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 ( ISSN: 2814-2098 )                                                                       RATSIMANDRESY NAOMY NAMBOARINTSOA
1
*  

https://ijojournals.com/                                                     Volume 08 || Issue 03 || March, 2025 || 

“EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON-RESTORED EDENTULOUSNESS IN THE TOWN OF FIANARANTSOA MADAGASCAR." 

 

 

EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON-RESTORED 

EDENTULOUSNESS IN THE TOWN OF FIANARANTSOA MADAGASCAR 

Authors: Ratsimandresy Naomy Namboarintsoa1, Razanadraisoa Albertine1, Rakotoniaina 

Iagarinosy Fanomezantsoa Shaffi2,Rabarijaona HSN1, Ralaiarimanana Liantsoa Fanja Emmanuel1 

1 Dental Prosthesis Section, Institutd'Odonto-Stomatologie Tropicale de Madagascar (IOSTM, 

University of Mahajanga) 

2 Private dental practice in Antananarivo 

Corresponding author: Ratsimandresy Naomy Namboarintsoa, Dental Prosthesis Section,  

Institutd'Odonto-Stomatologie Tropicale de Madagascar (IOSTM,  

                                          University of Mahajanga), BP : 98 Mahajanga Madagascar 

    

Abstract 

Background: Despite policies to prevent oral diseases, there are still many partially or 

completely edentulous patients.  

The aim of this study was to describe the epidemiological and clinical profile of unrestored 

edentulousness in the city of Fianarantsoa. 

Methods:This work was carried out in the Stomatology Department of CHU Tambobe and CSB II 

Anjoma on 207 people who came to these two departments for treatment, presenting with at 

least one missing permanent tooth. 

The number of missing teeth, the causes of edentulousness, the obstacles to wearing a 

prosthesis and the complications of edentulousness were assessed. 

Results: It was found that the average number of missing teeth was 5.37 ± 2.4 per person. 

Ninety-seven point one percent (97.1%) of the causes of edentulousness were caries-related, 

and 36.7% of edentulous patients cited financial problems as an obstacle to wearing dentures. 

Uncompensated edentulousness had repercussions not only in functional, anatomical and 

aesthetic terms, but also on the general health of the individual. 

Conclusion: It is necessary to raise awareness of the importance of wearing dentures and to 

inform the general public about them. 

Key words: edentulousness, prosthetic restoration, clinic 

 

IJO JOURNALS

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  

 ( ISSN: 2814-2098 )                                                                       RATSIMANDRESY NAOMY NAMBOARINTSOA
1
*  

https://ijojournals.com/                                                     Volume 08 || Issue 03 || March, 2025 || 

“EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON-RESTORED EDENTULOUSNESS IN THE TOWN OF FIANARANTSOA MADAGASCAR." 

 

 

Introduction 

Edentulousness is a major public health problem worldwide, due to its high prevalence. 

According to World Health Organization (WHO) estimates for 2022, the global average 

prevalence of edentulousness is almost 7% in people aged 20 or over. For people aged 60 or 

over, the estimated global prevalence of edentulousness is much higher, at 23% [1]. In Senegal 

in 2015, a study on the prevalence of edentulousness recorded a rate of 40.9% [2]. 

Tooth loss is usually the result of a lifelong history of disease, mainly advanced caries and 

severe periodontal disease, but it can also be due to trauma and other causes, all of which can 

lead to tooth extraction. It can also be a consequence of poor oral health services in resource-

poor settings where restorative and prosthetic care is generally unavailable or unaffordable [3]. 

In fact, prosthetic restoration is a solution for remedying the consequences of edentulousness. 

The treatment that uses prosthetic restoration will depend on the clinical characteristics of the 

edentulousness [4]. Lost teeth should normally be restored with the various types of dental 

prosthesis such as fixed prosthesis, removable prosthesis and implant-supported prosthesis; 

however, edentulous people do not necessarily have this attitude, whereas the repercussions 

of tooth loss affect not only the oro-facial sphere but also the well-being of the individual [5]. 

For the city of Fianarantsoa, a study in 2016 found that 59.8% of edentulous people had not 

had their teeth restored [5]. 

 Knowing the characteristics of these edentulous people will make it possible to take action to 

remedy problems relating to edentulousness.  Hence the interest of this study, the aim of which 

is to describe the epidemiological and clinical profile of unrestored edentulousness in the city of 

Fianarantsoa. 

Methods 

This study was carried out in two public dental practices in the city of Fianarantsoa: the 

Stomatology Department of the CHU Tambobe and the dental practice of the CSB II Anjoma.  

 This was a descriptive cross-sectional study conducted between March and May 2022. All 

people who came for treatment, had at least one permanent tooth missing for more than a 

month, had not been compensated and agreed to take part in the survey were included. 

