Dental and prosthodontic status of adults in Bulgaria: socio-demographic and functional aspects
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[S.l. : s.n.]
Radboud Universiteit Nijmegen, 12 september 2013
Promotor : Creugers, N.H.J. Co-promotores : Witter, D.J., Bronkhorst, E.M.
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SubjectNCEBP 7: Effective primary care and public health
The general discussion presents some methodological issues and the main findings of the papers constituting the present thesis. In addition, implications for oral health care for the adult population in Bulgaria are discussed and recommendations are made for future research. A detailed discussion of the results can be found in the individual papers included in this thesis. Based on the findings of the studies presented in this thesis, it was concluded that: (1) predominantly fixed restorations were provided to restore reduced dentitions to a functional level and not necessarily to complete dentitions; (2) age, female gender, having low education, and less frequent toothbrushing were identified as risk indicators for having “missing” teeth and should be considered in prevention program planning if reduction of tooth loss is to be achieved; (3) number of present teeth, age, regularity of dental visits, and frequency of toothbrushing were relevant factors with respect to tooth replacement. The cutoff value of 20 teeth did not discriminate high-risk from low-risk subjects with respect to tooth replacement; (4) satisfaction was strongly associated with dental functional status. Dental configurations comprising both natural and artificial teeth were less likely to provide the same level of satisfaction as equivalent dental configurations comprising natural teeth only. The present findings suggest that strategies aiming at retention of a natural functional dentition not requiring recourse to prostheses, as proposed by the WHO, may be appropriate in Bulgaria. Applying more functionally oriented approaches, however, requires revision of the role of prosthodontic care in a collective effort to maintain functional den¬titions for life. Before putting these recommendations into practice, further research on perceived oral health-related quality of life, nutritional status, and cost-effectiveness of conventional and functionally oriented tooth replacement strategies in relation to reduced dentitions is needed.
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