Associação entre cárie dentária e determinantes biológicos, individuais e ambientais: estudo transversal em idosos não institucionalizados

Abstract

Dental caries is a multifactorial disease, whose etiology includes biological, individual and environmental factors. The elderly population has an increased risk of developing coronary and root caries, due to dietary changes, difficulty in cleaning, root exposures, salivary changes and the presence of systemic diseases that imply the chronic use of medications. Population aging combined with increased risk factors for dental caries in the elderly demands a comprehensive examination of the disease process including different factors levels for the construction of a more robust analysis model. Thus, the objective of this study was to evaluate the occurrence of dental caries and the association with dental biofilm, free sugar intake, systemic factors, salivary, sociodemographic and economic characteristics in noninstitutionalized elderly. The study was approved by the Research Ethics Committee of the Universidade Federal de Minas Gerais (CEP / UFMG; CAAE: 12045119.7.0000.5149) and the participants signed a consent form. Sociodemographic and economic data, systemic diseases, and medications in use were collected using a questionnaire. The intake of free sugars was analyzed using 24-hour recall and a nutrition support software (NutWin). Visible plaque index, decayed, missed and filled teeth (DMFT) and decayed and filled roots (DFR) were collected by clinical examination in a dental chair. Unstimulated saliva was collected for five minutes to determine the flow rate using the volumetric method, and pH and buffering capacity with colorimetric strips (GC America Inc.). Descriptive analysis (IBM SPSS Statistics®) and multilevel logistic regression analysis (Stata®) of the variables were performed (p <0.05, 95% CI). Seventy-two individuals participated, with a mean age of 67.29 (SD = 6.12). Most participants were female (55.6%), had at least one systemic disease (81.9%) and used at least one medication (79.2%). The mean (SD) salivary flow rate was 0.61 (0.34) ml/minute. The mean (SD) salivary pH was 6.9 (0.45) and the mean (SD) salivary buffering capacity was 7.2 (3.07). The mean DMFT and DFR indexes were 24.44 and 3.21, respectively. The mean of decayed teeth was 1.76, with 0.75 decayed roots per individual. The frequencies of dental and root caries were 61.11% and 36.11%, respectively. In the adjusted regression model, the presence of dental caries was significantly associated with the presence of biofilm (OR = 1.840; 95% CI 1.237;2.736), salivary buffering capacity (OR = 0.874; 95% CI 0.769;0.993) and per capita income (OR = 0.0568; 95% CI 0.00438;0.738). The frequency of dental caries was high among noninstitutionalized elderly people, and its variability is better explained by the presence of biofilm, salivary buffering capacity and per capita income.