Key words:
Dental prosthetic status - edentulism - geriatric patients - prosthetic needs
INTRODUCTION
Aging is ubiquitous, imminent, and indelible biological process, which influence one
and all.[1] An increased number of the geriatric people suggests an imperative demographic change
throughout the world. As recommended by the World Health Organization (WHO), a populace
maturing over 60 years of age ought to be considered to be an elderly population,
and furthermore, the elderly constitute around 3.5% of the total population of Saudi
Arabia.[2] In recent time, progresses in therapeutic sciences and enhanced social conditions
have fundamentally expanded average life expectancy of the people around the world.
This may posture colossal difficulties to those included in providing the care that
is needed for geriatric population.[3] It turns into the mission of the health‑care providers to work not only to expand
the life expectancy but also rather additionally and maybe more vitally to make later
years of life more beneficial and pleasant.[4]
Optimal oral health is an indispensable component for the healthful living, and oral
well‑being can be regarded as an index of general well‑being and personal satisfaction
in elderly people. Disorders of the oral cavity are radical and amassing and can turn
into unpredictable after sometime.[5]
[6] Among the numerous maladies and ailments that the aged individuals experience the
ill effects of, disorders related to the oral cavity possess a critical role. Enhanced
oral health will permit aged individuals to ameliorate their self‑assurance, have
social contacts, and reestablish the capacity to work. Loss of tooth is turning into
a vital general health problem among a greater proportion of extent of geriatric persons.[5] Edentulism impacts dietary habit, particularly in terms of restricted masticatory
functioning, consequently leading to weight reduction and pertinent systemic illnesses
among the aged individuals. Aside from this, tooth loss might be sincerely discouraging
for the greater part of the elderly individuals. It can likewise prompt to abstaining
of day‑to‑day activities and may brunt personal satisfaction.[7]
[8]
The elderly individuals may confront the most noteworthy number of barriers to oral
health administrations regarding financial elements, absence of treatment resources,
and coinciding various chronic and psychological illnesses. The evaluation of therapeutic
requirements among elderly people is a critical prerequisite in oral health‑care planning,
and to accomplish this, it is fundamental to enact specific objectives.[9] One of the initial phases in planning dental administrations is subsequently, the
compilation of data on the prevalence of oral disorders in a given populace, and accordingly,
we should know about the prosthetic status and a prosthetic need of this populace.
With these data, it is conceivable to survey future treatment needs and requests for
services.[10]
Data on prosthetic status and prosthetic need among the geriatric individuals are
very minimal, and to the best our knowledge, no such study was carried out in Kingdom
of Saudi Arabia. Therefore, this research was carried out with an aim to exploring
and assessing the prosthetic status and prosthetic needs of the geriatric population.
MATERIALS AND METHODS
This cross‑sectional survey was carried out to determine the prosthetic status and
prosthetic need among the geriatric patients attending the College of Dentistry, Aljouf
University University, Saudi Arabia, from October 2014 to March 2016. Approval for
the study was obtained from the Institutional Ethical Committee. Patients had been
made aware of the nature and aim of the investigation and have been included in the
study after they signed informed consent. All patients aged 60 years and above constituted
the study sample. The WHO oral health assessment pro forma[11] was employed to record the data pertaining to the prosthetic status and prosthetic
treatment needs of the participants. Data were analyzed using the Statistical Package
for the Social Sciences (SPSS; IBM, USA) Version 20 software. Differences in proportions
were compared using the Chi‑square test.
RESULTS
Sociodemographic characteristics of study population are described in [Table 1]. It indicates that, out of 286 patients, a maximum of 56.64% were males, 33.91%
of patients belonged to <60 years of age group, 45.80% of patients belonged to upper
middle SES, and 40.55% of patients had secondary-school education followed by others.
Table 1:
Sociodemographic characteristics of study population
|
Variables
|
n (%)
|
P
|
|
*P<0.05
|
|
Gender
|
|
|
|
Male
|
162 (56.64)
|
0.0129*
|
|
Female
|
124 (43.35)
|
|
|
Age range (years)
|
|
|
|
61-65
|
79 (27.62)
|
0.0001*
|
|
66-70
|
70 (24.47)
|
|
|
71-75
|
58 (20.27)
|
|
|
76-80
|
51 (17.83)
|
|
|
>80
|
28
|
(9.79)
|
|
Economic status
|
|
|
|
Upper
|
37 (12.93)
|
0.0001*
|
|
Upper middle
|
131 (45.80)
|
|
|
Lower middle
|
48 (16.78)
|
|
|
Upper lower
|
36 (12.58)
|
|
|
Lower
|
34 (11.88)
|
|
|
Education level
|
|
|
|
Primary
|
61 (21.32)
|
0.0001*
|
|
Secondary
|
116 (40.55)
|
|
|
Graduate and higher
|
109 (38.11)
|
|
[Table 2] represents the distribution of study subjects according to gender and the prosthetic
status with regard to upper arch . Out of 286 patients, a maximum of 81.45% femalesand
67.90% males were without any prosthesis in upper arch as compared to 8.64% of males
and 4.03% of females having bridge, 5.64% of females and 6.79% of males having both
bridge and partial denture, and 7.40% of males and 4.03% of females having removable
denture followed by those having >1 bridge in the upper arch. The differences between
males and females with prosthesis status were found to statistically nonsignificant
(Chi-square = 8.7163, P = 0.1213).