All those who met the inclusion criteria during the study period were retained, and a total of 

207 patients were enrolled.  

The following variables were studied: universal variables, independent variables such as the 

number of missing teeth, the class of edentulousness, the causes of edentulousness, the 

IJO JOURNALS

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  

 ( ISSN: 2814-2098 )                                                                       RATSIMANDRESY NAOMY NAMBOARINTSOA
1
*  

https://ijojournals.com/                                                     Volume 08 || Issue 03 || March, 2025 || 

“EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON-RESTORED EDENTULOUSNESS IN THE TOWN OF FIANARANTSOA MADAGASCAR." 

 

 

obstacles to wearing prosthesis, and the dependent variable linked to the complications of 

edentulousness. 

A survey technique in the form of an interview was adopted to obtain epidemiological data and 

a clinical examination was carried out to record clinical information. 

 

Results 

Table 1: Distribution of patients by socio-demographic characteristics 

Socio-demographic 
characteristics 

N %  

Gender    

Male 115 55,6 Sex-ratio = 1,25 
 Female 92 44,4 

Age    

15 to 30 years old 73 35,3 Moyenne d’âge = 47,2 ± 
3,6 ans 

 
31 à 50 91 44 

51 and over 43 20,8 

Occupation    

Unemployed 38 18,4  

Student 50 24,2  

Employed 56 27,1  

Liberal 48 23,2  

Retired 15 7,2  

Total 207 100,0  
 

Table 1 summarises the distribution of patients according to socio-demographic 

characteristics.  

In terms of gender, the study population was predominantly male, with a sex ratio of 1.25. 

As for age, the mean age was 47.2±3.6 years, and the largest age group was between 31 and 50 

years.Occupation varied from unemployed to retired. 

 

 

 

 

IJO JOURNALS

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  

 ( ISSN: 2814-2098 )                                                                       RATSIMANDRESY NAOMY NAMBOARINTSOA
1
*  

https://ijojournals.com/                                                     Volume 08 || Issue 03 || March, 2025 || 

“EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON-RESTORED EDENTULOUSNESS IN THE TOWN OF FIANARANTSOA MADAGASCAR." 

 

 

Table 2: Distribution of patients by the number of missing teeth 

Number of missing teeth N %  

1 to 5 126 60,9 Average number of missing 
teeth = 5.37 ± 1.84 per 
person 

6 to 10 60 29 

11 to 20 16 7,7 

21 to 25 5 2,4 

Total 207 100,0 
 

According to Table 2, the average number of missing teeth per person was 5.37± 1.84 

per person. And the majority (60.9%) of the population had between one to five missing teeth 

in their mouths. 

Table 3:  Distribution of patients by causes of edentulousness 

Causes of edentulousness N % 

Tooth decay 201 97,1 

Periodontal disease 0 0 

Trauma 6 2,9 

Total 207 100,0 

 

According to the causes of edentulousness (reported in Table 3), dental caries is the 

leading cause at 97.1%. 

 

Table 4: Distribution of patients according to obstacles to wearing a prosthesis 

Obstacles to wearing a prosthesis N % 

Family history 1 0,5 

Financial 76 36,7 

Neglect 43 20,8 

Lack of information 22 10,6 

Lack of time 13 6,3 

Discomfort when wearing a 
prosthesis 

31 15 

Aesthetic carelessness 21 10,1 

Total 207 100,0 
 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  

 ( ISSN: 2814-2098 )                                                                       RATSIMANDRESY NAOMY NAMBOARINTSOA
1
*  

https://ijojournals.com/                                                     Volume 08 || Issue 03 || March, 2025 || 

“EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON-RESTORED EDENTULOUSNESS IN THE TOWN OF FIANARANTSOA MADAGASCAR." 

 

 

According to table 4, various reasons were given for the obstacles to wearing prosthesis, 

but the majority (36.7%) of respondents noted financial problems. 

 

Table 5: Distribution of patients according to type of mastication and number of missing teeth 

Type of 
mastication 

Number of missing teeth 

1-5 teeth 6-10 teeth 11-20 teeth 20 teeth and 
more 

p 

N(%) N(%) N(%) N(%)  

Normal 
mastication 

120(95.2) 36(60.0) 5(31.3) 1(20.0) 0.000*** 

Pathological 
mastication 

6(4.8) 24(40.0) 11(68.7) 4(80.0)  

TOTAL 126(100.0) 60(100.0) 16(100.0) 5(100.0à  

 

There is a highly significant difference (p=0,000) between the type of mastication and 

the number of missing teeth (table 5). Moreover, it has been found that pathological 

mastication increases with the number of missing teeth; the higher the number of missing 

teeth, the greater the increase in pathological mastication. 

