Consumo alimentar e saúde bucal em adultos e idosos

Abstract

Oral health is one of the fundamental pillars of both overall health and individual quality of life, playing an important role in psychosocial well-being. Difficulties in consuming certain foods may be directly linked to oral health problems, contributing to increased dietary selectivity in daily life. This doctoral thesis investigated two hypotheses based on data from the Brazilian National Health Survey (Pesquisa Nacional de Saúde – PNS), from the 2013 and 2019 editions, focusing on the relationship between oral health and dietary intake. The first article examined the association between self-perceived oral health and indicators of healthy and unhealthy food consumption among adults and older adults in both survey waves. After adjusting for potential confounding factors, the results from 2013 showed that individuals who reported their oral health as “poor/very poor” had a lower prevalence of regular consumption of raw and cooked vegetables (PR=0.92; 95%CI: 0.86–0.98), fruits (PR=0.82; 95%CI: 0.75– 0.90) and milk (PR=0.86; 95%CI: 0.80–0.93), compared to those who rated their oral health as “very good/good.” In 2019, similar patterns were observed, with lower prevalence of regular consumption of raw and cooked vegetables (PR=0.83; 95%CI: 0.78–0.88), fruits (PR=0.82; 95%CI: 0.76–0.88), and milk (PR=0.87; 95%CI: 0.82–0.93), and higher prevalence of regular consumption of soft drinks and sugar-sweetened beverages (PR=1.13; 95%CI: 1.02–1.24), sweets (PR=1.15; 95%CI: 1.03–1.29) and meal replacement with snacks (PR=1.18; 95%CI: 1.06–1.32). Additionally, participants with a “fair” self perception of oral health showed a lower prevalence of regular red meat consumption (PR=0.95; 95%CI: 0.91–0.98) when compared to those with a “very good/good” perception. The second article analyzed the association between tooth loss and poorer diet quality, considering the mediating role of denture use in adults aged 40 years or older, using data from the 2019 National Health Survey (PNS). The results indicated that individuals with severe tooth loss/edentulism had a higher chance of being in the lowest quintile of diet quality compared to those with no or mild tooth loss (OR=1.25; 95% CI: 1.07–1.47). Mediation analyses revealed that the effect of severe tooth loss/edentulism on poorer diet quality was mediated by denture use, corresponding to -2.01% of the direct and indirect effect. It is concluded that poor oral health is associated with a less healthy dietary pattern and that denture use may play a mediating role in this relationship, mitigating the effect of tooth loss on poor diet quality. The findings reinforce the need for integrated public policies that promote oral health as essential strategies to prevent chronic non-communicable diseases and improve the quality of life of the population.