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Previous issue date: 2014-07-03 / Introduction : Temporomandibular Disorder (TMD) represents a complex combination of signs and symptoms, having the pain as the most striking manifestation, and it may affect the masticatory muscles and / or temporomandibular joints. In the elderly population, this issue is poorly studied.
Objective : To evaluate the occurrence and manifestation of the Temporomandibular Disorder (TMD) and of the orofacial pain and their impact on quality of life of an elderly population served by the Family Health Program in Areia- Para?ba (Brazil).
Methods : Cross-sectional study, developed with 1410 non-institutionalized elderly, aged 60 or over, enrolled in the Family Health Program in Areia- Para?ba, Brazil, from January to June,2013.The following were used as data-collection instrument: Anamnesic Index of Fonseca (AIF) for screening; the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD): AXIS I for clinical diagnosis of TMD; AXIS II for evaluation of depressive symptoms and orofacial pain; Oral Health Impact Profile - OHIP-14 to assess quality of life , and the Perceived Coercion Scale derived from MacArthur Admission Experience Survey to assess the perception of coercion in research.
Results : In the sample of 1410 elderly the prevalence of TMD was 46.5 % , mainly female (63.0 %), aged between 60 and 69 (46.3 %), married (53.6 %), illiterate (59, 7 %), retired (87.6 %) and with ess than the minimum wage (p = 0.036) income. (86.3 %). There was a significant association between the prevalence of TMD and the variables: gender, level of education and income. The TMD was more prevalent in the female gender (49 %), among the illiterate (49.9%) and among those who had an income up to one minimum wage (49.1 %). Concerning the dysfunction severity degree, the mild TMD was highlighted, verifying significant association with being marital (p = 0.011) and with less than the minimum wage (p = 0.036) income . In the second phase of the study 410 seniors attended, confirming the diagnosis of TMD in 351, the RDC / TMD / AXIS I. Of these, 53.1% had muscular disorders; 22.7% had disc displacement and 42.6% had joint problems. There was significant association between joint problems and the following areas of the Oral Health Impact Profile (OHIP -14): functional limitation (p = 0.025), psychological distress (p = 0.002); psychological disability (p = 0.004) ; social disability (p = 0.001); disability (p = 0.022). 62.2 % reported the presence of chronic orofacial pain. Of these, 58 % had depressive symptoms. Of those without pain complaints, 42.6 % showed depressive symptoms. There was significant association among all areas of OHIP 14, orofacial pain and depressive symptoms. The Perceived Coercion Scale obtained an overall average of 1.25 + 1.15. The values ranged from zero (27.0%) to five points (0.1%), being that the Mode was equal to one point (41.4%). In the variable educational level in marital status, significant differences were obtained. Literate individuals had a mean value of perceived coercion (1.10 +1.06) significantly inferior (F = 29.65, P = 0.0001) to the illiterate (1.49 +1.25). In the group of married participants or with a consensual marriage, the average scored (1.19 +1.10) was inferior (F5, 90, P = 0.015) to those verified in the other marital statuses (1.34 +1.21) .
