Chewing impairment and associated factors among adults

Figueiredo, Daniela de Rossi; Peres, Marco Aurélio; Luchi, Carla Antoni; Peres, Karen Glazer

doi:10.1590/S0034-8910.2013047004789

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Original Articles • Rev. Saúde Pública 47 (6) • Dec 2013 • https://doi.org/10.1590/S0034-8910.2013047004789 copy

Chewing impairment and associated factors among adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

: The aim of this study was to estimate the prevalence of chewing impairment according to sex, and its associated factors in adults.

METHODS

: A cross-sectional population-based study was carried out with 2,016 subjects aged between 20 and 59 years in Florianopolis, SC, Southern Brazil, in 2009. The sampling was undertaken in two stages, census tracts and households. The outcome ‘chewing impairment’ was obtained from the question “How often do you have chewing impairment due to teeth or denture problems?”. Analyses were carried out with demographics and socioeconomic factors, dental services utilization, and self-related oral health using multivariable logistic regression and stratified by sex.

RESULTS

: The response rate was 85.3% (1,720 adults). The prevalence of chewing impairment was 13,0% (95%CI 10.3;15.8) and 18,0% (95%CI 14.6;21.3) among men and women, respectively. Women and men fifty years old and over, who had ten or fewer natural teeth and those who reported toothache were more likely to have chewing impairment. The combination of tooth loss and toothache on chewing impairment was almost four times higher among women.

CONCLUSIONS

: The magnitude of the associations among socioeconomic, demographics and self-related oral health factors was different according to sex, in general higher for women, with emphasis on toothache. The findings suggest that the impact of oral conditions varies by sex.

Adult; Mastication; Socioeconomic Factors; Gender and Health; Oral Health; Dental Health Surveys

Variable	Sample		Men		Women

	n	%	n	%	n	%
Age (years) (n = 1,720)
20 to 29	540	32.7	260	34.8	280	30.9
30 to 39	392	22.9	172	22.9	220	23.0
40 to 49	438	25.0	181	23.7	257	26.0
50 to 59	350	19.4	148	18.6	202	20.1
Self-reported skin color (n = 1,678)
White	1,444	86.0	642	85.1	802	86.3
Parda /Black	234	14.0	108	14.9	126	13.7
Per capita income in terciles (reais) (n = 1,685)
3^rd tercile (highest income)	559	34.1	258	35.7	301	32.9
2^nd tercile	562	33.3	258	34.4	304	32.4
1^st tercile (lowest income)	564	32.6	229	29.9	335	34.7
Schooling (years of study) (n = 1,716)
≥ 12	737	43.9	318	43.0	419	44.6
9 to 11	568	33.3	263	34.5	305	32.5
5 to 8	253	14.0	108	13.7	145	14.2
≤ 4	158	8.8	69	8.8	89	8.7
Most recent dental visit (years) (n = 1,705)
< 1	1,136	66.9	453	60.2	683	72.2
1 to 2	381	22.4	194	25.5	187	19.9
≥ 3	188	10.7	109	14.3	79	7.9
Type of service (n = 1,707)
Private	1,293	76.3	563	75.1	730	77.3
Public	331	19.0	150	19.3	181	18.7
Other	83	4.7	44	5.6	39	4.0
Dry mouth (n = 1,716)
Never/Sometimes	1,564	91.5	704	93.1	860	90.1
Often/Always	152	8.5	55	6.9	97	9.9
Wearing full prosthesis (n = 1,698)
No	1,575	93.0	711	94.1	864	91.9
Yes	123	7.0	41	5.9	82	8.1
Number of natural teeth (n = 1,717)
≥ 10 in both dental arches	1,394	82.0	629	83.3	765	81.0
< 10 in at least one arch	279	15.6	116	14.7	163	16.2
None	44	2.4	15	2.0	29	2.8
Toothache (n = 1,717)
No	1,463	85.4	661	87.5	802	83.8
Yes	254	14.6	100	12.5	154	16.2
Difficulty chewing (n = 1,712)
Never	1,443	84.2	653	87.0	790	82.0
Sometimes/Often/Always	269	15.8	104	13.0^a	165	18.0^a

