Article
Evaluating edentulism and frailty in a
group of elderly people treated at the
dental clinic of Universidad San Martín de
Porres in Lambayeque, Peru.
Condiciones de edentulismo y fragilidad en un grupo de
personas mayores que acudieron a la clínica odontológica de
la Universidad San Martín de Porres de Lambayeque, Perú.
Rubén Chumpitaz-Durand.1
Freddy Manayay-Llaguento.1
Daniel Córdova-Sotomayor.2
Affiliations:
1
Universidad San Martín de Porres. Facultad
de Odontología. Filial Norte, Chiclayo, Peru.
2
Universidad Peruana Cayetano Heredia.
Facultad de Estomatología. Lima, Peru.
Corresponding author: Carlos Neyra-Rivera.
Universidad San Martín de Porres. Facultad
de Odontología. Avenida la Pradera 19,
Chiclayo 14012, Perú. Phone: (51) 996475051.
E-mail: rubencd@hotmail.com
Receipt
: 01/19/2020 Revised: 04/15/2021
Acceptance : 08/30/2021
Cite as: Chumpitaz-Durand R, ManayayLlaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group
of elderly people treated at the dental clinic
of Universidad San Martín de Porres in
Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9
Doi:10.17126/joralres.2021.051
Abstract: Introduction: Dentistry should contribute to achieving healthy
aging based on the identification of the well-being and oral health needs of
the elderly. Objective: To evaluate the conditions of edentulism and frailty in a
group of elderly people treated at the dental clinic of Universidad San Martín
de Porres in Lambayeque, Peru, between the years 2016 and 2018. Material
and Methods: An observational, descriptive, retrolective, and cross-sectional
study was conducted. Two hundred and seven medical records that included
an odontogram were randomly selected to identify cases of total or partial
edentulism according to the Kennedy classification. The files were assessed
with Fried’s test to evaluate the conditions of frailty. The association between
variables was estimated by means of a significance analysis using the Chi
square test. Results: There was a statistically significant difference between
edentulism in both jaws and conditions of frailty (p<0.05). An association of
edentulism with physical inactivity and weakness was also demonstrated.
Additionally, a statistically significant difference between degrees of
edentulism was observed regarding poor diet (p<0.05). Conclusion: The
absence of teeth in the elderly acts as a risk factor leading to negative changes
in diet, weight, and physical activity. These changes may be associated with
frailty, as masticatory insufficiency results in a poor diet and subsequent
weakness.
Keywords: oral health; mouth, edentulous; tooth loss; frail elderly; healthy
aging; Peru.
Resumen: Introducción: El aporte de la Odontología debe contribuir a lograr
un envejecimiento saludable, basado en la identificación de las necesidades de
bienestar y salud bucal de las personas mayores. Objetivo: Evaluar la condición
de edentulismo y de fragilidad en un grupo de personas mayores atendidas en la
Clínica Odontológica de la Universidad San Martín de Porres de Lambayeque, entre
los años 2016 y 2018. Material y Métodos: Se diseñó un estudio observacional,
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1
Chumpitaz-Durand R, Manayay-Llaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9. Doi:10.17126/joralres.2021.051
descriptivo, retrolectivo y transversal, seleccionando de
manera aleatoria 207 historias clínicas que incluyeron un
odontograma para identificar casos de edentulismo total o
parcial de acuerdo a la clasificación de Kennedy: mientras que
para evaluar las condiciones de fragilidad fueron revisadas
las fichas con el test de Fried. Diferencias entre variables
fueron evaluadas con un análisis de significancia mediante la
prueba Chi cuadrado. Resultado: Se mostró una diferencia
estadísticamente significativa entre edentulismo en ambos
maxilares y condiciones de fragilidad (p<0,05). Se evidenció
además asociación de edentulismo con inactividad física
INTRODUCTION.
