Lesões orais e maxilofaciais em pacientes idosos: um estudo comparativo em dois serviços – clínico e laboratorial

Abstract

The Brazilian demographic profile is in transition, which the survival rate is increasing and, consequently, there is an increase in the older population. Public health services will have to adapt to attend needs and demands of this population. The aim of this study was to describe the frequency of oral and maxillofacial lesions among older individuals (≥60 years) as reported by two different services: clinical and laboratory services and to investigate the association between the occurrence of the three most frequent lesions and the independent variables. A retrospective study was performed using data obtained from the oral and maxillofacial pathology services. Data on the frequency of oral and maxillofacial lesions from the clinical and laboratory services were collected. Data on the sex, age group (young–old: 60–79 years and old–old: 80 years or older), and skin color of the individuals, as well as their habits, such as smoking, alcohol use, and the wearing of prosthesis, were also retrieved. Regarding the lesion, the symptoms and the anatomical location were considered. Descriptive analyses of the frequencies of oral and maxillofacial lesions reported by both services were performed. Univariate analysis was used to test the association between the occurrence of the three most frequent oral and maxillofacial lesions and the independent variables. The confidence interval was set at 95% and the level of significance was p < 0.05. From 32,842 records in the two services, 5,148 were individuals aged 60 years or older, theses 1,685 (32.7%) were from the clinical service and 3,463 (67.3%) were from the laboratory service. Considering the two services, the majority were female (62.3%), young-old (90.0%) and non-white individuals (48.7%). In 17.7% and 12.1% of the records, smoking and alcohol use was reported, respectively, while 29.3% of the records indicated that the individual wore a removable prosthesis. Painful symptoms were reported in 1,345 (26.1%) of the cases. The most affected anatomical site was the alveolar mucosa (943 cases; 18.3%). The inflammatory fibrous hyperplasia (IFH) was the most commom lesion in both services, while the candidiasis and varices were the second and third most frequent lesions in the clinical service, and squamous cell carcinoma (SCC) and epithelial dysplasia (ED) were more frequent in the laboratory service. Young-old individuals were likely to present with IFH: odds ratio (OR): 1.38 and confidence interval (CI): 1.11-1.71. However, females (OR: 2.01; CI: 1.77-2.29) and individuals who wore a removable prosthesis (OR: 4.21; CI: 2.99-5.93) were also likely to present with IFH. Old-old individuals who were 80 years or older (OR: 1.64; CI: 1.28- 2.11), male (OR: 3.66; CI: 3.07-4.36), or who had reported smoking (OR: 5.83; CI: 4.74-7.18) or alcohol use (OR: 3.69; CI: 2.96-4.60) were likely to present with SCC. Males (OR: 1.59; CI: 1.30-1.95) and individuals who had reported smoking (OR: 1.86; CI: 1.44-2.42) were likely to present with ED. The frequency of oral and maxillofacial lesions diagnosed in both services was different. The data source and the study design used in retrospective analyzes can direct the results found