1
|
Watanabe D, Yoshida T, Watanabe Y, Yokoyama K, Yamada Y, Kikutani T, Yoshida M, Miyachi M, Kimura M. Oral frailty is associated with mortality independently of physical and psychological frailty among older adults. Exp Gerontol 2024; 191:112446. [PMID: 38679352 DOI: 10.1016/j.exger.2024.112446] [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: 02/13/2024] [Revised: 03/18/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Although oral frailty is independently associated with an increased risk of mortality, evidence for the usefulness of screening tools for oral frailty is less than that for physical frailty screening tools. We aimed to investigate the relationship between oral frailty and mortality in older adults. METHODS This prospective cohort study included 11,374 adults aged ≥65 years, who provided valid responses to a baseline mail survey questionnaire from the Kyoto-Kameoka study. Oral frailty status was evaluated using the Oral Frailty Index-8 (range, 0 [best] to 10 [worst]). Participants were classified into four categories according to the Oral Frailty Index-8: robust (score, 0-2), oral pre-frailty (score, 3), oral frailty (score, 4-6), and oral severe frailty (score ≥ 7). Physical and psychological frailty were evaluated using the validated frailty-screening index and defined as a score of ≥3 out of a possible 5 points. Mortality data were collected from 30 July 2011 to 30 November 2016. Hazard ratios (HR) for all-cause mortality were calculated using a multivariable Cox proportional hazards model. RESULTS During the 5.3-year median follow-up period (57,157 person-years), 1184 deaths were recorded. After adjusting for confounders, including physical and psychological frailty, medical history, and lifestyle, in comparison with a robust oral status, oral pre-frailty (HR, 1.29; 95 % confidence interval [CI], 1.02-1.63), oral frailty (HR, 1.22; 95 % CI, 1.01-1.48), and oral severe frailty (HR, 1.43; 95 % CI, 1.16-1.76) were associated with higher HRs of mortality (p for trend = 0.002). CONCLUSION Oral frailty is associated with mortality independent of physical and psychological frailty in older adults. The Oral Frailty Index-8 may be useful for identifying individuals at high risk of mortality.
Collapse
Affiliation(s)
- Daiki Watanabe
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan.
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Senior Citizen's Welfare Section, Kameoka City Government, 8 Nonogami, Yasu-machi, Kameoka-city, Kyoto 621-8501, Japan; National Institute of Biomedical Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki-city, Osaka 567-0085, Japan.
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Faculty of Sport Study, Biwako Seikei Sport College, 1204 Kitahira, Otsu-city, Shiga 520-0503, Japan.
| | - Keiichi Yokoyama
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; National Institute of Biomedical Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki-city, Osaka 567-0085, Japan.
| | - Takeshi Kikutani
- Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo 184-0011, Japan.
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-city, Aichi 470-1192, Japan.
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan.
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto-city, Kyoto 602-8566, Japan.
| |
Collapse
|
2
|
Shen R, Chen S, Shen J, Lv L, Wei T. Association between missing teeth number and all-cause and cardiovascular mortality: NHANES 1999-2004 and 2009-2014. J Periodontol 2024; 95:571-581. [PMID: 37793053 DOI: 10.1002/jper.23-0277] [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: 04/28/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The association between tooth loss and all-cause and cardiovascular mortality requires further investigation. METHODS This study included 17993 participants from the National Health and Nutrition Examination Surveys (NHANES) 1999-2004 and 2009-2014. Weighted multivariable Cox proportional hazard models were used to assess the association between tooth loss and all-cause and cardiovascular mortality. Restricted cubic splines (RCS) were incorporated in the models to explore potential nonlinear relationships. RESULTS Over a median follow-up of 116 months, 2152 participants died, including 625 cardiovascular deaths. Compared to participants without missing teeth, participants with 11-19 missing teeth had the highest risk of all-cause mortality (hazard ratio [HR] 1.89, 95% confidence interval [CI] 1.43-2.51), while participants with 6-10 missing teeth had the highest risk of cardiovascular mortality (HR 2.51, 95% CI 1.68-3.76). RCS analyses revealed nonlinear associations between number of missing teeth and all-cause (p < 0.001) and cardiovascular (p = 0.001) mortality. With < 10 missing teeth, each additional missing tooth increased all-cause and cardiovascular mortality by 6% (HR 1.06, 95% CI 1.03-1.09) and 9% (HR 1.09, 95% CI 1.03-1.15), respectively. However, when the number of missing teeth was ≥10, the risk of mortality did not continue to increase with more missing teeth. A significant interaction was found between tooth loss and age (p < 0.001 for both outcomes). CONCLUSION We observed an inverted L-shaped association between tooth loss and mortality, wherein risks increased with more missing teeth until 10, but did not continue increasing thereafter. The association was stronger in adults < 65 years old.
