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Sawada N, Takeuchi N, Ekuni D, Morita M. Effect of oral health status and oral function on malnutrition in community-dwelling older adult dental patients: A two-year prospective cohort study. Gerodontology 2024; 41:393-399. [PMID: 37847782 DOI: 10.1111/ger.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment. BACKGROUND Malnutrition is common in older adults and increases the risk of frailty, sarcopenia, and mortality. However, few longitudinal studies have been performed to investigate the causal effect of oral status on malnutrition in detail, and the information reported in those longitudinal studies has been limited to dentition status and swallowing ability. MATERIALS AND METHODS The participants in this prospective cohort study were patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2021. The number of teeth, periodontal condition, oral function (oral diadochokinesis, masticatory ability, number of bacteria in tongue coating, occlusal force, oral moisture, tongue pressure, swallowing function), nutritional status, the number of comorbidities, and mental health status were examined. These variables were analysed using structural equation modelling (SEM). RESULTS The final analysis included 141 participants (40 males and 101 females; mean age, 73.5 ± 6.3 years; follow-up rate: 79.7%). The results of the SEM revealed that oral status (number of teeth present and swallowing function) was positively associated with nutritional status 2 years later. In addition, age was negatively associated with oral status. CONCLUSION In community-dwelling older adult dental patients (age ≥60 years), oral function at baseline was associated with nutritional status two years later.
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Affiliation(s)
- Nanami Sawada
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Noriko Takeuchi
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Morita
- Department of Oral Health, Takarazuka University of Medical and Health Care, Takarazuka, Japan
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Khan S, Chen Y, Crocombe L, Ivey E, Owen AJ, McNeil JJ, Woods RL, Wolfe R, Freak-Poli R, Britt C, Gasevic D. Self-reported oral health status, edentulism and all-cause mortality risk in 12 809 Australian older adults: a prospective cohort study. Aust Dent J 2024; 69:82-92. [PMID: 37916480 DOI: 10.1111/adj.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To investigate the association between oral health status and all-cause mortality in older adults using prospective cohort study design. SETTING AND PARTICIPANTS In total, 12 809 adults aged ≥70 years (54.3% females) were participants of the ASPREE Longitudinal Study of Older Persons (ALSOP). METHODS Participants self-reported the presence of natural teeth and oral health status. The association of self-reported oral health, edentulism and the integrative measure of the two with all-cause mortality were explored using the Cox-regression models adjusted for age, gender, socio-economic status, health-related behaviours, weight status, aspirin and polypharmacy. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported. RESULTS In total, 22.2% of participants reported edentulism and 13.8% had fair/poor oral health. After adjustment for confounders, risk of all-cause mortality was higher among those with edentulism (vs. no edentulism) HR (95% CI) 1.43 (1.18, 1.73); and those with edentulism and reporting poor/fair oral health HR (95% CI) 1.69 (1.02, 2.82), or with no edentulism but reporting poor/fair oral health HR (95% CI) 1.46 (1.19-1.80) vs. no edentulism and reporting good/very good/excellent oral health. No association was observed between self-reported oral health alone and all-cause mortality. CONCLUSIONS The risk of all-cause mortality was 69% higher among older adults reporting both edentulism and poor/fair oral health compared with those with teeth and more favourable self-reported oral health. © 2023 Australian Dental Association.