In elderly people, frailty is a condition characterized
by a progressive decrease in the physiological reserves
of multiple body systems, which worsens as the
person gets older.1 This causes greater vulnerability
to external conditions, which in turn leads to a greater
probability of developing disorders that may affect old
people’s health, well-being, and quality of life. 2,3
In its gradual process, the deterioration of various
functions and the decrease in their capacities are
accompanied by adverse manifestations such as
weakness, intolerance to effort, and development
of functional dependence, which consequently compromise the physical, emotional, and social integrity of
the elderly, 4,5 especially when they live in an unfavorable
socio-economic context. 5
It is evident that complications caused by chronic
degenerative diseases make old people extremely
vulnerable and significantly increase their risk of
mortality. 6,7 For this reason and in order to avoid
permanent damage, it is necessary to act promptly
and implement preventive measures aimed at ensuring
healthy aging. 8,9
In Peru, the projection for the year 2021 is 3,726,524
elderly people.10 In this context, 11.2% of the Peruvian
population could be exposed to different degrees of
frailty. As an additional element of this problematic
reality, a progressive tooth loss has been observed
with relative frequency as age increases, especially in
the inhabitants of rural areas of the country.11,12 The
severity of edentulism is evidenced in the physiological
2
y debilidad; observándose adicionalmente una diferencia
estadísticamente significativa entre grados de edentulismo
en relación a la mala alimentación (p<0,05). Conclusion: La
ausencia de dientes en las personas mayores funge como un
factor de riesgo que contribuye a cambios desfavorables en
la dieta, el peso y la actividad física, mismos que se asocian
con la fragilidad, donde la insuficiencia masticatoria puede
conducir a una deficiente alimentación y la consecuente
debilidad.
Palabra Clave: salud bucal; boca edéntula; pérdida de diente;
anciano frágil, envejecimiento saludable; Peru.
alterations of the stomatognathic system, including
the masticatory function, which eventually affects
the nutritional status of these people,12,13 and their
ability to speak, which hinders their communication
and socialization. Additionally, it alters their aesthetic
harmony, which leads to isolation and consequently to
the development of emotional problems,11,13 aspects
that could further worsen their frailty.
In this context, Eustaquio et al.,14 found an association
between older age and tooth loss. Researchers such
as Luengas et al.,15 and Ordaz et al.,16 found cases of
edentulism as a consequence of systemic diseases
such as diabetes. In other studies, authors such as
Bellamy et al.,17 as well as Porto et al.,18 concluded that
tooth loss is a predisposing factor for a low quality of
life, mainly in elderly people.
The gradual loss of teeth as a stigma and a sign of
health problems in older people deserves priority
attention, considering that they could be exposed
to conditions of vulnerability. Consequently, the
significant prevalence of edentulism in older people in
Lambayeque makes it possible to estimate a probable
association with cases of frailty, since such conditions
tend to be more prevalent in the elderly.
Precisely the purpose of this research, given the
scarce data from similar studies, is producing new
scientific evidence that may show the association
between edentulism and frailty in older adults who
attended the dental clinic at Universidad San Martín
de Porres - North Branch, during the years 2016,
2017, and 2018.
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Chumpitaz-Durand R, Manayay-Llaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9. Doi:10.17126/joralres.2021.051
MATERIALS AND METHODS.
An observational, descriptive, retrolective, and
cross-sectional study was carried out with the aim
of evaluating the possible association between the
conditions of edentulism and frailty, based on the
data collected from medical records that included an
odontogram and a medical file to evaluate the condition
of frailty. The population consisted of 447 medical
records of elderly patients, treated at the dental clinic
of Universidad San Martín de Porres, between March
and November of 2016, 2017, and 2018. The sample
was obtained based on the formula of population
proportions, with a statistical confidence level of
95%. In this way, a sample of 207 medical records was
obtained by means of a probabilistic method through a
simple random process.
Regarding the selection criteria, the medical records
of male and female patients over 59 years of age, who
did not present illnesses or any serious disability that
prevented their participation, were included in the
study. They consisted of properly registered medical
records with legible handwriting containing the data
required to evaluate the study variables. The medical
records of patients who at the time of their diagnostic
evaluation did not give their informed consent or that
of their direct relatives were excluded from the study.
The authorities of Universidad San Martín de
Porres granted the permission and gave access to the
files of medical records, which included the patients’
odontograms. The latter are widely used instruments
in multiple studies, such as in the cases of edentulism
registered following the criteria of Edward Kennedy,
cited by Huamanciza et al.,19 in which they considered
the following classes:
Class I: with edentulous posterior areas bilaterally
and remaining anterior teeth; Class II: a unilateral
edentulous area, due to the absence of posterior
teeth on that side, with no further teeth behind
the edentulous area; Class III: A posterior partial
edentulous area and the presence of teeth located
both anteriorly and posteriorly to it; Class IV: anterior
edentulous area on both sides of the midline.19
Regarding the form used to evaluate frailty, it was
organized in two sections.
