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Background The latest national oral health survey showed a high prevalence of the need for dental prostheses between the Brazilian elderly. To classify this need, normative (clinical) and subjective (self-reported) criteria must be considered since patients' self-perception takes into account social and functional issues that arise with oral health problems. Few studies investigate the agreement between these criteria, as well as its determinants. Thus, this study aimed to investigate the accuracy of the need for the use of total dental prosthesis and factors associated with the agreement between criteria. Methods Cross-sectional study, carried out in three municipalities in the Metropolitan Region of Recife, with a random sample of 816 elderly people from 65 to 74 years old. The dependent variable was the accuracy, calculated by the agreement between the self-reported and the normative need for a total dental prosthesis, and the independents were assembled in three blocks (socioeconomic/demographic, access to oral health services and self-perceived oral health). Hierarchical logistic models were conducted for total upper prosthesis (TUP) and total lower prosthesis (TLP). Results The self-perception of the need for prosthetic use presented an accuracy of 75.9% (95% CI = 72.8-78.7%) for TUP and 78.6% (95% CI = 75.6-81.3%) for TLP. In the multiple analysis, the accuracy for TUP and TLP needs holds an association with the variables: family income, age and time since the last dental appointment. Conclusions In conclusion, the self-perception of need for dental prosthesis demonstrates potential applicability for the elderly, presenting notable accuracy values. It suggests that studies based on patients' self-reports should be stimulated, aiming for the evaluation and validation of self-reported criteria in different contexts and cultures. Furthermore, the identification of accuracy associated factors can help to build more meaningful questions to be used in future surveys. Key messages The use of the self-reported need for total dental prosthesis may be feasible when considering lower cost, reduced time of execution and ease of use in population epidemiological surveys. Application of self-reporting as an epidemiological tool for planning and monitoring oral health services, incorporating it in the form of indicators for oral health surveillance.

Accuracy of the need for dental prosthesis and associated factors between elderly in Recife, Brazil