Collapse
Affiliation(s)
- Ruming Shen
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuaijie Chen
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiayi Shen
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingchun Lv
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tiemin Wei
- Lishui Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
3
|
Kang EJ, Moon SJ, Lee K, Park IH, Kim JS, Choi YJ. Associations between missing teeth and the risk of cancer in Korea: a nationwide cohort study. BMC Oral Health 2023; 23:418. [PMID: 37353779 PMCID: PMC10288806 DOI: 10.1186/s12903-023-02997-x] [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: 09/27/2022] [Accepted: 04/28/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Poor dental health is correlated with an increased risk of cancer. Using a nationwide population cohort database, we investigated which cancer is highly associated with poor dental health and which dental indicator mostly influences cancer risk. METHODS This study was conducted using the National Health Checkups (NHC) and National Health Insurance System (NHIS) database in Korea. NHC in Korea includes dental examinations. We retrieved subjects who underwent NHC between 2002 and 2003 and their medical information in NHIS database was followed until December 31,2015. RESULTS Data for 200,170 who participated in the NHC between 2002 and 2003 were analysed. During the maximum follow-up period of 13 years, 15,506 (7.75%) subjects were diagnosed with cancer. The median time to cancer diagnosis after the dental examination was 87 months (range, 51-119 months). The proportion of people with missing teeth was higher in the cancer-diagnosed group than in the non-diagnosed group (26.27% vs. 22.59%, p < 0.001). Among several dental health factors, missing teeth were significantly associated with higher cancer risk. Subjects with missing teeth showed a 12% increased cancer risk compared to those without missing teeth (odds ratio [OR] 1.12, 95% confidence interval [CI], 1.08-1.16). The risk was significantly higher, especially in lung, head and neck, pancreatic, liver, biliary, and esophageal cancers (OR 1.27 [95% CI, 1.14-1.41], 1.32 [95% CI, 1.13-1.55], 1.27 [95% CI, 1.02-1.58], 1.24 [95% CI, 1.1-1.4], 1.28 [95% CI, 1.03-1.6], 1.4 [95% CI, 1.04-1.88], respectively). CONCLUSIONS Missing teeth were the most important dental indicator associated with cancer risk. Korean adults with missing teeth should be cautious about the risk of several cancers, particularly head and neck, lung, gastrointestinal, hepatobiliary, and pancreatic cancer.
Collapse
Affiliation(s)
- Eun Joo Kang
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea.
| | - Seok-Joo Moon
- Smart Healthcare Center, Korea University Guro Hospital, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea
| | - Kyoungmin Lee
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea
| | - In Hae Park
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea
| | - Jung Sun Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-Ro, Danwon-Gu, Ansan, Gyeonggi-Do, 15355, Republic of Korea
| | - Yoon Ji Choi
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Goryeodae-Ro Seongbuk-Gu, Seoul, 02841, Republic of Korea
| |
Collapse
|
4
|
Beltrán V, Flores M, Sanzana C, Muñoz-Sepúlveda F, Alvarado E, Venegas B, Molina JC, Rueda-Velásquez S, von Marttens A. Tooth Loss and Caries Experience of Elderly Chileans in the Context of the COVID-19 Pandemic in Five Regions of Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3001. [PMID: 36833696 PMCID: PMC9967189 DOI: 10.3390/ijerph20043001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
Risk factors associated with tooth loss have been studied; however, the current status of the epidemiological profiles and the impact of the pandemic on the oral health of the elderly is still unknown. This study aims to determine the experience of caries and tooth loss among elderly Chilean citizens in five regions and to identify the risk factors associated with tooth loss. The sample includes 135 participants over 60 years old assessed during COVID-19 lockdown. Sociodemographic variables such as education and RSH (Social Registry of Households) were obtained through a teledentistry platform called TEGO. The history of chronic diseases such as diabetes, obesity, depression and dental caries reported by DMFT index scores were incorporated. The statistical analysis included Adjusted Odds Ratios (ORs) to assess risk factors associated with the lack of functional dentition. Multivariate hypothesis testing was used to compare the mean equality of DMFT and its components between regions (p-value < 0.05). Individuals with RSH ≤ 40% were at higher risk of having no functional dentition with OR 4.56 (95% CI: 1.71, 12.17). The only mean difference between regions was the filled tooth component. Tooth loss was associated with multidimensional lower income, where the elderly belonging to the 40% most vulnerable population had a higher prevalence of non-functional dentition. This study highlights the importance of implementing a National Oral Health Policy that focuses on oral health promotion and minimally invasive dentistry for the most vulnerable population.