The first section identified the presence or
absence of general frailty conditions, among them:
polypharmacy, hospitalization, disability, and poor
diet. The absence of frailty was registered with zero
and the presence with a score of one, so the minimum
value was zero and the maximum value was four points
for each patient. In the second section of the form, the
criteria established by Linda Fried, applied by Jurschik
et al., 20 were followed to evaluate the conditions of
frailty, based on: weakness, physical inactivity, weight
loss, decreased walking speed or slowness, and selfreported chronic fatigue or exhaustion, so that each
aspect that indicates an unfavorable criterion of
frailty was assigned a point. This resulted in three
categories: patient with absence of frailty with a value
of "zero points," patient with pre-frailty with a value
of "one to two points," and a frail patient with "three
to more points."3
The validation of the data provided in the medical
records and in the files to assess frailty conditions
was carried out by previously applying them as pilot
tests to a group of 30 elderly people from the “Señor
de los Milagros” nursing home in Lambayeque, having
obtained satisfactory levels of reliability.
Regarding the data analysis, the edentulous variable
was operationalized in two categories: cases without
edentulism and cases with partial or total edentulism.
The conditions of frailty were also organized into two
categories: cases without frailty and cases with prefrailty or frailty.
The data were processed using the SPSS statistical
software version 24, through which the frequencies
of the study variables were obtained, applying the Chi
square test. Statistical significance was assumed when
p<0.05. This study followed the bioethical principles
established in the Declaration of Helsinki and was
approved by the Bioethics Commission and the
Research Area of Universidad San Martín de Porres
under Rectoral Resolution No. 518-2017-CU-R-USMP.
RESULTS.
Table 1 shows that, of the general conditions of frailty
and edentulism analyzed in the elderly population,
there was a statistically significant difference between
conditions of edentulism in the maxilla (p<0.05) regarding poor nutrition.
Regarding the analysis carried out for the mandible,
Table 2 also shows statistical significance regarding
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3
Chumpitaz-Durand R, Manayay-Llaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9. Doi:10.17126/joralres.2021.051
Table 1. Frequency of general conditions of frailty and edentulism in the maxilla, in a group of elderly people treated at the
dental clinic of Universidad San Martín de Porres - North Branch. Data obtained from odontograms and records obtained using
Fried’s Test between the years 2016 and 2018.
General conditions of frailty
Polypharmacy
Hospitalization
Disability
Poor nutrition
Edentulous conditions in the mandible Kennedy classification
Without
edentulism
Class I
Class II
Class III
Class IV
Total
edentulous
Total
p-value*
Absence
Presence
Total
9
15
24
24
47
71
10
26
36
19
44
63
1
2
3
3
7
10
66
141
207
0.973
Absence
Presence
Total
23
1
24
57
14
71
29
7
36
55
8
63
3
0
3
8
2
10
175
32
207
0.436
Absence
Presence
Total
18
6
24
40
31
71
23
13
36
34
29
63
2
1
3
4
6
10
121
86
207
0.382
Absence
Presence
Total
24
0
24
27
44
71
10
26
36
12
51
63
1
2
3
0
10
10
74
133
207
0.000
*: Chi square test
Table 2. Frequency of general conditions of frailty and edentulism observed in the lower jaw, in a group of elderly people
treated at the dental clinic of Universidad San Martín de Porres - North Branch. Data obtained from odontograms and records
obtained using Fried’s Test between the years 2016 and 2018.
General conditions of frailty
Edentulous conditions in the mandible Kennedy classification
Without
Class I
edentulism
Polypharmacy
Hospitalization
Disability
Poor nutrition
Class II
Class III
Class IV
Total
edentulous
Total
p-value*
Absence
Presence
Total
9
15
24
24
47
71
10
26
36
19
44
63
1
2
3
3
7
10
66
141
207
0.973
Absence
Presence
Total
23
1
24
57
14
71
29
7
36
55
8
63
3
0
3
8
2
10
175
32
207
0.436
Absence
Presence
Total
18
6
24
40
31
71
23
13
36
34
29
63
2
1
3
4
6
10
121
86
207
0.382
Absence
Presence
Total
24
0
24
27
44
71
10
26
36
12
51
63
1
2
3
0
10
10
74
133
207
0.000
*: Chi square test
4
ISSN Print 0719-2460 - ISSN Online 0719-2479. Attribution 4.0 International (CC BY 4.0). www.joralres.com/2021
Chumpitaz-Durand R, Manayay-Llaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9. Doi:10.17126/joralres.2021.051
Table 3. Frequency of frailty conditions according to Fried's criteria and edentulous conditions observed in the maxilla, in a
group of elderly people treated at the dental clinic of Universidad San Martín de Porres - North Branch. Data obtained from
odontograms and records obtained using Fried’s Test between the years 2016 and 2018.