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Affiliation(s)
- S Khan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Victoria, Australia
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Y Chen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - L Crocombe
- University Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia
| | - E Ivey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - A J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - C Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - D Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
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Hong SW, Baek JH, Kim K, Kang JH. Complex interplay of oral health, muscle and bone metabolism, and frailty in older individuals. Clin Oral Investig 2024; 28:116. [PMID: 38270679 DOI: 10.1007/s00784-024-05521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To investigate molecular and clinical background of associations among oral health, muscle and bone metabolism, and frailty incidence in patients with fall and fracture history. MATERIALS AND METHODS In total, 88 elderly participants (mean age 71.9 ± 5.8 years) with the distal radius fractures were included. Participants were divided into three groups based on an Oral Health Assessment Tool score. Fried criteria and Mini-nutritional assessments were adopted to diagnose frailty and malnutrition, respectively. Blood samples were collected and analyzed for serum levels of bone turnover markers, proteins, insulin-like growth factor-1, 25-hydroxyvitamin D, and inflammatory cytokines. The mRNA levels of markers of inflammation, muscle synthesis and wasting, and muscle homeostasis regulator in the pronator quadratus muscle were analyzed. RESULTS Patients with deteriorated oral health demonstrated a higher prevalence of frailty and malnutrition. Significantly lower serum levels of total protein and higher concentrations of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were detected in patients with poor oral health. Significant interaction effects between oral health and frailty level in gait speed, serum TNF-α, IL-1β, and total protein levels were exhibited. Significantly different mRNA expression levels in the pronator quadratus muscle of TNF-α, IL-1β, NF kB, MYOG, and FOXO1 following the oral health were detected. CONCLUSION This study highlights relationship between oral health, nutritional uptake, systemic inflammation, and their combined impact on muscle and bone metabolism, ultimately affecting frailty development in the aging populations. CLINICAL RELEVANCE A comprehensive understanding of mutual interactions among oral health, nutrition, and inflammation is essential for managing frailty.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-Ro, Jongno-Gu, Seoul, 03181, Republic of Korea
| | - Jeong-Hwa Baek
- Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Kwangyeon Kim
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-Ro, Jongno-Gu, Seoul, 03181, Republic of Korea
| | - Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-Ro, Yeongtong-Gu, Suwon, Gyeonggi-Do, 16499, Republic of Korea.
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Wang M, Deng X, Chen H, Diao Y, Liu C, Gao J, Tang X, Li X, Liu Y, Duan J. Frailty mediated the association between tooth loss and mortality in the oldest old individuals: a cohort study. Front Public Health 2024; 11:1285226. [PMID: 38328540 PMCID: PMC10848322 DOI: 10.3389/fpubh.2023.1285226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/30/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction Tooth loss is associated with increased mortality risk; however, the mechanism underlying this is still not clear. The objective of this study was to explore whether frailty mediates the association between tooth loss and mortality risk among the oldest old individuals. Methods The participants were followed up from 1998 to 2018 in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Frailty was constructed following a standard procedure. Mortality, frailty, and tooth loss were applied as the outcome, mediator, and independent variables, respectively. The Cox model was fitted, including possible confounders, for causal mediation analysis. A total effect (TE), an average causal mediation effect (ACME), an average direct effect (ADE), and a proportion mediated (PM) effect were calculated. Results During the 129,936 person-years at risk, 31,899 individuals with a mean age of 91.79 years were included. The TE and ADE of severe tooth loss on mortality were 0.12 (95% CI: 0.08, 0.15) and 0.09 (95% CI: 0.05, 0.13); the ACME of frailty was 0.03 (95% CI: 0.02, 0.03) with 21.56% of the TE being mediated. Discussion This study illustrated that tooth loss is associated with mortality, and frailty appeared to mediate the relationship. It is recommended that oral health indicators and frailty status be incorporated into routine geriatric assessments to promote optimal oral health and non-frailty status.