Collapse
Affiliation(s)
- Víctor Beltrán
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
| | - Marco Flores
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
| | - Cristina Sanzana
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago 8380544, Chile
| | - Fernanda Muñoz-Sepúlveda
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Program of Master in Dental Sciences, Dental School, Universidad de La Frontera, Temuco 4811230, Chile
| | - Eloy Alvarado
- Department of Industrial Engineering, Universidad Técnica Federico Santa María, Santiago 7630000, Chile
| | - Bernardo Venegas
- Carlos Van Buren Hospital of Valparaíso, Valparaíso 2340000, Chile
| | | | - Sandra Rueda-Velásquez
- Department of Oral Pathology, Faculty of Dentistry, Universidad Santo Tomás, Bucaramanga 680001, Colombia
| | - Alfredo von Marttens
- Department of Prosthesis, Faculty of Dentistry, Interuniversity Center for Healthy Aging, University of Chile, Santiago 8380000, Chile
| |
Collapse
|
5
|
Dibello V, Lobbezoo F, Lozupone M, Sardone R, Ballini A, Berardino G, Mollica A, Coelho-Júnior HJ, De Pergola G, Stallone R, Dibello A, Daniele A, Petruzzi M, Santarcangelo F, Solfrizzi V, Manfredini D, Panza F. Oral frailty indicators to target major adverse health-related outcomes in older age: a systematic review. GeroScience 2022; 45:663-706. [PMID: 36242694 PMCID: PMC9886742 DOI: 10.1007/s11357-022-00663-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/14/2022] [Indexed: 02/03/2023] Open
Abstract
A well-preserved oral function is key to accomplishing essential daily tasks. However, in geriatric medicine and gerodontology, as age-related physiological decline disrupts several biological systems pathways, achieving this objective may pose a challenge. We aimed to make a systematic review of the existing literature on the relationships between poor oral health indicators contributing to the oral frailty phenotype, defined as an age-related gradual loss of oral function together with a decline in cognitive and physical functions, and a cluster of major adverse health-related outcomes in older age, including mortality, physical frailty, functional disability, quality of life, hospitalization, and falls. Six different electronic databases were consulted by two independent researchers, who found 68 eligible studies published from database inception to September 10, 2022. The risk of bias was evaluated using the National Institutes of Health Quality Assessment Toolkits for Observational Cohort and Cross-Sectional Studies. The study is registered on PROSPERO (CRD42021241075). Eleven different indicators of oral health were found to be related to adverse outcomes, which we grouped into four different categories: oral health status deterioration; decline in oral motor skills; chewing, swallowing, and saliva disorders; and oral pain. Oral health status deterioration, mostly number of teeth, was most frequently associated with all six adverse health-related outcomes, followed by chewing, swallowing, and saliva disorders associated with mortality, physical frailty, functional disability, hospitalization, and falls, then decline in oral motor skills associated with mortality, physical frailty, functional disability, hospitalization, and quality of life, and finally oral pain was associated only with physical frailty. The present findings could help to assess the contribution of each oral health indicator to the development of major adverse health-related outcomes in older age. These have important implications for prevention, given the potential reversibility of all these factors.
