Individual and contextual factors associated with tooth loss among Brazilian older adults.

OBJECTIVE

To assess factors associated with functional dentition, severe tooth loss, and edentulism among Brazilian older adults, investigating individual sociodemographic characteristics and contextual characteristics of municipal oral health services.

METHODS

This is a cross-sectional, analytical study with data from the SB Brasil 2023 survey on individuals aged 65-74 years. Tooth loss was evaluated based on three outcomes: functional dentition (≥20 permanent teeth), severe tooth loss (<10 remaining teeth), and edentulism (loss of all permanent teeth). Multilevel logistic regression accounted for the complex sampling design. Individual variables were sex, ethnicity/race, per capita household income, and level of education; contextual variables were oral health coverage in Primary Health Care and the presence of Dental Specialty Centers (CEO) and Regional Dental Prosthesis Laboratories (LRPD) (p<0.05).

RESULTS

Oral health coverage in Primary Health Care and the presence of CEO and LRPD were not associated with edentulism (p>0.05). Functional dentition was less likely among women (OR 0.66; 95%CI 0.57-0.76) and among residents of municipalities with oral health coverage ≥80% (OR 0.74; 95%CI 0.56-0.97). Higher income and level of education were associated with higher prevalence of functional dentition (p<0.05). Severe tooth loss and edentulism were more frequent among women and older adults with lower income and lower level of education (p<0.05). Severe tooth loss was less prevalent in municipalities with CEO (p<0.05).

CONCLUSION

Individual socioeconomic variables and contextual characteristics of oral health services were associated with tooth loss among older adults, evidencing the persistence of social inequalities in this outcome.