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Affiliation(s)
- MingXia Wang
- Department of Stomatology, Shenzhen Luohu Hospital of Traditional Chinese Medicine, Shenzhen Hospital of Shanghai University of Traditional Chinese Medicine, Shenzhen, China
| | - Xiaomeng Deng
- Department of Comprehensive Ward, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hanjie Chen
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yuhan Diao
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
| | - Chang Liu
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jun Gao
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xin Tang
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiaoyan Li
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yan Liu
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jun Duan
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
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Araujo CF, Schuch HS, Cademartori MG, Bielemann RM, Bertoldi AD, Tomasi E, Gonzalez MC, Demarco FF. Functional dentition and edentulism associated with mortality: A cohort study of older adults in Southern Brazil. Community Dent Oral Epidemiol 2023; 51:1209-1215. [PMID: 37186382 DOI: 10.1111/cdoe.12862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/11/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the association between the lack of a functional dentition and edentulism with mortality in a cohort of older adults in a Southern Brazilian city. MATERIALS AND METHODS This is a longitudinal study carried out with community-dwelling older adults (≥60 years old) from Pelotas, Brazil, using data from the baseline (2014) and the first follow-up (2017). Main exposures were functional dentition (20+ teeth present) and edentulism (absence of all teeth), derived from self-reported number of teeth. All-causes mortality was evaluated according to the city's Epidemiological Surveillance Department. Potential confounders were age, sex, socioeconomic position, smoking, diabetes, hypertension, and body mass index (BMI). To test the association between functional dentition and edentulism with mortality, Poisson regression models with robust variance were used, to estimate Relative Risks and 95% confidence intervals. RESULTS A total of 1289 older adults had information on all variables of interest and comprise the analytical sample (from 1451 at baseline). When analysing the presence of functional dentition, only 222 individuals (17.2%) had 20 or more teeth in their mouth, while 490 older adults were edentulous (38.0%). Crude analysis showed an association between tooth loss indicators and mortality. Models adjusted for sociodemographic variables and health conditions and behaviours revelled no association between the exposures and mortality. CONCLUSIONS With the findings of this study, we did not identify an association between edentulism and functional dentition with mortality, after considering important shared risk factors.
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Affiliation(s)
- Cinthia Fonseca Araujo
- Undergraduate student, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Renata Moraes Bielemann
- Postgraduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Elaine Tomasi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Flávio Fernando Demarco
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Arimoto N, Nishimura R, Kobayashi T, Asaeda M, Naito T, Kojima M, Umemura O, Yokota M, Hanada N, Kawamura T, Wakai K, Naito M. Effects of oral health-related quality of life on total mortality: a prospective cohort study. BMC Oral Health 2023; 23:708. [PMID: 37789315 PMCID: PMC10548558 DOI: 10.1186/s12903-023-03451-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The effects of oral health on mortality have been reported; however, the association between mortality and Oral Health-Related Quality of Life (OHQOL) is unknown. We investigated the effect of OHQOL on total mortality in a cohort consisting of dentists. METHODS In this cohort study, we analyzed data from the Longitudinal Evaluation of Multi-phasic, Odonatological and Nutritional Associations in Dentists study. We conducted a baseline survey of general and oral health factors. We called for 31,178 participants and collected responses from 10,256 participants. We followed up with 10,114 participants (mean age ± standard deviation, 52.4 ± 12.1 years; females, 8.9%) for 7.7 years, until March 2014, to determine the average total mortality. OHQOL was assessed using the General Oral Health Assessment Index (GOHAI). The total score was divided into quartiles (Q1 ≤ 51.6, Q2 = 51.7-56.7, Q3 = 56.8-59.9, and Q4 = 60.0), with higher GOHAI scores indicating better OHQOL (score range, 12-60). The association between OHQOL and total mortality was analyzed using the Cox proportional hazards model. RESULTS We documented 460 deaths. Males with low GOHAI scores possessed a remarkably high risk of total mortality. The multivariate adjusted-hazard ratios (aHRs), were 1.93 (95% confidence interval [CI], 1.07 - 3.48) for Q1, 1.69 (95% CI, 0.90 - 3.17) for Q2, and 0.65 (95% CI, 0.29 - 1.46) for Q3, relative to Q4 (trend p = 0.001). The aHRs in the multivariate model with all background variables were 1.69 (95% CI, 1.15-2.46) for Q1, 1.53 (95% CI, 1.04-2.27) for Q2, and 1.09 (95% CI, 0.71-1.70) for Q3, relative to Q4 (trend p = 0.001). In females, there was no significant association between the quartiles, in both the multivariate-adjusted model (trend p = 0.52) and multivariate-adjusted model with all background variables (trend p = 0.79). CONCLUSIONS A lower OHQOL indicated an increased risk of total mortality in dentists. OHQOL may be used as an indicator for selecting treatment plans and personalized care interventions, thus contributing to increased healthy life expectancy. TRIAL REGISTRATION Aichi Cancer Center, Nagoya University Graduate School of Medicine, and Hiroshima University (Approval numbers: 33, 632-3, 8-21, and E2019-1603).