Collapse
Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario Ernesto Quagliariello, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Hélio José Coelho-Júnior
- School of Physical Education, University of Campinas, Cidade Universitaria Zeferino Vaz, Barao Geraldo, Campinas, Brazil
| | - Giovanni De Pergola
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Roberta Stallone
- Neuroscience and Education, Human Resources Excellence in Research, University of Foggia, Foggia, Italy
| | - Antonio Dibello
- Accident and Emergency Department (AED), F. Perinei Hospital, Altamura, Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
- Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, Section of Dentistry, University of Bari Medical School, Bari, Italy
| | | | - Vincenzo Solfrizzi
- Cesare Frugoni Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy.
| |
Collapse
|
6
|
Chun H, Oh J, Doo M. The Risk of Cardiovascular Disease According to Chewing Status Could Be Modulated by Healthy Diet in Middle-Aged Koreans. Nutrients 2022; 14:nu14183849. [PMID: 36145225 PMCID: PMC9502299 DOI: 10.3390/nu14183849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 11/20/2022] Open
Abstract
To assess whether a healthy diet could change the risk of cardiovascular disease (CVD)-related chewing difficulty (CD) in relation to age distribution. In a cross-sectional study of 9411 middle-aged Koreans from the KNHANES VII. In this study, the Framingham 10-year general CVD risk prediction equations and the Korean Heathy Eating index (KHEI) were used to assess the 10-year estimated risk of CVD and dietary quality, respectively. CD was experienced by 16.7% of the total subjects. Among subjects with CD, the 10-year estimated CVD risk was 8.71% of the subjects in the 30−49 years age group and 30.38% of those in the 50−64 years age group, which is a difference of approximately 3.5 times. Regardless of age distribution, the total score of the KHEI in subjects who had CD was significantly lower than in those who had no CD (NCD) (p = 0.004 for the 30−49 years age group and p < 0.001 for the 50−64 years age group, respectively). Among the subjects with poor KHEI in the 30−49-year age group, the adjusted odds ratio for the 10-year estimated CVD risk of the subjects with CD was 2.204-fold (95% CI = 1.385−3.506) higher using NCD as a reference. The findings showed that dietary quality could modify the risk for CVD according to chewing status.
Collapse
Affiliation(s)
- Hyejin Chun
- Department of Family Medicine, Ewha Womans University College of Medicine, Seoul 07804, Korea
| | - Jongchul Oh
- Department of Mathematics, Kunsan National University, Gunsan 54150, Korea
| | - Miae Doo
- Department of Food and Nutrition, Kunsan National University, Gunsan 54150, Korea
- Correspondence: ; Tel.: +82-63-469-4631; Fax: +82-63-469-2085
| |
Collapse
|
7
|
Reduced masticatory performance and not using dentures are associated with hypertension in older adults with tooth loss: the Shimane CoHRE study. Hypertens Res 2022; 45:1553-1562. [DOI: 10.1038/s41440-022-00976-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 12/18/2022]
|
8
|
Factors Associated with Tooth Loss in General Population of Bialystok, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042369. [PMID: 35206557 PMCID: PMC8872086 DOI: 10.3390/ijerph19042369] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 01/23/2023]
Abstract
Background: The aim of this study was to assess risk factors for tooth loss in the population of the city of Bialystok, in north-eastern Poland, taking into account the entire population and different age groups. The study included 1138 subjects divided into three subgroups: 20–44 years, 45–64 years, and 65–79 years. Participants were classified according to the number of teeth lost (0–8 vs. 9–28). Socio-economic variables, smoking history, and dental habits were collected through a questionnaire. Medical examinations provided data on the body mass index and the fasting blood glucose level. Data were statistically analysed using Mann-Whitney U, Student’s t, chi2 tests, and binary logistic regression, p < 0.05. Results: For the general population, being female (OR 1.38, 1.07–1.79, p = 0.015), having secondary education (OR 4.18, Cl 2.97–5.87, p < 0.000), higher body mass index (OR 1.13, Cl 1.10–1.17, p < 0.000), higher fasting blood glucose level (OR 1.03 1.03–1.04, p < 0.000), being former smoker (OR 1.72, Cl 1.29–2.31, p < 0.000), ever smoker (OR 1.69, Cl 1.29–2.20, p < 0.000), current smoker (OR 1.62, Cl 1.15–2.29, p < 0.006), longer smoking period (OR 1.11, Cl 1.09–1.14, p < 0.000), last visit to the dentist over a year ago (OR 1.92, Cl 0.44–2.58, p < 0.000) and tooth brushing less than two times a day (OR 1.6, Cl 1.14–2.23, p < 0.006) were associated with losing more than 8 teeth. In the subgroup aged 20–44 years, only smoking duration was a risk factor for tooth loss (p = 0.02). For the middle-aged and oldest groups, education level (respectively p < 0.001, and p = 0.001), body mass index (respectively, p < 0.001, and p = 0.037), smoking status ever/former/current (respectively p < 0.001 and p = 0.002), smoking status never/ever (respectively p < 0.001 and p = 0.009), smoking duration (p < 0.001) were related to tooth loss. Additionally, in the elderly group, fasting blood glucose level (p = 0.044) and frequency of dental visits (p = 0.007) were related to tooth loss. We concluded that in the evaluated population, tooth loss was associated with socio-demographic, medical, and behavioural factors.