Table 2:
Distribution of study subjects according to gender and the prosthetic status of their
upper arch
|
Prosthetic status
|
Male (%)
|
Female (%)
|
Total (%)
|
|
No prosthesis
|
110 (67.90)
|
101 (81.45)
|
211 (73.77)
|
|
Bridge
|
14 (8.64)
|
5 (4.03)
|
19 (6.64)
|
|
More than one bridge
|
7 (4.32)
|
1 (0.80)
|
8 (2.79)
|
|
Partial denture
|
8 (4.93)
|
5 (4.03)
|
13 (4.54)
|
|
Both bridge and partial denture
|
11 (6.79)
|
7 (5.64)
|
18 (6.29)
|
|
Full removable denture
|
12 (7.40)
|
5 (4.03)
|
17 (5.94)
|
|
Not recorded
|
0
|
0
|
0
|
|
Total
|
162 (100)
|
124 (100)
|
286 (100)
|
|
χ2,P
|
|
8.7163, 0.1213
|
|
[Table 3] shows the distribution of study subjects according to gender and the prosthetic
status with regard to lower arch. Among 286 patients, a maximum of 88.7% females and
73.4% males had no prosthesis in lower arch as compared to 8.02% of males and 3.22%
of females having bridge, 0.80% of females and 3.70% of males having both bridge and
partial denture, and 6.17% of males and 4.03% of females having removable denture
followed by those having >1 bridge in lower arch. The differences between males and
females with prosthesis status were found to statistically significant (Chi-square
= 11.1712, P = 0.0483).
Table 3:
Distribution of study subjects according to gender and the prosthetic status of their
lower arch
|
Prosthetic status
|
Male (%)
|
Female (%)
|
Total (%)
|
|
*P<0.05
|
|
No prosthesis
|
119 (73.4)
|
110 (88.7)
|
229 (80.06)
|
|
Bridge
|
13 (8.02)
|
4 (3.22)
|
17 (5.94)
|
|
More than one bridge
|
5 (3.08)
|
1 (0.8)
|
6 (2.09)
|
|
Partial denture
|
9 (5.55)
|
3 (2.41)
|
12 (4.19)
|
|
Both bridge and partial denture
|
6 (3.70)
|
1 (0.8)
|
7 (2.44)
|
|
Full removable denture
|
10 (6.17)
|
5 (4.03)
|
15 (5.24)
|
|
Not recorded
|
0
|
0
|
0
|
|
Total
|
162 (100)
|
124 (100)
|
286 (100)
|
|
χ2,P
|
|
11.1712, 0.0483*
|
|
Distribution of study subjects according to gender and the prosthetic need with regard
to upper arch are mentioned in [Table 4]. Out of 286 patients, a maximum of 31.48% males and 42.74% females not required
any prosthesis in upper arch as compared to 4.93% of males and 8.06% of females needing
single-unit prosthesis in upper arch, 29.01% of males and 25.80% of females needing
multiunit prosthesis in upper arch, and 27.77% of males and 17.74% females needing
full-mouth prosthesis in upper arch followed by 6.79% of males and 5.64% of females
needing combination of single- or multiunit prosthesis in upper arch. The differences
between males and females with prosthetic needs were found to be statistically nonsignificant
(Chi-square = 6.9672, P = 0.1385).
Table 4:
Distribution of study subjects according to gender and the prosthetic need of their
upper arches
|
Prosthetic needs
|
Male (%)
|
Female (%)
|
Total (%)
|
|
No prosthesis required
|
51 (31.48)
|
53 (42.74)
|
104 (36.36)
|
|
Need for single‑unit prosthesis
|
8 (4.93)
|
10 (8.06)
|
18 (6.29)
|
|
Need for multiunit prosthesis
|
47 (29.01)
|
32 (25.80)
|
79 (27.62)
|
|
Need for combination of single‑ or multiunit prosthesis
|
11 (6.79)
|
7 (5.64)
|
18 (6.29)
|
|
Need for full mouth prosthesis (replacement of all teeth)
|
45 (27.77)
|
22 (17.74)
|
67 (23.42)
|
|
Not recorded
|
0
|
0
|
0
|
|
Total
|
162 (100)
|
124 (100)
|
286 (100)
|
|
χ2,P
|
|
6.9672, 0.1385
|
|
[Table 5] shows the distribution of study subjects according to gender and the prosthetic
need with regard to lower arch. Among 286 patients, in which 24.07% of males and 27.41%
of females required no prosthesis in lower arch as compared to 5.55% of males and
10.48% of females having need for single-unit prosthesis, 35.18% of males and 21.77%
of females having need for multiunit prosthesis, and 26.54% of males and 28.22% of
females having need for full mouth prosthesis followed by 8.64% of males and 12.09%
of females who needed combination of single-or multiunit prosthesis in lower arch.