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Affiliation(s)
- Nishiki Arimoto
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
| | - Rumi Nishimura
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Teruo Kobayashi
- Department of Dentistry and Oral Surgery, Asahi General Hospital, Asahi, Chiba, Japan
| | - Mayuka Asaeda
- Department of Oral Health, Faculty of Health Sciences, Kobe Tokiwa University, Kobe, Hyogo, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | | | | | | | - Nobuhiro Hanada
- Photocatalysis International Research Center, University of Shanghai for Science and Technology, Shanghai, P.R. China
| | - Takashi Kawamura
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Kikutani T, Takahashi N, Tohara T, Furuya H, Tanaka K, Hobo K, Isoda T, Fukui T. Relationship between maintenance of occlusal support achieved by home-visit dental treatment and prognosis in home-care patients-a preliminary study. Geriatr Gerontol Int 2022; 22:976-981. [PMID: 36127817 PMCID: PMC9825876 DOI: 10.1111/ggi.14482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/07/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023]
Abstract
AIM To determine whether occlusal maintenance and reconstruction by dental intervention is associated with the prognosis of older home-care patients. METHODS The study participants were 289 older home-care patients (101 males, mean age 82.2 ± 7.7 years) who received visiting dental treatment from dental clinics in the region between 2012 and 2018. The participants were followed up for 1000 days after receiving the necessary dental treatment in a home-visit setting. The participants were divided into three groups: those with natural tooth occlusion, those whose molar occlusion was maintained or reconstructed by dentures, and those whose occlusion was not reconstructed. Factors associated with prognosis were determined using the Cox proportional hazard model, with occlusal status, comorbidities, the activity of daily living, and residence status as explanatory variables. RESULTS In the overall population, occlusal status (hazard ratio [HR] of those with occlusal disintegration versus those with natural tooth occlusion: 2.1, confidence interval [95% CI]: 1.18-3.82) and age (HR: 2.28, 95% CI: 1.44-3.61) were identified as significant factors. In the group of participants aged <85 years, only occlusal status (HR of those with occlusal disintegration versus those with natural tooth occlusion: 3.4, 95% CI: 1.34-8.68) was a significant factor. In the group of participants aged ≥85 years, occlusal status was not significantly associated with prognosis. CONCLUSIONS The maintenance and acquisition of occlusal support achieved by dental treatment contribute to improved prognosis in older patients younger than 85 years requiring home nursing care. Geriatr Gerontol Int 2022; 22: 976-981.
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Affiliation(s)
- Takeshi Kikutani
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Noriaki Takahashi
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Takashi Tohara
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Hiroyasu Furuya
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Kumi Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Kimiko Hobo
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Tomoko Isoda
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
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Nonoyama T, Nonoyama K, Shimazaki Y. Cross-sectional study of the factors associated with the number of teeth in middle-aged and older persons with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:793-804. [PMID: 35929423 PMCID: PMC9544665 DOI: 10.1111/jir.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND We investigated the number of teeth in middle-aged and older individuals with intellectual disability and evaluated the related factors. METHODS A questionnaire survey on oral health was administered to 604 persons over 40 years old with intellectual disabilities in Aichi Prefecture, Japan. The questionnaire designed for this study included items on diagnosis of disability, severity of intellectual disability and type of residence. As oral-health-related factors, the proxy-reported number of teeth, family dentist, regular dental check-ups, problems during dental treatment and tooth-brushing frequency were evaluated. A multinomial logistic regression analysis was performed using the proxy-reported number of teeth (≥20, 10-19 or 0-9) as the dependent variable, and the odds ratios (ORs) and 95% confidence intervals (CIs) of independent variables were calculated. In addition, linear regression analysis was performed using the proxy-reported number of teeth as the dependent variable. RESULTS In the multivariate multinomial logistic regression analysis, age, diagnosis of disability and type of residence were significantly associated with having 10-19 versus ≥20 teeth. Participants with autism spectrum disorder had a significantly lower OR for 10-19 teeth compared with those with intellectual disability [OR (95% CI): 0.49 (0.22-1.08)]. Age, diagnosis of disability, regular dental check-ups and tooth-brushing frequency were significantly associated with having 0-9 versus ≥20teeth. Participants with Down syndrome had a significantly higher OR for 0-9 teeth compared with those with intellectual disability [OR (95% CI): 3.17 (1.09-9.23)]. The ORs for 0-9 teeth of participants who did not attend regular dental check-ups and who brushed their teeth 1 time/day compared with ≥3 times/day were significantly high, and the OR (95% CI) was 2.37 (1.06-5.30) and 4.76 (1.09-20.77), respectively. [Corrections made on 22 August 2022, after first online publication: in the previous sentence, "who attend" has been changed to "who did not attend".] In the multivariate linear regression analysis, age, diagnosis of disability and regular dental check-ups were significantly associated with the proxy-reported number of teeth. The proxy-reported number of teeth was -0.42 less with each 1-year increase in age. With autism spectrum disorder, the proxy-reported number of teeth was 0.74 more compared with intellectual disability. In Down syndrome, the proxy-reported number of teeth was -0.93 less compared with intellectual disability. The proxy-reported number of teeth was -2.12 less for those who did not have regular dental check-ups. CONCLUSIONS The number of teeth in middle-aged and older individuals with intellectual disability was related to age and the type of disability. Regular dental visits may be effective at preventing tooth loss in middle-aged and older persons with intellectual disability.
