Schulman skoru diş sayısı ile (rho=-0,154, p=0,036) ve PI skorları ile (rho=0,076, p=0,04) negatif korelasyon gösterdi. Lojistik regresyon analizi sonucunda, düşük eğitim düzeyi, azalmış diş sayısı ve azalmış tükürük akış hızı odds oranları (sırasıyla 12,3, 1,18 ve 3,944) göz önüne alınarak periodontitis ile ilişkili bulunmuştur. Sonuç: Çalışmamızda değerlendirilen bu popülasyonda bilişsel işlev bozukluğu plak giderim etkinliğinin azalmasına neden olmuş; eğitim düzeyi, diş sayısı, tükürük akış hızı ve periodontal parametrelerin periodontitis varlığı ile ilişkili olduğu görülmüştür.

Keywords

• Bilişsel işlev bozukluğu
• yaşlı
• ağız sağlığı

The Association of Sociodemographic, Medical, and Cognitive Factors on Periodontal Health Status of a Geriatric Population in Turkey

Abstract

Objective: The longevity of life brings oral health issues, which should be managed in order to improve the quality of life. It is necessary to determine the oral health condition and its determinants for geriatric individuals. The aim of this study was to investigate the sociodemographic, anthropometric, medical, and dental factors and cognitive status regarding their effects on, or associations with, “having periodontitis or not” in a geriatric population. Material and Methods: The sample comprised 200 older adults who applied to the Süleyman Demirel University, Faculty of Dentistry, between April 2017 and December 2018. Periodontal – plaque index (PI), bleeding on probing, clinical attachment loss and probing depth were measured and periodontal inflamed surface area (PISA) was calculated –, anthropometric, and sociodemographic parameters, and cognitive status (Schulman score) were recorded. Results: The percentage of geriatric patients having periodontitis was 58%. The cognitive status determined as minor visuospatial disorganization (2.69±1.34). The Schulman score was correlated negatively by the number of teeth (rho=-0.154, p = 0.036), and with PI scores (rho=0.076, p=0.04). Due to the logistic regression analysis, lower education level, decreased number of teeth, and decreased salivary flow rate presented odds ratios (12.3, 1.18, and 3.944, respectively), and found associated with having periodontitis. Conclusions: Cognitive dysfunction results in decreased plaque removal efficacy; and education level, number of teeth, salivary flow rate and periodontal parameters have presented association with having periodontitis in this population.

Keywords

• Cognitive dysfunction
• elderly
• oral health
• periodontitis

References

1. Referanslar Referans1. Turkey in Statistics (In Turkish). Çankaya, Ankara: TurkStat Publication Group Turkish Statistical Institute 2015, TUIK publication no. 4431.
2. Referans2. World population ageing. New York, USA: United Nations 2015, United Nations, Department of Economic and Social Affairs, Population Division. UN publication no. ST/ESA/SER.A/390.
3. Referans3. Scannapieco FA, Cantos A. Oral inflammation and infection, and chronic medical diseases: implications for the elderly. Periodontol 2000. 2016;72(1): 153-75.
4. Referans4. Bourgeois D, Nihtila A, Mersel A. Prevalence of caries and edentulousness among 65-74-year-olds in Europe. Bull World Health Organ. 1998;76(4):413-7.
5. Referans5. Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ, Borgnakke WS, et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015;86(5):611-22.
6. Referans6. Arpak MN, Ereş G. Oral and dental health in individuals with age 65 and older, II. prosthetic use and prosthetic requirements (in Turkish). AÜ Diş Hek Fak Derg. 1990;17(2): 239-43.
7. Referans7. Arpak MN, Ereş G. Oral and dental health in individuals with age 65 and older, CPITN (Community Periodontal Index of Treatment Needs) (in Turkish). AÜ Diş Hek Fak Derg. 1990;17(2): 345-7.
8. Referans8. Ünlüer Ş, Gökalp S, Doğan BG. Oral health status of the elderly in a residential home in Turkey. Gerodontology. 2007;24(1):22-9.