The differences between males and females with prosthesis needs were found to statistically
nonsignifi cant (Chi-square = 7.7265, P = 0.1024).
Table 5:
Distribution of study subjects according to gender and the prosthetic need of their
lower arches
|
Prosthetic needs
|
Male (%)
|
Female (%)
|
Total (%)
|
|
No prosthesis required
|
39 (24.07)
|
34 (27.41)
|
73 (25.52)
|
|
Need for single‑unit prosthesis
|
9 (5.55)
|
13 (10.48)
|
22 (7.69)
|
|
Need for multiunit prosthesis
|
57 (35.18)
|
27 (21.77)
|
84 (29.37)
|
|
Need for combination of single‑ or multiunit prosthesis
|
14 (8.64)
|
15 (12.09)
|
29 (10.13)
|
|
Need for full mouth prosthesis (replacement of all teeth)
|
43 (26.54)
|
35 (28.22)
|
78 (27.27)
|
|
Not recorded
|
0
|
0
|
0
|
|
Total
|
162 (100)
|
124 (100)
|
286 (100)
|
|
χ2,P
|
|
7.7265, 0.1024
|
|
DISCUSSION
This was the first cross‑sectional study carried out to evaluate the prosthetic status
and prosthetic needs of the geriatric patients attending the College of Dentistry,
Al Jouf University, Kingdom of Saudi Arabia.
The population aged 60 years and above residing were selected, and a total of 286
patients were included in this study. All the examinations were carried out under
standardized conditions, and prosthetic status and prosthetic needs of the participants
were recorded.
Out of 286 edentulous patients, 69.06% needed some form of prosthetic treatment, and
an incidence varying from 76% to 88% was reported in various studies. This low extent
of individuals with prostheses regardless of the need might be ascribed to one of
these few reasons such as absence of information, paucity of enthusiasm for esthetics,
monetary limitations, and the lack of availability of dental services.
Out of 286 edentulous patients, 73.77% did not have any prosthesis in upper arch and
80.06% did not have any prosthesis in lower arch; this rate was comparably high in
comparison to institutionalized samples in study of Deogade et al.[12] and was lower than that of Shenoy and Hegde.[13] This finding was also low when compared with observation of Shah et al. and Ettinger et al., where they included patients with wider age group.[14]
Out of 162 males, 32.09% and 26.54% had prosthesis in upper and lower arch, respectively.
Among 124 females, 18.54% and 19.35% had prosthesis in upper and lower arch, respectively.
Females had comparatively less prosthesis in both arches than males. This was in accordance
with the findings of Shah et al.,[5] Deogade et al .,[12] and Shenoy and Hegde.[13] Comparable findings have been recorded in studies conducted in various parts of
the world.[15]
[16]
[17]
[18] The rationale behind female patients presenting fewer prostheses than their counterparts
was due to their dependency, a lower level of education, and lack of employment. These
conclusions are in accordance with the study conducted by Shenoy and Hegde.[13]
The differences between males and females with prosthesis need were found to be statistically
not significant in relation to both upper and lower arches; this observation was similar
with that of Shenoy and Hegde,[13] whereas Shah et al.[5] found that males had higher prosthetic need as compared to females.
In males, the need for any type of prosthesis in upper and lower arch was 68.51% and
75.92%, respectively. It was higher than survey held by Montal et al. in France[19] and Shah et al.[5] and Shigali et al. in India.[20]
In female patients, the need for prosthesis in upper and lower arch was 57.25% and
72.58%, respectively, which was more than that of Shah et al.[5] and Shenoy and Hegde[13] and less than that of Deogade et al.[12]
The need for multiunit prosthesis was more in both upper and lower arches in both
genders. This observation was similar to that of Shah et al.,[5] Deogade et al.,[12]
and Shenoy and Hegde.[13]
In the present study, the need for complete denture and combination of single‑or multiunit
prosthesis was more among the males as compared to females in maxilla and vice versa
for mandible. Deogade et al .[2l]
and Slade et al.[18]
observed that the need for full prostheses was more than the need for multiunit prostheses
or the need for a combination of one and multiunit prosthesis in females. Shenoy and
Hegde[13] observed that the need for full prostheses in upper and lower arches was more in
comparison to the need for partial dentures, and the need was slightly more in males
than in females. Shah et al.[5] noted that a need for complete denture was more among the males as compared to females,
and they proposed that these might be due to tobacco‑related habits which are common
in males. Hongal et al . noted that the need for single‑unit prosthesis was highest among females, and males
were required more multiunit prosthesis.[21]
CONCLUSION
The results of this study propose that the greater part of the prosthetic needs were
insufficient among the geriatric people. These outcomes may serve as a beneficial
guideline for the future assessment of prosthetic status and prosthetic need among
the geriatric people. The observations from this study may accord to the evolution
of an oral health‑care concord for the elderly individuals to enhance their dental
perception and revamp their oral health.
Financial support and sponsorship
Nil.