Conclusion : The prevalence of TMD was 46.5%, with a predominance of mild degree of severity, reaching women more often. The joint disorders (group III) had a negative impact on quality of life. Over half of the sample presented symptomatology of chronic orofacial pain and depressive symptoms, having significant association among all areas of OHIP 14, orofacial pain and depressive symptoms. The elderly group was perceived somewhat coerced to decide. on their participation in the research object of this work. / Introdu??o : A disfun??o temporomandibular (DTM) representa uma complexa associa??o de sinais e sintomas, cuja manifesta??o mais marcante ? a dor, que pode afetar os m?sculos da mastiga??o e/ou as articula??es temporomandibulares. Em popula??es idosas, essa problem?tica ? pouco estudada. Objetivo : Avaliar a ocorr?ncia e a manifesta??o da disfun??o temporomandibular (DTM) e da dor orofacial e seu impacto na qualidade de vida de uma popula??o de idosos atendidos pelo Programa de Sa?de da Fam?lia do Munic?pio de Areia-Para?ba (Brasil). M?todos : Estudo transversal, desenvolvido com 1410 idosos n?o institucionalizados, com idade igual ou superior a 60 anos, cadastrados no Programa da Sa?de da Fam?lia do Munic?pio de Areia/ Para?ba-Brasil, no per?odo de janeiro a junho de 2013. Foram utilizados como instrumento de coleta o ?ndice Anamn?sico de Fonseca (DMF) para triagem, o Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD): EIXO I para diagn?stico cl?nico da DTM, o EIXO II para avalia??o dos sintomas depressivos e dor orofacial, o Oral Health Impact Profile OHIP- 14 para avaliar a qualidade de vida e a Escala de Percep??o de Coer??o derivada da MacArthur Admission Experience Survey para avaliar a percep??o de coer??o em pesquisa. Resultados : Na amostra de 1410 idosos, a preval?ncia de DTM foi de 46,5%, a maioria do g?nero feminino (63,0%), com faixa et?ria entre 60 e 69 anos (46,3%), casados (53,6%), analfabetos (59,7%), aposentada (87,6%) e com renda de at? um sal?rio m?nimo (86,3%). A DTM foi mais prevalente no g?nero feminino (49,%), entre os analfabetos (49,9%) e entre aqueles que tinham renda at? um sal?rio m?nimo (49,1%). Quanto ao grau de severidade da disfun??o, destacou-se a DTM leve verificando-se associa??o significativa com o estado civil casado (p=0,011) e com a renda inferior a um sal?rio m?nimo (p=0,036). Na segunda fase do estudo, compareceram 410 idosos, confirmando-se o diagn?stico da DTM em 351, pelo RDC/TMD/EIXO I. Desses, 53,1% apresentaram desordens musculares; 22,7%, deslocamento do disco, e 42,6%, problemas articulares. Houve associa??o significativa entre os problemas articulares e os seguintes dom?nios do Oral Health Impact Profile (OHIP-14): limita??o funcional (p= 0,025), desconforto psicol?gico (p=0,002); incapacidade psicol?gica (p= 0,004); incapacidade social (p=0,001) e defici?ncia (p=0,022). Da amostra final, 62,2% relataram a presen?a de dor orofacial cr?nica. Desses, 58% apresentaram sintomas depressivos. Dos que n?o se queixaram de dor, 42,6% apresentaram sintomas depressivos. Houve associa??o significativa entre todos os dom?nios do OHIP 14, dor orofacial e sintomas depressivos. A Escala de Percep??o de Coer??o obteve uma m?dia geral de 1,25+ 1,15. Os valores variaram de zero (27,0%) a cinco pontos (0,1%), e a Moda foi igual a um ponto (41,4%). Nas vari?veis escolaridade e estado civil, foram obtidas diferen?as significativas. Os indiv?duos n?o alfabetizados obtiveram um valor m?dio de coer??o percebida (1,10+1,06) significativamente inferior (F=29,65; P=0,0001) aos alfabetizados (1,49+1,25). No grupo dos participantes casados ou com uni?o est?vel, a m?dia obtida (1,19+1,10) foi inferior (F5, 90; P=0,015) ? verificada nos demais estados civis (1,34+1,21). Conclus?o : A preval?ncia de DTM foi de 46,5%, com predomin?ncia do grau de severidade leve, que atingiu, com mais frequ?ncia, as mulheres. As desordens articulares (grupo III) tiveram um impacto negativo na qualidade de vida. Mais da metade da amostra final estudada apresentou sintomatologia de dor orofacial cr?nica e sintomas depressivos e houve associa??o significativa entre todos os dom?nios do OHIP 14, dor orofacial e sintomas depressivos. O grupo de idosos percebeu-se pouco coagido ao decidir quanto ? sua participa??o na pesquisa objeto deste trabalho.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2739 |
| Date | 03 July 2014 |
| Creators | Cavalcanti, Maria de Oliveira Alves |
| Contributors | Goldim, Jos? Roberto |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 600, 2296420844541114010 |
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