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Affiliation(s)
- T. Nonoyama
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
| | - K. Nonoyama
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
- Nonoyama Dental OfficeTogoJapan
| | - Y. Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
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Bond JC, McDonough R, Alshihayb TS, Kaye EA, Garcia RI, Heaton B. Edentulism is associated with increased risk of all-cause mortality in adult men. J Am Dent Assoc 2022; 153:625-634.e3. [PMID: 35241269 DOI: 10.1016/j.adaj.2021.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prior reports of positive associations between edentulism and all-cause mortality have been limited by onetime assessments of edentulism and inadequate control of known confounding variables. The authors aimed to assess the association between edentulism and mortality using a longitudinal clinical oral health cohort. METHODS The authors used data from the Department of Veterans Affairs Dental Longitudinal Study, an ongoing, closed-panel cohort study from 1968 through 2019 (N = 1,229). Dentition status was evaluated through triennial clinical examinations. Mortality was assessed via the National Death Registry. The authors used Cox regression models to estimate the association between edentulism and all-cause mortality after covariate adjustment. Furthermore, the authors calculated propensity scores and assessed hazard ratios (HRs) in a trimmed, matched, and inverse probability weighted sample. RESULTS Participants who were edentulous (N = 112) had 1.24 (95% CI, 1.00 to 1.55) times the hazard of all-cause mortality compared with those who were nonedentulous, after adjustment with time-varying covariates. Use of propensity scores in the model resulted in slightly elevated HRs compared with the standard Cox model, regardless of propensity score method; adjusted HRs were 1.35 (95% CI, 1.01 to 1.80) after matching, 1.26 (95% CI, 1.00 to 1.59) after trimming, and 1.29 (95% CI, 1.18 to 1.42) after inverse probability weighting. CONCLUSIONS Edentulism was associated with an increased risk of all-cause mortality in a cohort that captured incident edentulism. This association was consistent after multiple methods to account for confounding. PRACTICAL IMPLICATIONS The findings of this study suggest that edentulism is associated with an increase in risk of mortality, after accounting for salient confounding variables using multiple approaches. Efforts to improve equitable access to tooth-preserving treatments are critical.
