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Avaliação clínica da saúde oral em idosos com Diabetes Tipo 2
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Introdução: A Diabetes Mellitus Tipo 2 é uma doença crónica frequente na população idosa e pode estar associada a várias alterações orais. Entre estas destacam-se a acumulação de biofilme oral, alterações periodontais, xerostomia, edentulismo e impacto na qualidade de vida relacionada com a saúde oral. A avaliação destes parâmetros tornase importante em idosos diabéticos, uma vez que esta população apresenta frequentemente multimorbilidade, polimedicação e maior vulnerabilidade sistémica. Objetivos: Avaliar a condição de saúde oral em idosos com Diabetes Mellitus Tipo 2, com especial atenção ao índice de placa, ao CPI, à xerostomia e ao impacto na qualidade de vida relacionada com a saúde oral. Pretendeu-se ainda analisar possíveis associações entre estes parâmetros e variáveis clínicas, sistémicas e comportamentais. Métodos: Foi realizado um estudo observacional transversal em indivíduos idosos com Diabetes Mellitus Tipo 2. A recolha de dados incluiu a aplicação de questionários e avaliação clínica oral, com análise de parâmetros sociodemográficos, clínicos, salivares e comportamentais. A xerostomia foi avaliada através do Xerostomy Inventory, o impacto da saúde oral na qualidade de vida através do OHIP, o controlo de biofilme pelo Índice de Placa de Silness e Löe e a condição periodontal pelo CPI. Foram ainda analisadas possíveis associações entre as variáveis clínicas e de saúde oral. Resultados: A amostra foi constituída por 77 idosos com Diabetes Mellitus Tipo 2, verificando-se predominância do sexo feminino e das faixas etárias mais avançadas. Observou-se elevada prevalência de multimorbilidade, polimedicação e edentulismo. Relativamente ao índice de placa predominaram os níveis médio e elevado. Na avaliação periodontal pelo CPI verificou-se maior frequência de bolsas periodontais de 4–5 mm, seguida de bolsas ≥6 mm. A associação entre o índice de placa e o CPI foi estatisticamente significativa (p<0,001), constituindo resultado estatisticamente mais relevante do estudo. Não se verificou associação estatisticamente significativa entre o índice de placa ou o CPI e a classificação do OHIP. No entanto, observou-se associação significativa entre o número de medicações e o OHIP, bem como entre problemas<br/>cardíacos e índice de placa. A xerostomia apresentou elevada frequência na amostra, sendo interpretada como parâmetro complementar da condição oral. Discussão: Os resultados sugerem uma relação importante entre maior acumulação de biofilme oral e pior condição periodontal em idosos com Diabetes Mellitus Tipo 2. Apesar desta associação clínica, o impacto na qualidade de vida relacionada com a saúde oral não acompanhou diretamente o índice de placa nem o CPI, o que pode estar relacionado com adaptação funcional, perda dentária, uso de prótese e perceção individual da condição oral. A polimedicação e a multimorbilidade ajudam a compreender o perfil de vulnerabilidade da amostra. A xerostomia, embora não tenha sido o foco principal das análises de associação, reforça a importância de considerar alterações salivares na<br/>avaliação destes indivíduos. Conclusão: A saúde oral dos idosos com Diabetes Mellitus Tipo 2 deve ser avaliada de forma integrada, considerando o biofilme oral, a condição periodontal, o edentulismo, a polimedicação, a xerostomia e o impacto na qualidade de vida. A associação significativa entre índice de placa e CPI reforça a importância do controlo do biofilme e da vigilância periodontal regular nesta população. Em estudos futuros seria importante incluir amostras de maior dimensão, bem como um grupo controlo sem Diabetes Mellitus Tipo 2. A avaliação do controlo glicémico e a medição objetiva do fluxo salivar também poderiam ajudar a compreender melhor a relação entre diabetes, biofilme oral e condição periodontal em idosos.
