Original article Edentulousness and associated risk factors in a south Brazilian elderly population Claudia Flemming Colussi 1 and Se ´ rgio Fernando Torres de Freitas 2 1 Postgraduate Programme in Dentistry, Federal University of Santa Catarina, Floriano ´ polis, SC, Brazil; 2 Postgraduate Programme in Public Health, Federal University of Santa Catarina, Floriano ´ polis, SC, Brazil Gerodontology 2007; 24; 93–97 Edentulousness and associated risk factors in a south Brazilian elderly population Aim: To examine the relationship between edentulousness and the socioeconomic and behavioural variables collected in a cross-sectional study of an elderly population. Methods: The study was conducted on 277 elderly (60 years or older) in the municipality of Biguac ¸u, Southern Brazil. The oral examinations and questionnaires were conducted by two calibrated dentists. The criteria used followed the WHO and FDI standards. Results: Prevalence of edentulousness reached 48.4%. A significant association was found in bivariate analysis for gender, satisfaction with appearance, time since last dental visit, the type of dental service sought in the last 5 years, educational level of the elderly and their children, and age of the elderly. In the multivariate analysis, gender, time since last dental visit and level of education of the elderly were signi- ficantly associated with edentulousness. Conclusions: Female sex and low educational level were the main risk factors for edentulousness in this population. Although various Brazilian studies suggest a decline in edentulousness in the country, methodologically robust research into edentulousness in Brazil is still limited, demanding further studies into this highly prevalent yet preventable health problem amongst the elderly. Keywords: oral health, elderly, edentulousness. Accepted 11 December 2006 Introduction The prevalence and distribution of edentulousness in different age groups vary significantly between developed or less developed countries as it is asso- ciated with a complex combination of cultural, socioeconomic and individual factors. In developed countries, oral health services are more easily accessible to the population and oral diseases are treated before causing major tooth destruction. Limited studies of edentulousness in Brazil have shown a high prevalence in the elderly 1 and this is likely to be a consequence of inadequate dental assistance to the population, either because of the absence of specific preventive programmes or the incapacity to satisfy the high demand for these services. However, it may be observed that all published studies on the subject have been con- ducted among institutionalised elderly or in sam- ples not representative of the population. In Brazil, significant extraction of teeth forms a standard or unavoidable custom which has become the rule after the age of 30 as restorative treatment becomes more complex and expensive. In addition, there is widespread popular belief that the loss of teeth is unavoidable in older age, and so is not seen as unnecessary mutilation. Moreover, sound teeth are often extracted to make it possible to insert prostheses. Most of the recent studies conducted on the elderly have demonstrated a reduction in the number of edentulous persons. This could be associated with several factors, amongst which is a reduction in the number of otherwise avoidable extractions. For example, McCaul et al. 2 investi- gated the reasons and the number of extractions per week in Scotland during a 15-year period and found a 25% reduction per patient and a 30% reduction per dentist. The authors concluded that caries was still the major cause of tooth loss Ó 2007 The Authors. Journal compilation Ó 2007 The Gerodontology Association and Blackwell Munksgaard Ltd Gerodontology 2007; 24: 93–97 93