Tooth loss in Brazil: analysis of the 2010 Brazilian Oral Health Survey

OBJECTIVE: To estimate the mean number of missing teeth, lack of functional dentition and total tooth loss (edentulism) among adolescents, adults and the elderly in Brazil, comparing the results with those of 2003. METHODS: Data from 5,445 adolescents aged 15-19, 9,779 adults aged 35-44 and 7,619 elderly individuals aged 65-74, participants in the Brazilian Oral Health Survey (SBBrasil) 2010, were analyzed. The mean missing teeth, proportion of lack of functional dentition (< 21 natural teeth) and proportion of edentulism (total tooth loss) were estimated for each age group, each state Capital and each macro region. Multivariable logistic regression (tooth loss) and Poisson (absence of functional dentition and edentulism) analyses were performed in order to identify socioeconomic factors and demographic characteristics associated with each outcome. RESULTS: The prevalence of tooth loss among adolescents was 17.4% (38.9% in 2002-03) ranging from 8.1% among those earning higher income to almost 30% among those with less schooling. Among adolescents, females, those with black or brown skin and those with the lowest levels of income and schooling had a higher prevalence of tooth loss. Lack of functional dentition affected nearly ¼ of adults, it was higher among women, among those with black and brown skin and among those with the lowest levels of income and schooling. Mean missing teeth in adults decreased from 13.5 in 2002-03 to 7.4 in 2010. More than half of elderly is edentulous (similar to the 2002-03 findings); higher prevalence of edentulism was found among women and those with the lowest levels of income and schooling. Among adolescents the mean missing teeth ranged from 0.1 (in Curitiba, South Brazil and Vitória, Southeast Brazil) to 1.2 (in the North countryside). Among adults the lowest mean missing teeth was found in Vitória (4.2) and the highest in Rio Branco, North Brazil (13.6). CONCLUSIONS: A remarkable reduction in tooth loss among adolescents and adults was identified between 2010 and 2003. Among the elderly, tooth loss figure remained the same. In spite of important achievements in tooth loss figures, social and regional inequalities persist.

研究目标：估算巴西青少年、成人及老年人的平均缺牙数、功能性牙列缺失情况与全牙缺失（edentulism）发生率，并与2003年的调查结果进行对比。
研究方法：分析2010年巴西口腔健康调查（Brazilian Oral Health Survey, SBBrasil）的受试人群数据，其中包括5445名15-19岁青少年、9779名35-44岁成人以及7619名65-74岁老年人。针对各年龄组、各州首府及各宏观区域，分别估算平均缺牙数、功能性牙列缺失（自然牙少于21颗）占比与全牙缺失（edentulism）占比。为明确与各结局指标相关的社会经济因素及人口学特征，本研究开展了多变量logistic回归（针对牙缺失）与泊松回归（针对功能性牙列缺失及全牙缺失）分析。
研究结果：青少年群体的牙缺失患病率为17.4%（2002-2003年为38.9%），其中高收入群体的患病率仅为8.1%，而受教育程度最低群体的患病率接近30%。青少年群体中，女性、黑棕肤色人群以及收入与受教育水平最低的群体牙缺失患病率更高。近四分之一成人存在功能性牙列缺失，该情况在女性、黑棕肤色人群以及收入与受教育水平最低的群体中更为普遍。成人平均缺牙数已从2002-2003年的13.5颗降至2010年的7.4颗。超半数老年人为无牙颌患者（与2002-2003年的调查结果相近），女性及收入与受教育水平最低的群体无牙颌患病率更高。青少年群体的平均缺牙数区间为0.1颗（巴西南部库里提巴市与东南部维多利亚市）至1.2颗（北部乡村地区）。成人群体中，平均缺牙数最低的为维多利亚市（4.2颗），最高的为巴西北部的里奥布朗库市（13.6颗）。
研究结论：2010年与2003年相比，巴西青少年与成人的牙缺失情况已出现显著改善。老年群体的牙缺失水平则保持不变。尽管在牙缺失防控方面取得了重要进展，但社会与区域层面的健康不平等现象依然存在。