Variable	Men			Women

	%	95%CI	p^a	%	95%CI	p^a
Age (years)			< 0.001			0.049
20 to 29	7.3	3.8;10.9		12.7	8.5;17.0
30 to 39	15.4	9.9;20.9		18.2	12.6;23.8
40 to 49	12.4	7.5;17.3		20.1	14.1;26.0
50 to 59	21.6	14.9;28.3		23.1	15.4;30.8
Self-reported skin color			0.191			0.082
White	13.5	10.3;16.7		17.2	13.6;20.9
Parda /Black	10.0	6.1;13.9		23.6	16.8;30.5
Per capita income in terciles (reais)			0.008			0.006
3^rd tercile (highest income)	8.5	4.6;12.4		12.6	17.5;28.2
2^nd tercile	13.2	8.7;17.7		17.8	12.5;23.2
1^st tercile (lowest income)	18.9	13.7;24.1		22.9	8.7;16.6
Schooling (years of study)			< 0.001			0.004
≥ 12	8.7	5.6;11.9		13.2	9.9;16.5
9 to 11	12.0	7.6;16.5		20.6	14.9;26.3
5 to 8	18.0	9.4;26.6		21.1	14.5;27.7
≤ 4	31.0	19.5;42.5		27.9	17.3;38.6
Most recent dental visit (years)			0.102			0.061
< 1	12.2	8.8;15.6		19.5	15.4;23.6
1 to 2	11.4	5.7;17.0		10.2	5.1;15.4
≥ 3	20.1	13.1;27.0		19.4	8.1;30.7
Type of service			0.011			0.599
Private	12.4	9.4;15.3		17.0	13.6;20.4
Public	19.2	12.3;26.0		20.4	12.7;28.1
Other	2.2	0.0;6.7		18.4	7.1;29.6
Dry mouth			0.512			0.010
Never/Sometimes	13.3	10.4;16.2		16.6	13.6;19.7
Often/Always	10.1	2.0;18.2		30.0	17.3;42.8
Wearing full dentures			0.013			0.006
No	12.4	9.7;15.1		17.1	14.0;20.2
Yes	26.5	11.8;41.3		29.4	17.7;41.1
Number of natural teeth			< 0.001			< 0.001
≥ 10 in both dental arches	9.1	6.7;11.5		14.6	11.9;17.3
< 10 in at least one arch	31.8	21.7;41.8		30.7	21.7;39.7
None	37.6	15.2;60.1		42.1	22.4;61.8
Toothache			0.002			< 0.001
No	11.6	8.8;14.3		12.3	9.7;14.8
Yes	23.3	15.0;31.7		47.0	35.6;58.4