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Suenaga H, Aida J, Kumasaka A, Shibamoto A, Sato S, Shinohara Y, Hatakeyama T, Yamaguchi H, Sasaki K, Takahashi T, Koseki T, Peck C, Iikubo M. Impact of Dental Referral Prior to Elective Surgery on Postoperative Outcomes. J Am Med Dir Assoc 2022; 23:638-645.e2. [PMID: 35219603 DOI: 10.1016/j.jamda.2022.01.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Oral bacteria may contribute to postoperative infectious complications including postoperative pneumonia or surgical site infection. The aim of this study was to investigate the impact of preoperative dental care on postoperative outcomes among surgical patients under general anesthesia. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS We analyzed clinical records of major surgical patients at a university hospital between 2016 and 2018. Subjects were categorized into either the preoperative dental care group, those being referred to dentists by their surgeons based on an individual surgeon's judgment for dental care before surgery, or the control group. METHODS The primary outcome was postoperative infectious complications. Secondary outcomes were postoperative inflammation markers (C-reactive protein and fever), and economic outcomes (postoperative length of hospital stay and medical expenses). As the main analysis, the average treatment effects of the preoperative dental care were obtained from the augmented inverse-probability weighting (AIPW) method with consideration of demographics and perioperative risk factors to estimate causal effect of the intervention from the observational data. Then, stratified analyses by age and surgical sites were conducted with the inverse-probability weighting and linear regression methods, respectively. RESULTS In the AIPW estimation, compared with the control group, the care group saw a significantly lower rate of postoperative infection (average treatment effect -3.02) and shorter fever duration (-2.79 days). The stratified analysis by age revealed significant positive impact of dental care in all age groups, including the highest treatment effects observed among patients younger than 60. Also, treatment effect was observed in wider surgical sites than previously known. CONCLUSION/IMPLICATIONS This study indicates a significant impact of preoperative dental care on preventing postoperative infection and inflammation. Along with old age or certain types of surgeries in which advantages of dental referral have been already known, preoperative dental referral could be beneficial for broader types of patients.
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Affiliation(s)
- Hanako Suenaga
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Level 2 Westmead Centre for Oral Health, Westmead, NSW, Australia; Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan; Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Akira Kumasaka
- Division of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan; Division of Perioperative Oral Health Management, Tohoku University Hospital, Aoba-ku, Sendai, Japan
| | - Aya Shibamoto
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Level 2 Westmead Centre for Oral Health, Westmead, NSW, Australia; Division of Perioperative Oral Health Management, Tohoku University Hospital, Aoba-ku, Sendai, Japan
| | - Satoko Sato
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Level 2 Westmead Centre for Oral Health, Westmead, NSW, Australia; Division of Perioperative Oral Health Management, Tohoku University Hospital, Aoba-ku, Sendai, Japan; Division of Oral Ecology and Biochemistry, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Yuta Shinohara
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Level 2 Westmead Centre for Oral Health, Westmead, NSW, Australia
| | - Takenori Hatakeyama
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Level 2 Westmead Centre for Oral Health, Westmead, NSW, Australia
| | - Hirofumi Yamaguchi
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Level 2 Westmead Centre for Oral Health, Westmead, NSW, Australia
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial surgery, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Takeyoshi Koseki
- Division of Perioperative Oral Health Management, Tohoku University Hospital, Aoba-ku, Sendai, Japan; Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - Chris Peck
- Faculty of Medicine and Health, The University of Sydney, Level 2 Westmead Centre for Oral Health, Westmead, NSW, Australia
| | - Masahiro Iikubo
- Division of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan; Division of Perioperative Oral Health Management, Tohoku University Hospital, Aoba-ku, Sendai, Japan.
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11
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Lin YS, Wang Q, Shen ZK, Sun HX, Wu C, He H, Zou GQ, Xu F, Bu YL, Li JW, Zhao C, Hong M, Lu X, Xu JS, Gao W. Association of Loss of Occlusal Pairs of Teeth with Sarcopenia in a Chinese Population of Community-Dwelling Elderly. J Nutr Health Aging 2022; 26:439-444. [PMID: 35587755 DOI: 10.1007/s12603-022-1784-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Tooth loss, which usually leads to malnutrition, is common in the elderly. However, limited information is available regarding its association with sarcopenia. This study aimed to investigate the relationship between loss of occlusal pairs of tooth and sarcopenia. DESIGN A cross-sectional retrospective study was performed. SETTING The elderly who participated in the National Basic Public Health Project in the Maigaoqiao Community Medical Center in Nanjing, Jiangsu Province, China. PARTICIPANTS A total of 2850 individuals aged ≥60 years were enrolled. MEASUREMENTS Sarcopenia was defined according to the criteria proposed by the Asian Working Group for Sarcopenia. A trained dentist assessed oral health status and counted the number of present teeth. Logistic regression analyses were performed to evaluate the association between the loss of occlusal pairs and sarcopenia. RESULTS The prevalence of sarcopenia was 7.1% (201/2850). Univariate logistic regression analysis showed that loss of occlusal pairs was associated with sarcopenia [anterior occlusal pairs (AOPs): odd ratio (OR) = 1.292, 95% confidence interval (CI) = 1.158-1.442; posterior occlusal pairs (POPs): OR = 1.147, 95% CI = 1.018-1.221]. Multivariate logistic regression analysis indicated that loss of POPs was still an independent risk for sarcopenia (OR = 1.108, 95% CI = 1.007-1.220) after adjustment for traditional confounders. Subgroup analysis showed that loss of POPs was more significantly linked to sarcopenia in those with advanced age (≥80years) (OR = 1.307, 95% CI = 1.116-1.532) and in females (OR = 1.165, 95%CI = 1.038-1.308). Compared to individuals with ≥5 occluding pairs of POPs, those with <5 occluding pairs of POPs had a higher incidence of sarcopenia. CONCLUSIONS Loss of POPs is associated with an increased risk of sarcopenia in the elderly in a Chinese population. Further research on the mechanism of the observed causal relationship is needed.