Collapse
|
9
|
Are Public Oral Care Services Evenly Distributed?-Nation-Wide Assessment of the Provision of Oral Care in Japan Using the National Database of Health Insurance Claims. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010850. [PMID: 34682591 PMCID: PMC8536066 DOI: 10.3390/ijerph182010850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/10/2021] [Accepted: 10/10/2021] [Indexed: 01/05/2023]
Abstract
The provision of oral health care services is one of the global challenges under the realization of universal health coverage in many countries. Despite the increasing importance of oral health care in an aging society, the disparities in the provision of oral care in Japan have not been clarified. Therefore, this study investigated the status of oral and dental care provision using the National Database of Health Insurance Claims and Specific Health Checkups (NDB) at the level of prefectures and secondary medical care areas. Additionally, a multiple regression model was applied to identify the influence of human resources in oral care services and economic factors on the standardized claims data ratio (SCR) of total dental receipts. The results showed that the total amount of oral care provided tended to be higher in metropolitan areas, with bimodal peaks in children aged 5-9 and adults in their 70s. The SCR for dental caries showed little difference nationally, but SCR for periodontal disease tended to be higher in prefectures including metropolitan areas. In a multiple regression model, the number of dentists and prefectural income per capita influenced the SCR of total dental receipts. In secondary medical care areas, some depopulated areas are supplemented by adjacent areas. These results suggest that oral health care services in the national health insurance system are generally well provided; however, they are likely to be influenced by human resources and economic disparities, and regional differences may occur in the care of periodontal diseases.
Collapse
|
10
|
Rajiah K, Lim WK, Madeline Teoh PL, Binti Mas'od MA, Lim WY, Poh Chou LL, Mak ZQ. Community pharmacists' knowledge, attitudes and practices towards oral healthcare and its management: A systematic review. Int J Clin Pract 2021; 75:e14096. [PMID: 33619786 DOI: 10.1111/ijcp.14096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 02/18/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Community pharmacists play a significant part in providing oral healthcare advice as there are significant connections between oral healthcare and body system healthcare. OBJECTIVE To systematically review the literature regarding the knowledge, attitudes and practice of community pharmacists in managing oral healthcare problems. METHODS A systematic review was conducted through Scopus, PubMed and Google Scholar databases. Studies regarding knowledge, attitudes and practice of management of dental care by community pharmacists between 1990 and 2019 were included. RESULTS Forest plot was performed to access knowledge, attitudes and practice of community pharmacist on oral healthcare. The results showed there were 44% of community pharmacists have a lack of knowledge on oral healthcare to provide an appropriate recommendation to patients with dental problems. Eighty-eight per cent of community pharmacists were willing to improve their knowledge of oral healthcare. There were 86% of them recognised that their role was significant in oral health. However, there were 59% of community pharmacists who had poor attitude in providing oral health information. CONCLUSIONS Community pharmacists were lacking knowledge on oral health mainly because of paucity in providing appropriate training courses. This has led to poor practices towards oral healthcare as they were unable to provide suitable products recommendations to the patients. This has led the community pharmacists into lack of attitudes in providing oral health information. However, most of the community pharmacists were conscious of their role in the oral healthcare system and were willing to improve their knowledge of oral healthcare.