9. Referans9. Uzun H, Nazlıel-Çelenligil H. Medical, dental history and extraoral, intraoral and dental findings in the elderly (in Turkish). Turkish J Geriatr. 2000;3(1):15-21.
10. Referans10. Eren G, Köse T, Atilla G. Determination of periodontal status in elderly individuals and oral care habits of these individuals (in Turkish). SÜ Dişhek Fak Derg. 2011;20:84-94.
11. Referans11. Tezel A, Orbak R, Çiçek Y,Yanıkoğlu N. Evaluation of periodontal status in elderly people and their response to periodontal treatment (in Turkish). Atatürk Üniv Diş Hek Fak Derg. 1997;7(1):74-80. Referans
12. Referans12. Gökalp S, Dogan G, Tekçiçek M, Berberoğlu A, Ünlüer Ş. The oral health profile of adults and elderly, Turkey-2004. Hacettepe Dişhek Fak Derg. 2007;31(4):11-8.
13. Referans13. Silness J, Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22:121-35.
14. Referans14. Lobene RR, Weatherford T, Ross NM, Lamm RA, Menaker L. A modified gingival index for use in clinical trials. Clin Prev Dent. 1986;8(1):3-6.
15. Referans15. Nesse W, Abbas F, van der Ploeg I, Spijkervet FKL, Dijkstra PU, Vissink A. Periodontal inflamed surface area: quantifying inflammatory burden. J Clin Periodontol. 2008;35(8):668-73.
16. Referans16. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: consensusreport of workgroup 2 of the 2017 World Workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol. 2018;89(Suppl 1):173-82.
17. Referans17. Eke PI, Page RC, Wei L, Thornton-Evans G, Genco RJ. Update of the case definitions for population-based surveillance of periodontitis. J Periodontol. 2012;83(12):1449-54.
18. Referans18. Steinmassl PA, Steinmassl O, Kraus G, Dumfahrt H, Grunert I. Is cognitive status related to oral hygiene level and appropriate for determining need for oral hygiene assistance? J Periodontol. 2016; 87(1):41-7.
19. Referans19. Arpak M, Candan S, Ereş G. Oral and dental health in individuals with age 65 and older (in Turkish). AÜ Diş Hek Fak Derg. 1990;17(2):245-9.
20. Referans20. Paula K, Friedman LBK, Steven L, Karpas D. Oral health disparity in older adults dental decay and tooth loss. Dent Clin N Am. 2014;58(4):757-70.
21. Referans21. Coccia E, Santarelli A, Ponzio E, Procaccini M, Rappelli G. Oral health conditions of the elderly in Ancona: a population-based study. Minerva Stomatol. 2015;64(5): 241-52.
22. Referans22. Leite FRM, Peres KG, Do LG, Demarco FF, Peres MAA. Prediction of periodontitis occurrence: influence of classification and sociodemographic and general health information. J Periodontol. 2017;88(8):731-43.
23. Referans23. Kassebaum N, Bernabé E, Dahiya M, Bhandari B, Murray CJL , Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res. 2014;93(11):1045-53.
24. Referans24. Eke PI, Wei L, Borgnakke WS, Thornton-Evans G, Zhang X, Lu H, et al. Periodontitis prevalence in adults≥ 65 years of age, in the USA. Periodontol 2000. 2016;72(1): 76-95.
25. Referans25. Szymańska J, Fetkowska-Mielnik K. Aspects of dental health in adult rural population in Poland. Ann Agric Environ Med. 1998;5(2):103-8.
26. Referans26. Aktas A, Ozbek M, Tumer C, Tasar F. Xerostomia in elderly population. Turk Geriatri Derg. 2010;13(4):285-90.
27. Referans27. Kaye EK, Valencia A, Baba N, Spiro 3rd A, Dietrich T, Garcia RI. Tooth loss and periodontal disease predict poor cognitive function in older men. J Am Geriatr Soc. 2010; 58(4):713-8.
28. Referans28. Nilsson H, Berglund JS, Renvert S. Periodontitis, tooth loss and cognitive functions among older adults. Clin Oral Invest. 2018; 22(5): 2103-9.
29. Referans29. Gil‐Montoya JA, Sánchez‐Lara I, Carnero‐Pardo C, Fornieles-Rubio F, Montes J, Barrios, et al. Oral hygiene in the elderly with different degrees of cognitive impairment and dementia. J Am Geriatrics Soc 2017; 65(3):642-7.
30. Referans30. Peres MA, Bastos JL, Watt RG, Xavier AJ, Barbato PR, D'Orsi E. Tooth loss is associated with severe cognitive impairment among older people: findings from a population-based study in Brazil. Aging Ment Health. 2015;19(10):876-84.
31. Referans31. Sochocka M, Sender-Janeczek A, Zwolinska K, Zwolińska K, Błachowicz O, Tomczyk T, et al. Association between periodontal health status and cognitive abilities. The role of cytokine profile and systemic inflammation. Curr Alzheimer Res. 2017;14(9):978-90.
32. Referans32. Christensen LB, Petersen PE, Krustrup U, Kjøller M. Self-reported oral hygiene practices among adults in Denmark. Community Dent Health. 2003; 20(4):229-35.
33. Referans33. Vyšniauskaité S, Kammona N, Vehkalahti MM. Number of teeth in relation to oral health behaviour in dentate elderly patients in Lithuania. Gerodontology. 2005; 22(1):44-51.
34. Referans34. Simons D, Brailsford S, Kidd E, Beighton D. Relationship between oral hygiene practices and oral status in dentate elderly people living in residential homes. Community Dent Oral Epidemiol. 2001;29(6):464-70.
35. Referans35. Ogawa H, Yoshihara A, Hirotomi T, Ando Y, Miyazaki H. Risk factors for periodontal disease progression among elderly people. J Clin Periodontol. 2002;29(7):592-7.