Incidence of Tooth Loss in Remote Indigenous Populations of the Amazon Region: A 13-Year Cohort Study Before and After Belo Monte Dam

Abstract

Tooth loss among indigenous people in the Amazon emphasizes the need for culturally appropriate oral health interventions. The objective of this study was to analyze the incidence of tooth loss in two remote Amazon indigenous populations. This prospective cohort evaluated a total of 47 indigenous in the permanent dentition at T0 and thirteen years later (T1) from two villages, Arara-Laranjal (n = 28, mean age 16.1 and 29.9 years) and Assurini do Xingu (n = 19, mean age 15.9 and 29.5 years), of different ethnic groups. A multilevel Poisson regression model assessed the influence of village, sex, and age on tooth loss. At T0, the indigenous people had all their permanent teeth. Forty-two lost at least one tooth (89%), and a total of 172 teeth were lost at T1 at an incidence of 97% among females and 76% in males. There was no influence of ethnicity on tooth loss (p = 1.000). A lower risk of tooth loss was associated with male subjects (β = −0.50, p < 0.05) but not with age. In females (22/46.8%) and males (11/23.4%), the highest incidence of tooth loss was the lower second molars. The risk was higher among females, and there was no influence on age, village, or ethnicity. The second and first molars were the most affected teeth. These findings suggest an increase in tooth loss caused by close contact between indigenous and urban populations.