Associação entre autopercepção da necessidade de prótese total e configurações dentárias reduzidas entre adultos brasileiros: estudo transversal

Abstract

The condition that ensures the performance of all oral functions even when the dental arch is not complete is called Functional Dentition (FD). It was evaluated the direct association and mediated by the presence of oral impacts between the self-perception of the need for complete dentures (CD) and dental configuration among Brazilian adults (35-44 years) with teeth. Data were obtained by the National Oral Health Survey (2010) by sampling by conglomerate in multiple stages random with probability proportional to the size of the population. Data collection involved oral exams and the application of questionnaires on demographic characteristics, socioeconomic conditions and perceptions about oral health. Self-perception of the need for a prosthesis was measured by the question: Do you consider that you need to use CD (complete denture) or change the one you are currently using? The reduced dental configurations were classified based on a hierarchical functional classification system of teeth, which sequentially considers the presence of: i) at least one tooth in each arch; ii) 10 teeth in each arch; iii) 12 anterior teeth; iv) three or four Posterior Occlusion Pairs (POP) of premolars; and v) at least one bilateral molar POP. The dental configuration that has all the criteria, of the five levels, was defined as a functional dentition (DFClassV). The Dental Impact on Daily Performance (OIDP) evaluated the presence of oral impacts. The association between the outcome (self-perception of CD need) and the main independent variable (reduced dental configurations) was investigated by logistic regression model and analysis of structural equations, including the following covariates: mouth satisfaction, oral impacts (IODD), bleeding, calculus, shallow and deep periodontal pockets, dental pain, sex, skin color, income and schooling. The total sample was 9547 individuals and 6,083 individuals were included in this study. Adults with DFclassV presented a 56% lower chance of self-perception of the prosthesis requirement (OR = 0.44, 95% CI: 0.28-0.70). According to the results of the analysis of structural equations, DFclassV was negative and directly associated with the outcome (Total effect [CP] = -0.294, p <0.001). Dental configurations with loss of anterior teeth and / or POP were associated with greater self-perception of the need for PT (positive direct effect). Dental configuration without POP of molars had no direct effect on the outcome, but an indirect effect via IODD (p = 0.002). Higher selfperception of the need for prostheses was observed among those whose dental configurations presented fewer functionality criteria, be it well-distributed teeth, aesthetics and / or occlusion.