General conditions of frailty
Edentulous conditions in the mandible Kennedy classification
Without
Class I
edentulism
Weight loss
Exhaustion
Physical inactivity
Slowness
Weakness
Class II
Class III
Class IV
Total
edentulous
Total
p-value*
Absence
Presence
Total
18
5
23
32
25
57
17
19
36
37
39
76
4
2
6
6
3
9
114
93
207
0.157
Absence
Presence
Total
12
11
23
25
32
57
14
22
36
43
33
76
4
2
6
0
9
9
98
109
207
0.022
Absence
Presence
Total
17
6
23
33
24
57
21
15
36
47
29
76
1
5
6
2
7
9
121
86
207
0.037
Absence
Presence
Total
14
9
23
26
31
57
16
20
36
46
30
76
2
4
6
2
7
9
106
101
207
0.123
Absence
Presence
Total
14
9
23
18
39
57
7
29
36
24
52
76
1
5
6
1
8
9
65
142
207
0.016
*: Chi square test
Table 4. Frequency of frailty conditions according to Fried's criteria and edentulous conditions observed in the mandible, in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres - North Branch. Data
obtained from odontograms and records obtained using Fried’s Test between the years 2016 and 2018.
Conditions of frailty according to Fried*
Without
edentulism
Weight loss
Exhaustion
Physical inactivity
Slowness
Weakness
Edentulous conditions in the mandible Kennedy classification
Class I
Class II
Class III
Class IV
Total
edentulous
Total
p-value*
Absence
Presence
Total
18
6
24
42
29
71
21
15
36
28
35
63
1
2
3
4
6
10
114
93
207
0.115
Absence
Presence
Total
14
10
24
31
40
71
16
20
36
32
31
63
2
1
3
3
7
10
98
109
207
0.604
Absence
Presence
Total
23
1
24
43
28
71
21
15
36
30
33
63
2
1
3
2
8
10
121
86
207
0.000
Absence
Presence
Total
14
10
24
36
35
71
19
17
36
31
32
63
3
0
3
3
7
10
106
101
207
0.382
Absence
Presence
Total
13
11
24
27
44
71
7
29
36
16
47
63
1
2
3
1
9
10
65
142
207
0.025
*: Chi square test
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5
Chumpitaz-Durand R, Manayay-Llaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9. Doi:10.17126/joralres.2021.051
Table 5. Frequency of the conditions of frailty and edentulism observed in the maxilla and mandible , in a group of elderly
people treated at the dental clinic at Universidad San Martín de Porres - North Branch. Data obtained from odontograms and
records obtained using Fried’s Test between the years 2016 and 2018.
Conditions
Edentulous conditions in the mandible Kennedy classification
Without
Class I
Class II
Class III
Class IV
Total
Total
Edentulism
edentulous
p-value*
Frailty
No frailty
Pre-Frailty
Frailty
Total
5
12
6
23
6
20
31
57
0
16
20
36
4
41
31
76
0
2
4
6
0
1
8
9
15
92
100
207
0.006
Mandible
No frailty
Pre-Frailty
Frailty
Total
4
18
2
24
7
32
32
71
1
13
22
36
3
25
35
63
0
2
1
3
0
2
8
10
15
92
100
207
0.004
*: Chi square test
Table 6. Frequency of frailty and edentulous conditions observed in the mandible, in a group of elderly people treated
at the dental clinic of Universidad San Martín de Porres - North Branch. Data obtained from odontograms and records
obtained using Fried’s Test between the years 2016 and 2018.
Conditions of Frailty
Maxilla
No frailty
Pre-Frailty
Frailty
Total
Without
Edentulism
4
18
2
24
Edentulism conditions according to Kennedy classification
Class I
Class II
Class III
Class IV
Total
edentulous
7
32
32
71
1
13
22
36
3
25
35
63
0
2
1
3
0
2
8
10
Total
p-value*
15
92
100
207
0.004
*: Chi square test
poor nutrition and degrees of tooth loss (p<0.05), which
did not happen with the other general conditions of
frailty corresponding to polypharmacy, hospitalization,
and disability.