 

Discussion  

Causes ofedentulousness 

In terms of the causes of edentulousness, dental caries is the leading cause at 97.1%. 

Several authors confirm that tooth loss is generally the result of a lifelong history of disease, 

mainly advanced caries [3, 6].  

Number of missing teeth 

Our study population had an average of 5.37 ± 1.84 lost teeth per person. This is much 

lower than the average number of missing teeth found by Ratsimandresy and al. in 

Fianarantsoa in 2016 which was 8.57 [5] and by Batista and al. in Brazil in 2015 which was 8.52 

[7].   

Obstacles to wearing prosthesis 

With regard to obstacles to wearing dentures, it was found that the main obstacle to 

wearing dentures was financial problems, cited by 36.7% of respondents. A similar result was 

IJO JOURNALS

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  

 ( ISSN: 2814-2098 )                                                                       RATSIMANDRESY NAOMY NAMBOARINTSOA
1
*  

https://ijojournals.com/                                                     Volume 08 || Issue 03 || March, 2025 || 

“EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON-RESTORED EDENTULOUSNESS IN THE TOWN OF FIANARANTSOA MADAGASCAR." 

 

 

reported by the study carried out in 2016 in Fianarantsoa by Ratsimandresy's team, who found 

that the financial reason was the main obstacle preventing edentulous people from wearing 

prostheses - 36.4% [5]. 

Number of missing teeth and type of mastication 

There is a highly significant difference between the type of chewing and the number of 

missing teeth. Pathological mastication increases with the number of missing teeth, and the 

higher the number of missing teeth, the more pathological the mastication. According to some 

authors, the loss of natural teeth alters the masticatory function. This impairment is correlated 

with the number of missing teeth [8, 9]. Postaire also adds that the number of missing teeth 

does influence masticatory efficiency, particularly below 10 pairs of teeth in occlusion [10]. 

Conclusion 

In conclusion, this study described the epidemio-clinical profile of unrestored 

edentulousness in the city of Fianarantsoa.  

It was found that 97.1% of edentulous teeth were caused by dental caries, followed by 

financial problems (36.7%), which were the main obstacle to edentulous people not wearing 

dentures. Finally, the repercussions of edentulousness extend to the patient's aesthetic and 

functional appearance. In functional terms, mastication is the first function to be affected. 

Acknowledgments  

None 

Conflict of Interest  

Authors declare no conflict of interest. 

References  

1. World Health Organisation (2022). Global oral health status report: towards universal health 

coverage for oral health by 2030:44 

2. Gueye ME, Dieng L, Seck AK, Toure A, Thioune N (2015). Evaluation of the prevalence of 

edentulism in an urban population in Senegal. Rev Iv Odonto-Stomatol;17 (2):15-20 

3. Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Marthur MR and al (2019). Oral 

diseases: a global public health challenge. Lancet ;394(10194) :249-60. Doi:10.1016/SO140-

6736(19)31146-8 

4. Ratsimandresy NN, Delina N, Ralaiarimanana LFE (2023). Epidemio-Clinical Profile of 

Edentulousness of Patients Who Came for Prosthetic Restoration to the Dental Care and 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  

 ( ISSN: 2814-2098 )                                                                       RATSIMANDRESY NAOMY NAMBOARINTSOA
1
*  

https://ijojournals.com/                                                     Volume 08 || Issue 03 || March, 2025 || 

“EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON-RESTORED EDENTULOUSNESS IN THE TOWN OF FIANARANTSOA MADAGASCAR." 

 

 

Treatment Centre in Mahajanga from 2015 to 2019. Online Journal of Dentistry & Oral 

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5. Ratsimandresy NN, Rakotondratsara MA, Ralaiarimanana LFE (2020). Knowledge, attitude 

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teeth. Revue d'odontostomatologie malgache en ligne ISSN 2220-069X2020;18:01-10 

6. Al-Rafee MA (2020). The epidemiology of edentulism and the associated factors: A literature 

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7. Batista MJ, Lawrence HP (2015). Tooth loss classification: factors associated with a new 

classification in an adult population group. Cien Saude Colet ; 20(9) : 2825-35 

8. Natapov L, Kushnir D, Goldsmith R, Dichtiar R, Zusman SP (2018). Dental status, visits, and 

functional ability and dietary intake of elderly in Israel. Israel journal of health policy 

research ;7(1):58. 

9. Okamoto N, Amano N, Nakamura T, Yanagi M (2019). Relationship between tooth loss, low 

masticatory ability, and nutritional indices in the elderly: a cross-sectional study. BMC oral 

health ;19(1):110. 

10. Postaire M, Boittin A (2016). Edentulism and mastication. Les cahiers de prothèse ;176:23-7 

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