Construction of a multidimensional oral health indicator for the older population in the city of Manaus-Amazonas

Birman, Dina; Rebelo, Maria Augusta Bessa; Freitas, Yan Nogueira Leite de; Cardoso, Evangeline Maria; Vieira, Janete Maria Rebelo

doi:10.1590/1981-22562021024.220012.en

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Original Articles • Rev. bras. geriatr. gerontol. 24 (5) • 2021 • https://doi.org/10.1590/1981-22562021024.220012.en copy

Construction of a multidimensional oral health indicator for the older population in the city of Manaus-Amazonas

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Produce a multidimensional indicator of oral health, based on dental and non-dental variables, for the older adult in the urban area of the city of Manaus-AM.

Method

The data used are from a cross-sectional population-based study conducted in 2008 with randomly selected individuals aged 65 to 74 years, residing in the city of Manaus. To produce the proposed indicator, the dental variables (DMFT- Decayed, Missing and Filled Teeth; CPI- Community Periodontal Index; PIP- Periodontal Insertion Loss Index) and non-dental (socioeconomic and index GOHAI- General Oral Health Assessment Index) were considered. An exploratory factor analysis synthesized these variables, facilitating the construction of the multidimensional indicator

Results

The analysis generated three factors that, together, explained 72.9% of the model’s variance (KMO = 0.749 and p<0.001 for Bartlett’s test of sphericity). These three factors were reduced to the “sum” variable, calculated from the sum of the factor scores per individual. The median of this new variable was the reference value for categorizing the individual’s oral health condition into “favorable” or “unfavorable”.

Conclusion

The indicator was able to aggregate several dimensions of oral health into a single measure, in addition to enabling its reproducibility for the construction of other health status indicators.

Keywords
Older Adults; Health Status Indicator; Oral Health; Tooth Loss

Variables	Average ± SD	Median	Q₂₅ – Q₇₅	CI (95%)
Age	69.26 ± 3.00	69.00	67.00 – 72.00	69.02 – 69.50
Years of study	4.54 ± 3.97	4.00	1.00 – 7.00	4.22 – 4.85
Personal income in reais	705.35 ± 908.03	415.00	415.00 – 800.00	633.26 – 777.43
Number of people/room	0.98 ± 0.75	0.80	0.58 – 1.25	0.92 – 1.04
Number of missing teeth	28.09 ± 5.37	32.00	25.00 – 32.00	27.67 – 28.52
Number of teeth present	3.82 ± 5.22	0.00	0.00 – 6.50	3.41 – 4.24
Number of healthy teeth	2.64 ± 3.70	0.00	0.00 – 5.00	2.34 – 2.93
number of decayed teeth	0.52 ± 1.46	0.00	0.00 – 0.00	0.41 – 0.64
Number of teeth restored	0.66 ± 1.95	0.00	0.00 – 0.00	0.50 – 0.82
DMFT	29.27 ± 3.86	32.00	27.00 – 32.00	28.97 – 29.58
Number of sextants with calculus	0.34 ± 0.64	0.00	0.00 – 1.00	0.29 – 0.39
Number of sextants with bleeding	0.01 ± 0.1	0.00	0.00 – 0.00	0.00 – 0.01
Number of sextants with shallow periodontal pocket (4-5 mm)	0.03 ± 0.21	0.00	0.00 – 0.00	0.01 – 0.05
Number of sextants with deep periodontal pocket (≥ 6 mm)	0.00 ± 0.00	0.00	0.00 – 0.00	0.00 – 0.01
Total GOHAI score	33.87 ± 2.74	35.00	33.00 – 36.00	33.65 – 34.09
GOHAI score physical dimension	11.29 ± 1.20	12.00	11.00 – 12.00	11.19 – 11.38
GOHAI score psychosocial dimension	14.26 ± 1.26	15.00	14.00 – 15.00	14.16 – 14.36
GOHAI score pain/discomfort dimension	8.32 ± 1.01	9.00	8.00 – 9.00	8.21 – 8.40

Variables	FACTORS			SAM	Commonalities
Variables	F1	F2	F3	SAM	Commonalities
N^o of missing teeth	-0.961	-0.007	-0.111	0.708	0.936
N^o. of teeth present	0.965	0.001	0.118	0.690	0.946
N^o. of healthy teeth	0.940	0.021	0.053	0.942	0.887
Years of study	0.155	0.019	0.813	0.612	0.686
Personal Income	-0.016	0.038	0.810	0.523	0.658
physical GOHAI	0.091	0.823	0.090	0.618	0.694
psychosocial GOHAI	-0.089	0.773	-0.109	0.631	0.617
pain GOHAI	-0.016	0.760	0.087	0.682	0.585
N^o. of sextants with calculus	0.744	-0.046	-0.026	0.958	0.556

Variable	Oral health status	Median ± DP	Difference between the medians	CI (95%)	p *
Age	Unfavorable	69.52 ± 3.07	0.52	0.05 – 0.10	0.03
Age	Favorable	69.00 ± 2.92	0.52	0.05 – 0.10	0.03
Number of people/ room	Unfavorable	1.07 ± 0.84	0.17	0.04 – 0.28	0.007
Number of people/ room	Favorable	0.90 ± 0.63	0.17	0.04 – 0.28	0.007
Family Income	Unfavorable	1153.62 ± 892.98	-904.44	-1147.68 – -661.20	<0.001
Family Income	Favorable	2058.06 ± 1974.61	-904.44	-1147.68 – -661.20	<0.001

Variable	Oral health status		p**
Variable	Unfavorable n (%)	Favorable n (%)	p**
Sex			<0.001
Male	72 (38.1)	117 (61.9)
Female	238 (55.2)	193 (44.8)
Housing Zone			<0.001
East	54 (69.2)	24 (30.8)
Midsouth	20 (32.8)	41 (67.2)
West	39 (39.0)	61 (61.0)
South	114 (52.1)	105 (47.9)
North	39 (52.0)	36 (48.0)
Midwest	41 (55.4)	33 (44.6)

Universidade do Estado do Rio Janeiro Rua São Francisco Xavier, 524 - Bloco F, 20559-900 Rio de Janeiro - RJ Brasil, Tel.: (55 21) 2334-0168 - Rio de Janeiro - RJ - Brazil
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[1] Correspondence Dina Birman dinabirman1@gmail.com

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Construction of a multidimensional oral health indicator for the older population in the city of Manaus-Amazonas

Abstract

Objective

Method

﻿Results

Conclusion

Results