comparison of dental caries based on DMFT index between users of five or more drugs (polypharmacy) with the control group in Azar cohort population

Abstract

Abstract Introduction: Given the increase in life expectancy and the number of elderly individuals, the consumption of medications and the prevalence of chronic diseases have risen. This situation, along with polypharmacy resulting from various illnesses and multiple systemic conditions, can lead to complications. Today, polypharmacy has become one of the common issues among the adult and middle-aged population. This problem affects not only general health but also oral and dental health. However, there have been limited studies worldwide on the dental caries index (DMFT) in individuals using multiple medications, and to our knowledge, no such study has been conducted in Iran. Considering that comprehensive data has been collected in the Azar cohort population regarding various aspects, including the number of medications used and related variables, the present study is designed to compare the dental caries index (DMFT) between individuals using five or more medications and a control group in the Azar cohort population.

Materials and Methods: The Azar cohort study began in 2014 in the Shabestar in East Azerbaijan Province in northwestern Iran, involving a population of 15,006 adults aged 35-70 years. Various variables in the Azar cohort study were collected through questionnaires. The DMFT index was recorded by a trained examiner according to the national protocol of the Persian cohort. In the present study, which is a cross-sectional analytical study, data from the Azar cohort study were utilized. The cohort data of Azar regarding the status of the number of medications used was divided into a polypharmacy group (users of five or more medications) and the remaining individuals were considered as the control group (users of fewer than five medications). Data from 6 individuals were excluded from the study due to incompleteness. The outcome variable is the DMFT index and its components. To compare the mean DMFT and its components with the status of the number of medications used, t-tests and ANOVA analyses were used. To determine the relationship between the DMFT index and the status of the number of medications used, advanced analytical analysis was conducted using both adjusted and unadjusted Negative Binomial regression with a log link. The effects of confounding variables such as socioeconomic status, gender, age, body mass index, smoking, physical activity, and marital status were also included in the regression model.

Results: The average DMFT index for individuals with polypharmacy was 25.04 ± 8.14, while the average DMFT index for the control group was 20.88 ± 8.93, with the highest proportion attributed to missing teeth (M) (P < 0.001). Accordingly, there was a significant difference between the average DMFT index and the average M in relation to the number of medications consumed. In the unadjusted regression model, a significant relationship was found between polypharmacy and components D, M, F, and the DMFT index (P < 0.001). However, in the adjusted regression model, only component D had a significant relationship with polypharmacy (P = 0.03).

Conclusion: Despite the lack of observed correlation between the DMFT index and polypharmacy, there was a significant difference between the average DMFT index and the number of lost teeth in relation to the number of medications consumed. The high prevalence of edentulism in the Azar cohort emphasizes the importance of paying special attention to the oral health of patients using multiple medications.