HOOTH LOSS AND RISK FACTORS AMONG ELDERLY VIETNAMESE
often than anterior teeth . This finding is expected because of the morphology of the occlusal surfaces of posterior teeth , which easily accumulates plaque and food debris . Furthermore , it was often difficult for the elders to perform oral hygiene on the last position of the dental arch , and this could increase the risk of caries and periodontitis , leading to tooth loss . We observed that the prevalence of losing canine and posterior teeth of the maxilla were statistically higher than that of the mandible . The maxilla is known as the spongy bone type , and the mandibular is of the compact bone type ; consequently , inflammation of the supporting bone in the maxilla could lead to a more rapid resorption of bone and earlier tooth loss than in the mandibular 12 . However , our finding was in contrast with the study of Nguyen et al . 11 , which indicated that loss of lower posterior teeth was more frequent than that of upper posterior teeth .
The elderly Vietnamese had an average of 7.6 missing teeth . At the same age group , this observed number is higher compared to the study conducted in Australia ( 5.3 ) 13 , Turkey ( 7.0 ) 14 , but lower than the one reported in China ( 11.2 ) 8 , and Brazil ( 26.1 ) 15 . Regarding the influence of sociodemographic factors on tooth loss , participants aged 70 – 74 had lost significantly more teeth on average than those aged 65 – 69 . This finding was in agreement with previous studies , which indicated that the number of lost teeth tends to increase with age 14 , 15 . Maintaining more than 20 teeth is a core mission of Oral health care programmes for the older population 16 . Approximately 60 % of the elderly Vietnamese still had 20 teeth or more . This prevalence was far lower compared with the findings in a neighbouring country 17 , but in line with a study conducted in Iran 18 , and higher than the ones reported in Turkey 14 .
Table 1 . The odds of > 6 lost teeth in relation to risk factors
Variables Frequency of cleaning teeth
Time in education
Tobacco smoking
Drink alcohol
Binary logistic regression Ref : reference , * p < 0.01
|
Odds ratio |
|
OR |
95 % CI |
p-value |
≥2 times / day 1.0 ( ref ) ≤1 time / day 1.4 0.8-2.7 0.15
> 5 years 1.0 ( ref ) ≤5 years 2.2 1.3 – 3.8 0.004 *
No 1.0 ( ref ) Yes 2.8 1.4 – 5.6 0.003 *
No 1.0 ( ref ) Yes 0.3 0.1 – 0.7 0.003 *
Rural residents had significantly higher tooth loss than urban residents . This reflected the difference in oral health services among regions in Vietnam where the density of dentists in the rural area was much lower than in the urban area ( 1 / 200,000 for rural vs . 1 / 13,500 inhabitants for urban ) 11 . Moreover , the elderly Vietnamese living in a rural area often prefer to remove a painful tooth rather than having it restored because they think that tooth loss is a natural part of the aging process . The frequency of dental visits reflect the attitudes of the patient or the provider , accessibility to dental care and prevailing societal attitudes regarding oral health care . We found that 74.6 % of the elderly Vietnamese ignored an oral health checkup during the previous year , they only visited dentists with the unique aim to remove teeth due to an acute toothache or an impaired ability to chew ( i . e . mobility teeth ). Moreover , material and transportation-related obstacles , especially in the rural areas , are also factors that limit access to oral health care services 19 , 20 . Therefore , the number of teeth lost in this group was much higher than those who annually visited the dentist for oral care . Our finding was close to the third China National
Oral Health Survey . This survey reported that more than three-fourths of the Chinese aged 65 – 74 had missing teeth more often than those who regularly visited a dentist 8 . The risk factors for tooth loss have been studied all over the world . However , as far as we know , no data have been reported on the risk factors of tooth loss in Vietnam . Lack of knowledge among the elderly Vietnamese regarding oral health might be influenced by the level of education 21 . Forty percent of the elderly Vietnamese in the current study who were in education ≤5 years had lost 10.2 teeth on average . Their education might have been interrupted due to the Vietnam War ( 1945 – 1975 ). The subjects believe that the prolonging the existence of a tooth in their mouth would have an adverse impact on the life of their descendants . Also , the elders with less time in education were significantly associated with the odds of losing > 6 teeth ( OR = 2.2 ), it might be due to the lack of awareness about oral health behaviours for maintaining teeth . In the current study , we found that smokers ( 23.4 %) had significantly higher tooth loss ( 9.3 ± 7.6 ) than non-smokers ( 7.2 ± 6.8 ). It could be due to the well-
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