Oral impact of dental prosthesis use in different patterns of tooth loss.

Statement of problem: Tooth loss is a critical indicator of oral health and negatively impacts oral health-related quality of life (OHRQoL) depending on the number and location of the missing teeth. Reports of oral rehabilitation have been conflicting depending on the tooth loss pattern and prostheses provided.

Purpose: The purpose of this population-based study was to evaluate the association between the use of different dental prostheses according to different tooth loss patterns and OHRQoL.

Material and methods: A representative sample of 22 843 individuals aged between 15 and 75 years was recruited in Brazil. The dependent variable was the OHRQoL as measured by the score on the oral impact on daily performance (OIDP), and the main predictor was the pattern of tooth loss and prosthesis use. Covariates included sex, age, income, education, missing teeth, dental pain, and dental visits. The zero-inflated negative binomial regression was applied with sampling weights.

Results: Participants with only anterior missing teeth had an OIDP mean ratio, MR) 1.49 times higher than those without tooth loss and not wearing a prosthesis (95% CI=1.12-1.98); those with a distal extension, with anterior tooth loss MR=1.68 (95%CI=1.17-2.43); and complete edentulism in one or both jaws MR=1.53 (95%CI=1.04-2.25). Participants wearing a removable partial denture (RPD) or a combination of an RPD and fixed prostheses with a few missing teeth reported worse OIDP (MR=3.57, 95% CI=2.11-6.04) than those with fixed prostheses only or without a prosthesis. Individuals with edentulism using complete dentures in both jaws had lower OIDP scores (MR=0.9, 95% CI=0.59-1.37) than those using or those who do not use other categories of prosthetic rehabilitation.

Conclusions: Some types of prosthetic rehabilitation were not associated with better OHRQoL in individuals with tooth loss. The impact of prosthetic rehabilitation was associated with the pattern of tooth loss.