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Affiliation(s)
- Y-S Lin
- Wei Gao, MD, PhD, Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, 211166, Nanjing, Jiangsu Province, China. . Jin-Shui Xu, MD, Jiangsu Province Center for Disease Control and Prevention, Nanjing 210009, China. E-mail: . Tel: +86-25-83759916, Fax: +86-25-83759546
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12
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Wang CC, Chen YY, Hung KC, Wu SJ, Yen YF, Chen CC, Lai YJ. Association between teeth loss and nasogastric tube feeding dependency in older adults from Taiwan: a retrospective cohort study. BMC Geriatr 2021; 21:640. [PMID: 34772343 PMCID: PMC8588643 DOI: 10.1186/s12877-021-02596-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022] Open
Abstract
Background To examine the association between teeth loss and nasogastric tube feeding dependency in older people. Methods The National Health Interview Survey (NHIS) 2005, 2009, and 2013 in Taiwan. Participants were selected by a multistage stratified sampling method and baseline characteristics, including socioeconomic status and health habits, were obtained by well-trained interviewers. The NHIS was linked with the National Health Insurance research database 2000–2016 and the National Deaths Dataset, which contains all the medical information of ambulatory and inpatient care. Cox regression was used to examine the association between the number of teeth lost and nasogastric tube feeding dependency. Results There were 6165 adults older than 65 years old enrolled in the analysis, with 2959 male (48%) and the mean (SD) age was 73.95(6.46) years old. The mean follow-up duration was 6.5(3.3) years. Regarding the teeth loss categories, 1660 (26.93%), 2123 (34.44%), and 2382 (38.64%) of participants were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. During 39,962 person-years of follow-up, new-onset nasogastric feeding dependency was recognized in 220(13.25%), 256(12.06%), and 461(19.35%) participants who were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. Kaplan-Meier curves demonstrated significant findings (Log-rank P < 0.01). After potential confounders were adjusted, compared with those without teeth loss, older adults who had lost 10–28 teeth had significantly increased risks of occurrence nasogastric feeding dependency (AHR, 1.31; 95% CI, 1.05–1.62; p-value = 0.02). Furthermore, a significant dose-response relation between the number of teeth lost and increased risk of nasogastric feeding was found (p for trend< 0.01). Conclusions Older adults who had lost 10–28 teeth had a significantly increased risk of nasogastric tube feeding dependency. Early identification of the oral disease is crucial for the prevention of the occurrence of teeth loss and the following nutrition problems, which would reduce risk of nasogastric tube feeding dependency.
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Affiliation(s)
- Chun-Chieh Wang
- Division of Chest Medicine, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan.,Department of Eldercare, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Yu-Yen Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan.,Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,National Chung Hsing University, Taichung, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Shang-Jung Wu
- Department of Nursing, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan.,College of Nursing Taichung, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Yung-Feng Yen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei City, 112, Taiwan.,Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei City, 112, Taiwan.
| | - Yun-Ju Lai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei City, 112, Taiwan. .,Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan. .,Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, No.1, Rongguang Rd, Puli Township, Nantou County, 545, Taiwan.