Introduction: Type 2 Diabetes Mellitus is a chronic disease frequently observed in the elderly population and may be associated with several oral changes. These include oral biofilm accumulation, periodontal changes, xerostomia, edentulism and impact on oral health-related quality of life. The assessment of these parameters becomes important in elderly diabetic individuals, since this population often presents multimorbidity, polypharmacy and greater systemic vulnerability. Objectives: To assess the oral health condition of elderly individuals with Type 2 Diabetes Mellitus, with special attention to plaque index, CPI, xerostomia and the impact on oral health-related quality of life. This study also aimed to analyze possible associations between these parameters and clinical, systemic and behavioural variables. Methods: An observational cross-sectional study was conducted in elderly individuals with Type 2 Diabetes Mellitus. Data collection included the application of questionnaires and an oral clinical assessment, with analysis of sociodemographic, clinical, salivary and behavioural parameters. Xerostomia was assessed using the Xerostomy Inventory, the impact of oral health on quality of life through the OHIP, biofilm control through the Silness and Löe Plaque Index and periodontal condition through the CPI. Possible associations between clinical and oral health variables were also analysed. Results: The sample consisted of 77 elderly individuals with Type 2 Diabetes Mellitus, with a predominance of females and older age groups. A high prevalence of multimorbidity, polypharmacy and edentulism was observed. Regarding plaque index, medium and high levels were predominant. In the periodontal assessment using CPI, periodontal pockets of 4–5 mm were the most frequent, followed by pockets ≥6 mm. The association between plaque index and CPI was statistically significant (p<0.001), representing the main finding of the study. No statistically significant association was found between plaque index or CPI and OHIP classification. However, a significant association was observed between the number of medications and OHIP, as well as between cardiac problems and plaque index. Xerostomia was highly frequent in the sample and was interpreted as a complementary parameter of oral condition. Discussion: The results suggest an important relationship between greater oral biofilm accumulation and worse periodontal condition in elderly individuals with Type 2 Diabetes Mellitus. Despite this clinical association, the impact on oral health-related quality of life did not directly follow plaque index or CPI, which may be related to functional adaptation, tooth loss, denture use and individual perception of oral condition. Polypharmacy and multimorbidity help to understand the vulnerability profile of the sample. Xerostomia, although not the main focus of the association analyses, reinforces the importance of considering salivary changes in the assessment of these individuals. Conclusion: The oral health of elderly individuals with Type 2 Diabetes Mellitus should be assessed in an integrated way, considering oral biofilm, periodontal condition, edentulism, polypharmacy, xerostomia and impact on quality of life. The significant association between plaque index and CPI reinforces the importance of biofilm control and regular periodontal monitoring in this population. Future studies should include larger samples, as well as a control group without Type 2 Diabetes Mellitus. Assessment of glycemic control and objective measurement of salivary flow could also help to better understand the relationship between diabetes, oral biofilm and periodontal condition in elderly individuals.
Introduction: Type 2 Diabetes Mellitus is a chronic disease frequently observed in the elderly population and may be associated with several oral changes. These include oral biofilm accumulation, periodontal changes, xerostomia, edentulism and impact on oral health-related quality of life. The assessment of these parameters becomes important in elderly diabetic individuals, since this population often presents multimorbidity, polypharmacy and greater systemic vulnerability. Objectives: To assess the oral health condition of elderly individuals with Type 2 Diabetes Mellitus, with special attention to plaque index, CPI, xerostomia and the impact on oral health-related quality of life. This study also aimed to analyze possible associations between these parameters and clinical, systemic and behavioural variables. Methods: An observational cross-sectional study was conducted in elderly individuals with Type 2 Diabetes Mellitus. Data collection included the application of questionnaires and an oral clinical assessment, with analysis of sociodemographic, clinical, salivary and behavioural parameters. Xerostomia was assessed using the Xerostomy Inventory, the impact of oral health on quality of life through the OHIP, biofilm control through the Silness and Löe Plaque Index and periodontal condition through the CPI. Possible associations between clinical and oral health variables were also analysed. Results: The sample consisted of 77 elderly individuals with Type 2 Diabetes Mellitus, with a predominance of females and older age groups. A high prevalence of multimorbidity, polypharmacy and edentulism was observed. Regarding plaque index, medium and high levels were predominant. In the periodontal assessment using CPI, periodontal pockets of 4–5 mm were the most frequent, followed by pockets ≥6 mm. The association between plaque index and CPI was statistically significant (p<0.001), representing the main finding of the study. No statistically significant association was found between plaque index or CPI and OHIP classification. However, a significant association was observed between the number of medications and OHIP, as well as between cardiac problems and plaque index. Xerostomia was highly frequent in the sample and was interpreted as a complementary parameter of oral condition. Discussion: The results suggest an important relationship between greater oral biofilm accumulation and worse periodontal condition in elderly individuals with Type 2 Diabetes Mellitus. Despite this clinical association, the impact on oral health-related quality of life did not directly follow plaque index or CPI, which may be related to functional adaptation, tooth loss, denture use and individual perception of oral condition. Polypharmacy and multimorbidity help to understand the vulnerability profile of the sample. Xerostomia, although not the main focus of the association analyses, reinforces the importance of considering salivary changes in the assessment of these individuals. Conclusion: The oral health of elderly individuals with Type 2 Diabetes Mellitus should be assessed in an integrated way, considering oral biofilm, periodontal condition, edentulism, polypharmacy, xerostomia and impact on quality of life. The significant association between plaque index and CPI reinforces the importance of biofilm control and regular periodontal monitoring in this population. Future studies should include larger samples, as well as a control group without Type 2 Diabetes Mellitus. Assessment of glycemic control and objective measurement of salivary flow could also help to better understand the relationship between diabetes, oral biofilm and periodontal condition in elderly individuals.
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Diabetes Mellitus Tipo 2 Idosos Biofilme oral Índice de placa Condição periodontal Qualidade de vida Type 2 Diabetes Mellitus Elderly Oral biofilm Plaque index Periodontal condition Quality of life
Contexto Educativo
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Sem licença CC