Collapse
Affiliation(s)
- Kingston Rajiah
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Weng Kit Lim
- Department of Pharmacy, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Pei Lin Madeline Teoh
- Department of Pharmacy, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | | | - Win Yi Lim
- Department of Pharmacy, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Lorni Ling Poh Chou
- Department of Pharmacy, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Zi Qing Mak
- Department of Pharmacy, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| |
Collapse
|
11
|
Kotronia E, Brown H, Papacosta AO, Lennon LT, Weyant RJ, Whincup PH, Wannamethee SG, Ramsay SE. Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA. Sci Rep 2021; 11:16452. [PMID: 34385519 PMCID: PMC8361186 DOI: 10.1038/s41598-021-95865-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/02/2021] [Indexed: 11/09/2022] Open
Abstract
Preventing deterioration of oral health in older age can be crucial for survival. We aimed to examine associations of oral health problems with all-cause, cardiovascular disease (CVD), and respiratory mortality in older people. We used cohort data from the British Regional Health Study (BRHS) (N = 2147, 71-92 years), and the Health, Aging and Body Composition (HABC) Study (USA) (N = 3075, 71-80 years). Follow-up was 9 years (BRHS) and 15 years (HABC Study). Oral health comprised tooth loss, periodontal disease, dry mouth, and self-rated oral health. Cox regression was performed for all-cause mortality, competing risks for CVD mortality, and accelerated failure time models for respiratory mortality. In the BRHS, tooth loss was associated with all-cause mortality (hazard ratio (HR) = 1.59, 95% CI 1.09, 2.31). In the HABC Study, tooth loss, dry mouth, and having ≥ 3 oral problems were associated with all-cause mortality; periodontal disease was associated with increased CVD mortality (subdistribution hazard ratio (SHR) = 1.49, 95% CI 1.01, 2.20); tooth loss, and accumulation of oral problems were associated with high respiratory mortality (tooth loss, time ratio (TR) = 0.73, 95% CI 0.54, 0.98). Findings suggest that poor oral health is associated with mortality. Results highlight the importance of improving oral health to lengthen survival in older age.
Collapse
Affiliation(s)
- Eftychia Kotronia
- Population Health Sciences Institute, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Heather Brown
- Population Health Sciences Institute, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - A Olia Papacosta
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Lucy T Lennon
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Robert J Weyant
- Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| |
Collapse
|
12
|
Lăzureanu PC, Popescu F, Tudor A, Stef L, Negru AG, Mihăilă R. Saliva pH and Flow Rate in Patients with Periodontal Disease and Associated Cardiovascular Disease. Med Sci Monit 2021; 27:e931362. [PMID: 34305133 PMCID: PMC8323473 DOI: 10.12659/msm.931362] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/15/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Periodontal disease, a frequent oral health problem, is connected with cardiovascular morbidity and mortality. This study aimed to assess the unstimulated saliva flow rate and saliva pH as markers of the severity of periodontal disease in patients with cardiovascular disease. MATERIAL AND METHODS A cohort of 155 patients (78 men and 77 women, aged 30-92 years) was included, and a structured questionnaire obtained information about their health status, oral healthcare behaviors, and eating habits. An oral examination was performed to assess periodontal status and presence of dental calculus. The unstimulated whole salivary flow rate and salivary pH were measured. An oral hygienization was performed, and 3 months later, salivary flow rate and pH were reevaluated. RESULTS A severe form of periodontal disease was found in 22.4% of patients. Disease severity was strongly correlated with low pH values (6.25 in stage IV periodontal disease), lower salivary flow rate (0.28 mL/min), smoking, poor oral hygiene habits and obesity, with no significant differences by sex. We observed a significant increase of pH (up to 6.30±0.17) in patients with severe periodontal disease (P=0.001) and salivary flow rate values (0.29±0.07 mL/min; P=0.014) 3 months after oral hygienization. There was a strong association between the severity of periodontal disease and presence of cardiovascular disease (P=0.001). CONCLUSIONS Our study suggests that the decrease of salivary flow rate and pH level might be associated with the severity of periodontal disease.