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13
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Iwasaki M, Hirano H, Ohara Y, Motokawa K. The association of oral function with dietary intake and nutritional status among older adults: Latest evidence from epidemiological studies. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:128-137. [PMID: 34471440 PMCID: PMC8387741 DOI: 10.1016/j.jdsr.2021.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/11/2021] [Accepted: 07/18/2021] [Indexed: 12/16/2022] Open
Abstract
Inadequate and poor quality of diet and malnutrition are common and associated with adverse health outcomes, including morbidity and mortality, among older persons. This review aimed to establish the latest evidence from studies investigating the association between oral function and nutrition among older adults. An electronic search of MEDLINE using PubMed for literature published in English between March 2018 and March 2021 was conducted, and 27 papers were identified. The selected studies comprised 23 observational studies (17 cross-sectional and 6 longitudinal studies) and 4 interventional studies. Most of the observational studies demonstrated the following associations in older adults: older adults with poor oral function are likely to have poorer dietary intake and poorer nutritional status, and malnourished older adults are likely to have poorer oral function. The results of the intervention studies demonstrated that the combination of prosthodontic treatment and dietary counseling is more effective for improving dietary intake and nutritional status in older persons with tooth loss than the prosthodontic treatment alone. Our review confirmed that a relationship exists between oral function and nutrition and revealed the need for additional high-quality studies investigating comprehensive oral function, rather than a single aspect of oral function, with regard to nutritional status.
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Affiliation(s)
- Masanori Iwasaki
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
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14
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Glycemic control and number of natural teeth: analysis of cross-sectional Japanese employment-based dental insurance claims and medical check-up data. Diabetol Int 2021; 13:244-252. [DOI: 10.1007/s13340-021-00533-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/16/2021] [Indexed: 02/08/2023]
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15
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Beukers NGFM, Su N, Loos BG, van der Heijden GJMG. Lower Number of Teeth Is Related to Higher Risks for ACVD and Death-Systematic Review and Meta-Analyses of Survival Data. Front Cardiovasc Med 2021; 8:621626. [PMID: 34026863 PMCID: PMC8138430 DOI: 10.3389/fcvm.2021.621626] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/22/2021] [Indexed: 12/17/2022] Open
Abstract
Tooth loss reflects the endpoint of two major dental diseases: dental caries and periodontitis. These comprise 2% of the global burden of human diseases. A lower number of teeth has been associated with various systemic diseases, in particular, atherosclerotic cardiovascular diseases (ACVD). The aim was to summarize the evidence of tooth loss related to the risk for ACVD or death. Cohort studies with prospective follow-up data were retrieved from Medline-PubMed and EMBASE. Following the PRISMA guidelines, two reviewers independently selected articles, assessed the risk of bias, and extracted data on the number of teeth (tooth loss; exposure) and ACVD-related events and all-cause mortality (ACM) (outcome). A total of 75 articles were included of which 44 were qualified for meta-analysis. A lower number of teeth was related to a higher outcome risk; the pooled risk ratio (RR) for the cumulative incidence of ACVD ranged from 1.69 to 2.93, and for the cumulative incidence of ACM, the RR ranged from 1.76 to 2.27. The pooled multiple adjusted hazard ratio (HR) for the incidence density of ACVD ranged from 1.02 to 1.21, and for the incidence density of ACM, the HR ranged from 1.02 to 1.30. This systematic review and meta-analyses of survival data show that a lower number of teeth is a risk factor for both ACVD and death. Health care professionals should use this information to inform their patients and increase awareness on the importance of good dental health and increase efforts to prevent tooth loss.
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Affiliation(s)
- Nicky G F M Beukers
- Academic Centre for Dentistry Amsterdam, Department of Periodontology, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Naichuan Su
- Academic Centre for Dentistry Amsterdam, Department of Social Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bruno G Loos
- Academic Centre for Dentistry Amsterdam, Department of Periodontology, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Geert J M G van der Heijden
- Academic Centre for Dentistry Amsterdam, Department of Social Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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