Oral Pain and Eating Problems in Spanish Adults and Elderly in the Spanish National Survey Performed in 2005

Aims: To analyze and quantify the sociodemographic, behavioral, and clinical factors influencing the oral pain and eating difficulties reported by Spanish 35- to 44-year-old adults and more elderly people in the most recent Spanish National Oral Health Survey. Methods: Pain and chewing difficulties were gathered in a Likert-scale format from a representative sample of the Spanish general population between the ages of 35 and 44 years (n = 540) and 65 to 74 years (n = 540). Risk factors were identified using bivariate analysis, after which the crude association between risk factors (sociodemographic, behavioral, and clinical) and outcome variables (pain and eating problems) was assessed by adjusted odds ratios, calculated by means of multivariate logistic regression. Results: In the 35- to 44-year-old adults, eating problems were mainly associated with caries and prosthetic treatment needs and oral pain by the number of decayed teeth. In the more elderly individuals, eating problems and oral pain were influenced by prosthetic needs and the number of missing teeth. Female sex was seen to be a risk factor for suffering pain and eating restrictions. Additionally, several independent variables such as social class, place of residence, brushing habits, or periodontal needs became nonsignificant after logistic regression modelling. Conclusion: According to this high-specificity regression model, caries and prosthetic treatment needs should be considered key factors in determining the oral well-being of the Spanish population. Missing teeth represent the most relevant influencing factor for the elderly and decayed teeth for younger adults.

eating difficulties;epidemiological studies;oral healthrelated quality of life;oral pain;self-assessment

1.Cuenca i Sala E. La encuesta de la O.M.S. sobre la salud buco-dental en España. Una aproximación personal. Arch Odontoestomatol 1986;2:15–22.

2.Sicilia A, Cobo J, Noguerol B. Prevalencia de caries en los niños y jóvenes escolares españoles de siete, doce y quince a diecinueve años. Av Odontoestomatol 1990;6:323–330.

3.Noguerol Rodríguez B, Llodra Calvo JC, Sicilia Felechosa A, Follana Murcia M. La salud bucodental en España. 1994. Antecedentes y perspectivas de futuro. Madrid: Ediciones Avances, 1995.

4.Llodra Calvo JC, Bravo Pérez M, Cortés Martinicorena FJ. En-cuesta de salud oral de España (2000). RCOE 2002;7:19–63.

5.Bravo Pérez M, Casals Peidró E, Cortés Martinicorena FJ, Llodra Calvo JC. Encuesta de salud oral en España 2005. RCOE 2006;11(suppl 1):409–456.

6.World Health Organization. Oral Health Surveys: Basic Methods, ed 3. Geneva: World Health Organization, 1987.

7.World Health Organization. Oral Health Surveys: Basic Methods, ed 4. Geneva: World Health Organization, 1997.

8.World Health Organization. Preamble to the Constitution of the World Health Organization as Adopted by the International Health Conference. New York: World Health Organization, 1948.

9.Montero J, Bravo M, Albaladejo A. Validation of two complementary oral health-related quality of life indicators in two qualitatively distinct samples of the Spanish population. Health Qual Life Outcomes 2008;18:101–115.

10.Montero J, Bravo M, Albaladejo A, Hernández LA, Rosel EM. Validation of the Oral Health Impact Profile (OHIP

14) for adults in Spain. Med Oral Patol Oral Cir Bucal 2009;14:e44–e50.

11.Cohen J. Statistical power analysis for the behavioral sciences, ed 2. Hissdale, NJ: Lawrence Erlbaum, 1988.

12.Grupo de trabajo de la Sociedad Española de Epidemiología y de la Sociedad Española de Medicina de Familia y Comunitaria. Una propuesta de medida de la clase social. Aten Primaria 2000;25:350–363.

13.Bourgeois DM, Llodra JC, Nordblad A, Pitts NB. Health surveillance in Europe. A selection of essential oral health indicators. Lyon: European Commission Health and Consumer Directorate General, 2005.

14.Ware JE. SF-36 health survey update. Spine 2000;25: 3130–3139.

15.Borritz M, Rugulies R, Bjorner JB, Villadsen E, Mikkelsen OA, Kristensen TS. Burnout among employees in human service work: Design and baseline findings of the PUMA study. Scand J Public Health 2006;34:49–58.

16.Slade GD, Spencer AJ. Development and evaluation of the oral health impact profile. Community Dent Health 1994;11:3–11.

17.Chavers LS, Gilbert GH, Shelton BJ. Two-year incidence of oral disadvantage: A measure of oral health-related quality of life. Community Dent Oral Epidemiol 2003;31:21–29.

18.Locker D. Measuring oral health: A conceptual framework. Community Dent Health 1988;5:3–18.

19.Slade GD. Measuring Oral Health and Quality of Life. Chapel Hill: University of North Carolina, 1997.