The results in the previous tables show that tooth
loss is probably related to poor chewing function, which
may result in poor nutrition in the elderly. Regarding the
results based on Fried’s criteria to evaluate conditions
of frailty, Table 3 shows that in the upper jaw, there is a
statistically significant difference between the types of
tooth loss regarding weakness, self-reported chronic
fatigue or exhaustion, and physical inactivity, obtaining
in the three cases a value of (p<0.05). Likewise, the
absence of an association between edentulism and
weight loss was evidenced, as well as the non-existent
association between tooth loss and slowness.
6
Regarding the lower jaw, Table 3 shows statistical
significance between weakness and physical inactivity
with respect to edentulous conditions. In the same
way, a significant difference is observed between
types of tooth loss regarding presence of weakness
(p<0.05). These results also indicate that no significant
relationship could be found between tooth loss and
exhaustion, weight loss, and slowness.
Results presented in Table 3 and Table 4 may show
that the absence of teeth and poor nutrition could lead
to conditions of weakness and physical inactivity.
Regarding the absence of teeth and types of frailty,
Table 5 shows a significant difference between edentulous conditions in the upper and lower jaw in regards
to frailty (p<0.05). Consequently, older people have
been considered patients in conditions of frailty or
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Chumpitaz-Durand R, Manayay-Llaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9. Doi:10.17126/joralres.2021.051
pre-frailty. Regarding the conclusive results in Table 6,
a greater statistical significance is observed between
frailty and edentulous conditions but at the level of the
lower jaw. Correlation studies between the two study
variables should be proposed.
It should be noted as additional information that
the most frequent classes of tooth loss correspond
to Kennedy Class III and Class I, followed by Class II,
while Class IV and cases of total edentulism were the
ones that occurred less frequently, both in the upper
and lower jaw. Regarding frailty conditions, a vast
majority of cases consisted of frail and pre-frail elderly
people, while non-frail patients represent the least
number of cases.
DISCUSSION.
According to the Economic Commission for Latin
America and the Caribbean (ECLAC), 21 between
the years 2015 and 2030 the world population aged
60 and over will rise from 900 to 1.4 billion, being
the population group that will grow the most in that
period. In Peru, experts from the National Institute
of Statistics and Informatics – INEI,10 have estimated
a projection towards the year 2021 of 3,726,534
older adults, corresponding to 11.2% of the Peruvian
population. Faced with this tendency, studies carried
out by Moles et al.,3 and by Riquelme et al., 22 indicate
that the vulnerability to which the elderly are exposed
predisposes them to conditions of frailty, presenting a
greater risk of adverse events to their health.
Based on the problems that come with aging,
the ECLAC 21 specialists consider seeking the best
conditions for a decent quality of life in older adults
within a framework of human rights as a priority
in the 2030 agenda for sustainable development.
On their part, for the group of experts of the World
Health Organization – WHO, 23 promoting healthy
aging means generating favorable conditions for a
sustainable quality of life, facilitating environments
adapted to their older age, developing social insertion
policies, and anticipating risks that may affect their
well-being and health.
According to the articles published by Castro 9 and
Varela, 24 a preventive approach from a multidisciplinary methodology is necessary along with the active
participation of different specialists to ensure healthy
aging. In relation to dentistry as one of the areas
or specialties that are linked to the general health
status of the elderly, Ordaz et al.,16 recognize that the
elderly represent a group of special interest due to
the vulnerability of their oral health. Additionally, the
chronic diseases that affect them limit their tolerance
to oral procedures and interventions.
In this regard, Azañedo et al., 25 point out the
importance of strengthening research in the field of
oral health of the elderly, to promote the creation of
public policies that not only may improve their oral
health but also their well-being and quality of life. With
this orientation, some researchers such as León et al., 26
have reported that factors such as caries, periodontal
disease, tooth loss, non-functional dental prostheses,
lesions in the oral mucosa, and xerostomia, can have an
unfavorable impact on quality of life in old age.