Collapse
Affiliation(s)
| | - Florina Popescu
- Department of Occupational Health, Victor Babeş University of Medicine and Pharmacy, Timișoara, Romania
| | - Anca Tudor
- Department of Functional Science, Discipline of Medical Informatics and Biostatistics Victor Babeş University of Medicine and Pharmacy, Timișoara, Romania
| | - Laura Stef
- Department of Oral Health and Nursing, Faculty of Medicine, Research Center for Complex Physical Systems, Lucian Blaga University, Sibiu, Romania
| | - Alina Gabriela Negru
- Department of Cardiology, Victor Babeş University of Medicine and Pharmacy, Timișoara, Romania
| | - Romeo Mihăilă
- Department of Internal Medicine, County Emergency Hospital Sibiu, Faculty of Medicine, Lucian Blaga University, Sibiu, Romania
| |
Collapse
|
13
|
Abe T, Tominaga K, Ando Y, Toyama Y, Takeda M, Yamasaki M, Okuyama K, Hamano T, Isomura M, Nabika T, Yano S. Number of teeth and masticatory function are associated with sarcopenia and diabetes mellitus status among community-dwelling older adults: A Shimane CoHRE study. PLoS One 2021; 16:e0252625. [PMID: 34077486 PMCID: PMC8172058 DOI: 10.1371/journal.pone.0252625] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/19/2021] [Indexed: 01/13/2023] Open
Abstract
Objectives We aimed to examine the number of teeth and masticatory function as oral health indices and clarify their roles in the pathogenesis of sarcopenia and diabetes mellitus in community-dwelling older adults. Subjects and methods This cross-sectional study was conducted with 635 older adults in Ohnan, Shimane Prefecture, in rural Japan. The number of teeth and masticatory function (measured by the number of gummy jelly pieces collected after chewing) were evaluated by dental hygienists. Sarcopenia status was assessed using handgrip strength, skeletal muscle index, calf circumference, and a possible sarcopenia diagnosis based on the Asian Working Group for Sarcopenia 2019. Diabetes mellitus status was defined as a hemoglobin A1c level ≥6.5% or self-reported diabetes. A multivariable logistic regression model was used to analyze the association between oral health, sarcopenia, and diabetes mellitus after adjusting for confounders. Results After adjusting for all confounders, logistic regression analysis showed that the number of remaining teeth was negatively associated with a low level of handgrip strength (odds ratio [OR], 0.961; 95% confidence interval [CI], 0.932–0.992) and possible sarcopenia (OR, 0.949; 95% CI, 0.907–0.992). Higher levels of masticatory function were also negatively associated with a low level of handgrip strength (OR, 0.965; 95% CI, 0.941–0.990) and possible sarcopenia (OR, 0.941; 95% CI, 0.904–0.979). Logistic regression analysis showed that the number of remaining teeth and a higher level of masticatory function were negatively associated with diabetes mellitus (OR, 0.978; 95% CI, 0.957–0.999; OR, 0.976; 95% CI, 0.960–0.992, respectively). Conclusion Our findings suggest that improvement in oral health, including the maintenance of masticatory function and remaining teeth, may contribute to the prevention of sarcopenia and diabetes mellitus in older adults.
Collapse
Affiliation(s)
- Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
| | - Kazumichi Tominaga
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Tominaga Dental Office, Ochi-gun, Shimane, Japan
| | - Yuichi Ando
- Department of Health Promotion, National Institute of Public Health, Wako City, Saitama, Japan
| | - Yuta Toyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
| | - Miwako Takeda
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
| | - Masayuki Yamasaki
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Human Sciences, Shimane University, Matsue City, Shimane, Japan
| | - Kenta Okuyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Tsuyoshi Hamano
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Sociology, Department of Sports Sociology and Health Sciences, Kyoto Sangyo University, Kita-ku, Kyoto, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Human Sciences, Shimane University, Matsue City, Shimane, Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Medicine, Department of Functional Pathology, Shimane University, Izumo City, Shimane, Japan
| | - Shozo Yano
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan
- Faculty of Medicine, Department of Laboratory Medicine, Shimane University, Izumo City, Shimane, Japan
- * E-mail:
| |
Collapse
|
14
|
Chatzopoulou E, Rangé H, Deraz O, Boutouyrie P, Perier MC, Guibout C, Thomas F, Andrieu M, Bailly K, Vedie B, Danchin N, Jouven X, Bouchard P, Empana JP. Poor Masticatory Capacity and Blood Biomarkers of Elevated Cardiovascular Disease Risk in the Community: The Paris Prospective Study III. Arterioscler Thromb Vasc Biol 2021; 41:2225-2232. [PMID: 34039017 DOI: 10.1161/atvbaha.121.316085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Eirini Chatzopoulou
- Department of Periodontology, Université de Paris, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7 - UFR Odontologie-Garancière, France (E.C., H.R., P.B.).,Université de Paris, UR2496, France (E.C., H.R., P.B., P.B.)