20.Bravo M, Cortés J, Casals E, Llena C, Almerich-Silla JM, Cuenca E. Basic oral health goals for Spain 2015/2020. Int Dent J 2009;59:78–82.

21.World Health Organization Oral Health Epidemiological Profiles website. http://www.whocollab.od.mah.se/. Accessed 25 January 2011.

22.Mason J, Pearce MS, Walls AW, Parker L, Steele JG. How do factors at different stages of the life-course contribute to oral health-related quality of life in middle age for men and women? J Dent Res 2006;85:257–261.

23.Global Oral Data Bank Periodontal Country Profiles website. http://www.dent.niigata-u.ac.jp/prevent/perio/contents. html. Accessed 25 January 2011.

24.Sanders AE, Slade GD, Lim S, Reisine ST. Impact of oral disease on quality of life in the US and Australian populations. Community Dent Oral Epidemiol 2009;37:171–181.

25.Slade GD, Nuttall N, Sanders AE, Steele JG, Allen PF, Lahti S. Impacts of oral disorders in the United Kingdom and Australia. Br Dent J 2005;198:489–493.

26.Locker D, Quiñonez C. Functional and psychosocial impacts of oral disorders in Canadian adults: A national population survey. J Can Dent Assoc 2009;75:521.

27.Pohjola V, Lahti S, Suominen-Taipale L, Hausen H. Dental fear and subjective oral impacts among adults in Finland. Eur J Oral Sci 2009;117:268–272.

28.Chen MS, Hunter P. Oral health and quality of life in New Zealand: A social perspective. Soc Sci Med 1996;43:1213– 1222.

29.Lawrence HP, Thomson WM, Broadbent JM, Poulton R. Oral health-related quality of life in a birth cohort of 32-years old. Community Dent Oral Epidemiol 2008;36:305–316.

30.Segú M, Collesano V, Lobbia S, Rezzani C. Cross-cultural validation of a short-form of the oral health impact profile for temporomandibular disorders. Community Dent Oral Epidemiol 2005;33:125–130.

31.Barros V de M, Seraidarian PI, Côrtes MI, de Paula LV. The impact of orofacial pain on the quality of life of patients with temporomandibular disorder. J Orofac Pain 2009;23:28–37.

32.Reissmann DR, John MT, Schierz O, Wassell RW. Functional and psychosocial impact related to specific temporomandibular disorder diagnoses. J Dent 2007;35:643–650.

33.Inglehart MR, Silverton SF, Sinkford JC. Oral health-related quality of life: Does gender matter? In: Inglehart MR, Bagramian RA (eds). Oral Health-Related Quality of Life. Chicago: Quintessence, 2002:111–121.

34.Locker D, Slade GD. Association between clinical and subjective indicators of oral health status in an older adult population. Gerodontology 1994;11:108–114.

35.John MT, Koepsell TD, Hujoel P, Miglioretti DL, LeResche L, Micheelis W. Demographic factors, denture status and oral health-related quality of life. Community Dent Oral Epidemiol 2004;32:125–132.

36.Steele JG, Sanders AE, Slade GD, et al. How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples. Community Dent Oral Epidemiol 2004;32:107–114.

37.Åstrom AN, Haugejorden O, Skaret E, Trovic TA, Klock KS. Oral impacts on daily performance in Norwegian adults: The influence of age, number of missing teeth, and sociodemographic factors. Eur J Oral Sci 2006;114:115–121.

38.Lahti S, Suominen-Taipale L, Hausen H. Oral health impacts among adults in Finland: Competing effects of age, number of teeth, and removable dentures. Eur J Oral Sci 2008;116:260–266.

39.Pallegedara C, Ekanayake L. Effect of tooth loss and denture status on oral health-related quality of life of older individuals from Sri Lanka. Community Dent Health 2008;25:196–200.

40.Bae KH, Kim C, Paik DI, Kim JB. A comparison of oral health related quality of life between complete and partial removable denture-wearing older adults in Korea. J Oral Rehabil 2006;33:317–322.

41.Jones JA, Orner MB, Spiro A, Kressin NR. Tooth loss and dentures: Patients’ perspectives. Int Dent J 2003;53(suppl 5):327–334.

42.Needleman I, McGrath C, Floyd P, Biddle A. Impact of oral health on the life quality of periodontal patients. J Clin Periodontol 2004;31:454–457.

43.Saito A, Hosaka Y, Kikuchi M, et al. Effect of initial periodontal therapy on oral health-related quality of life in patients with periodontitis in Japan. J Periodontol 2010;81: 1001–1009.

44.Wandera MN, Engebretsen IM, Rwenyonyi CM, Tumwine J, Astrøm AN. Periodontal status, tooth loss and selfreported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: A cross-sectional study. Health Qual Life Outcomes 2009;14:89–99.