In addition, they have shown an association between
oral health and systemic diseases such as diabetes
mellitus, cardiovascular and respiratory diseases, due
to common risk factors in the elderly population. In this
sense, Porto et al.,18 as well as Padilla et al., 27 also confirm
the impact that oral health has on general health, so
that some oral conditions and functional limitations
in chewing, communication, and aesthetics, can cause
some psychosocial alterations such as depression,
anxiety, and isolation, which may negatively influence
the living conditions of older adults.
Regarding the results of the present study, a
statistically significant difference was found between
the types of edentulism regarding the presence of
frailty, in which tooth loss can consequently lead to
poor nutrition, due to insufficient masticatory function.
There was also observed a link between edentulism
and physical inactivity and weakness, caused by factors
inherent to aging and especially by poor nutrition.
Although it is true that it was not possible to find many
directly related studies, authors such as León et al., 26
concluded that tooth loss, in addition to reducing the
ability to speak, smile and socialize, decreases chewing
capacity, leading to the consumption of a soft diet of
low nutritional value, which in turn represents a risk
factor for the aging process. In this regard, authors such
as Almirón et al., 28 when reporting a high prevalence
of partial and total edentulism, agree on suggesting
that the deterioration in oral functions brings about
ISSN Print 0719-2460 - ISSN Online 0719-2479. Attribution 4.0 International (CC BY 4.0). www.joralres.com/2021
7
Chumpitaz-Durand R, Manayay-Llaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9. Doi:10.17126/joralres.2021.051
additional limitations for patients exposed to frailty.
In another study conducted by Osterberg et al., 29 it is
concluded that tooth loss can increase morbidity and
even mortality in frail older people.
It should be noted, as reported by Bellamy and
Moreno,17 as well as Azañedo et al., 25 that in the
absence of teeth, rehabilitation through partial or
total prostheses have become an additional concern,
because many times their deficient adaptability and
precision, far from contributing to complementing oral
functions, cause alterations that affect the patients’
well-being and health, and consequently worsen
their conditions of frailty. In this sense, Leónet al., 26
argue that a poorly adjusted or defective prosthesis
can be the cause of some oral alterations, but that
also some chronic diseases in the elderly can reduce
their neuromuscular capacity to adapt to prosthetic
rehabilitation treatments.
As indicated by the studies carried out by León et
al., 26 and by Cepero et al.,30 the training of professionals
with experience and skills for the oral health care of the
geriatric population should be based on a high-impact
preventive and restorative approach that can meet the
complex needs of older people.
As a contribution of the present study, the
characterization of the elderly as fragile or non-fragile,
added to their edentulous conditions according to
the Kennedy classification, will allow the creation of a
database that will be of utmost importance to address
the oral health needs of the elderly. It will undoubtedly
help to support a culture for healthy aging.
Consideration of the guidelines described in
the STROBE statement, in addition to criteria that
contributed to guaranteeing consistency in the control
of possible biases, made it possible to rule out other
factors that could have affected this research.
8
CONCLUSION.
Statistically significant results were evidenced
between the cases of edentulism and the presence of
frailty, both at the level of the upper and lower jaw,
establishing a significant relationship between loss of
teeth and poor nutrition, due to insufficient masticatory
function.
Consequently, it was also observed that edentulism
was associated with physical inactivity and weakness in
the older adults who were part of the present study.
Therefore, simultaneous exposure to edentulous
and frailty conditions predisposes older people to
conditions of vulnerability that would continue to
worsen if preventive measures aimed at healthy aging
are not implemented. This calls for further studies in
this regard.
Conflict of interests: The authors declare no conflict
of interest of any kind.
Ethics approval: Study was approved by the Bioethics
Commission and the Research Area of Universidad
San Martín de Porres under Rectoral Resolution No.
518-2017-CU-R-USMP.
Funding: This study was self-financed.
Authors’ contributions: All authors contributed
equally to the entire investigation.
Acknowledgements: The authors would like to
thank Red Peruana de Prevención Integral en Salud
– EDUSALUD, for their technical support.
ISSN Print 0719-2460 - ISSN Online 0719-2479. Attribution 4.0 International (CC BY 4.0). www.joralres.com/2021
Chumpitaz-Durand R, Manayay-Llaguento F & Córdova-Sotomayor D.
Evaluating edentulism and frailty in a group of elderly people treated at the dental clinic of Universidad San Martín de Porres in Lambayeque, Peru.
J Oral Res 2021; 10(4):1-9. Doi:10.17126/joralres.2021.051
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Freddy A . Manayay