Variable	Unadjusted analysis		Model 1^a		Model 2^b		Model 3^c

	OR	95%CI	OR	95%CI	OR	95%CI	OR	95%CI
Demographic block
Age (years)	p < 0.001		p < 0.001
20 to 29	1		1
30 to 39	2.3	1.2;4.4	2.4	1.3;4.5
40 to 49	1.8	0.9;3.6	1.8	0.9;3.6
50 to 59	3.5	1.9;6.3	3.4	1.9;5.9
Self-reported skin color	p = 0.192		p = 0.440
White	1		1
Parda /Black	0.7	0.4;1.2	0.8	0.5;1.4
Socioeconomic block
Per capita income terciles (reais)	p = 0.002				p = 0.083
3^rd tercile (highest income)	1				1
2^nd tercile	1.6	0.9;3.2			1.4	0.7;2.8
1^st tercile (lowest income)	2.5	1.4;4.6			2.0	0.9;2.1
Schooling in years of study	p < 0.001				p = 0.017
≥ 12	1				1
9 to 11	1.4	0.8;2.6			1.2	0.7;2.1
5 to 8	2.3	1.2;4.6			1.4	0.7;3.0
≤ 4	4.7	2.5;8.9			2.4	1.1;5.2
Use of dental services block
Most recent dental visit (years)	p = 0.100						p = 0.755
< 1	1						1
1 to 2	0.9	0.5;1.7					0.9	0.5;1.7
3	1.8	1.1;3.1					1.2	0.6;2.3
Type of service	p = 0.930
Private	1							–
Public	1.7	1.0;2.7						–
Other	0.2	0.02;1.3						–
Bloco de condições bucais autorreferidas
Wearing full dentures	p = 0.016						p = 0.147
No	1						1
Yes	2.6	1.2;5.4					0.5	0.2;1.4
Number of natural teeth	p < 0.001						p < 0.001
≥ 10 in both arches	1						1
< 10 in at least one arch	4.6	2.8;7.6					3.9	2.1;7.1
None	6.0	2.3;15.9					6.1	1.7;21.8
Toothache	p = 0.002						p = 0.002
No	1						1
Yes	2.3	1.4;3.9					2.2	1.3;3.8
Number of natural teeth x toothache							p < 0.001
Number of natural teeth x toothache							1.8	1.4;2.2

Variable	Unadjusted analysis		Model 1^a		Model 2^b		Model 3^c

	RC	95%CI	RC	95%CI	RC	95%CI	RC	95%CI
Demographic block
Age (years)	p = 0.006		p = 0.002
20 to 29	1		1
30 to 39	1.5	0.8;2.8	1.6	0.8;2.9
40 to 49	1.7	1.1;2.6	1.8	1.2;2.8
50 to 59	2.1	1.2;3.5	2.1	1.3;3.6
Cor da pele autorreferida	p = 0.084		p = 0.055
White	1		1
Parda /Black	1.5	0.9;2.3	1.6	(1.0;2.4)
Socioeconomic block
Per capita income terciles (reais)	p = 0.001				p = 0.021
3^rd tercile (highest income)	1				1
2^nd tercile	1.5	0.9;2.4			1.5	0.9;2.8
1^st tercile (lowest income)	2.1	1.3;3.1			1.9	1.1;3.2
Schooling in years of study	p = 0.001				p = 0.499
≥ 12	1				1
9 a 11	1.7	1.1;2.7			1.4	0.8;2.3
5 a 8	1.8	1.1;2.8			1.2	0.7;2.0
≤ 4	2.6	1.4;4.6			1.3	0.6;2.8
Use of dental services block
Most recent dental visit (years)	p = 0.309						^d
< 1	1							–
1 to 2	0.5	0.3;0.9						–
3	1.0	0.5;2.1						–
Self-reported oral health conditions block
Dry mouth	p = 0.012						p = 0.082
Never/Sometimes	1						1
Often/Always	2.2	1.2;3.9					1.8	0.9;3.3
Wearing full dentures	p = 0.006						p = 0.192
No	1						1
Yes	2.0	1.2;3.3					0.5	0.2;1.3
Number of natural teeth	p < 0.001						p = 0.005
≥ 10 in both arches	1						1
< 10 in at least one arch	2.6	1.7;3.9					2.2	1.1;4.3
None	4.3	1.9;9.3					6.6	1.8;24.4
Toothache	p < 0.001						p < 0.001
No	1						1
Yes	6.4	4.0;10.0					6.8	4.1;11.3
Number of natural teeth x toothache							p < 0.001
Number of natural teeth x toothache							2.5	2.0;3.3

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[1] Correspondence
: Karen Glazer Peres. Australian Research Centre for Population Oral Health. School of Dentistry. The University of Adelaide. 122 Frome Street. Adelaide, SA, Australia 5000. E-mail: karen.peres@adelaide.edu.au