| | - Hélène Rangé
- Department of Periodontology, Université de Paris, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7 - UFR Odontologie-Garancière, France (E.C., H.R., P.B.).,Université de Paris, UR2496, France (E.C., H.R., P.B., P.B.)
| | - Omar Deraz
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| | - Pierre Boutouyrie
- Department of Periodontology, Université de Paris, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7 - UFR Odontologie-Garancière, France (E.C., H.R., P.B.).,Université de Paris, UR2496, France (E.C., H.R., P.B., P.B.).,Université de Paris, INSERM U970, Cellular, molecular and pathophysiological mechanisms of heart failure, Paris, France (P.B.)
| | - Marie-Cécile Perier
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| | - Catherine Guibout
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| | - Frédérique Thomas
- Preventive and Clinical Investigation Center (IPC), Paris, France (F.T., N.D.)
| | - Muriel Andrieu
- Université de Paris, INSERM U1016, Cochin Institute, Platform CYBIO, Paris, France (M.A., K.B.)
| | - Karine Bailly
- Université de Paris, INSERM U1016, Cochin Institute, Platform CYBIO, Paris, France (M.A., K.B.)
| | - Benoît Vedie
- AP-HP, Department of biochemistry, Tissue and blood samples biobank, Georges Pompidou European Hospital, France (B.V.)
| | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France (F.T., N.D.)
| | - Xavier Jouven
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| | | | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Integrative Epidemiology of Cardiovascular Disease, France (O.D., M.-C.P., C.G., X.J., J.-P.E.)
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Parolini F, Biancalana E, Rossi C, Raggi F, Mengozzi A, Solini A. Clinical and epigenetic determinants of edentulism in type 2 diabetic subjects referring to a tertiary center. J Diabetes Complications 2021; 35:107910. [PMID: 33757716 DOI: 10.1016/j.jdiacomp.2021.107910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/12/2021] [Accepted: 03/09/2021] [Indexed: 12/21/2022]
Abstract
AIMS Edentulism, extreme consequence of severe periodontitis, carries a high cardiovascular and all-cause death risk. The prevailing phenotype of edentulous patients with type 2 diabetes (T2D) has never been defined, neither it is known whether an epigenetic signature of such condition exists. METHODS We collected clinical and biochemical data and administered a questionnaire on oral health in 248 consecutive T2D individuals. Vital status was checked after 17 ± 7 months. miRNAs involved in periodontal inflammation were measured. RESULTS Forty-seven patients (19%) were edentulous (ED), a higher prevalence than in the Italian general population (10.9% from ISTAT data). ED were older, with low level of instruction and higher fasting glucose vs not edentulous (noED). Participants displayed a scarce awareness of the association periodontitis-T2D. ED showed a specific epigenetic signature (lower miR214-5p and higher miR126-5p urinary levels). At the follow-up, metabolic profile similarly improved in ED and noED; death occurrence was similar. CONCLUSIONS In this cohort of T2D, age is the only variable associated with edentulism; such condition displays an epigenetic signature, independent of the clinical phenotype; awareness of the clinical relevance and implications of periodontitis and edentulism are scarce. However, edentulism does not mark an increased rate of micro-macrovascular complications or mortality.
Collapse
Affiliation(s)
- Federico Parolini
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Edoardo Biancalana
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Chiara Rossi
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Italy
| | - Francesco Raggi
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Italy
| | | | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Italy.
| |
Collapse
|
17
|
Badewy R, Singh H, Quiñonez C, Singhal S. Impact of Poor Oral Health on Community-Dwelling Seniors: A Scoping Review. Health Serv Insights 2021; 14:1178632921989734. [PMID: 33597810 PMCID: PMC7841244 DOI: 10.1177/1178632921989734] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022] Open
Abstract
The aim of this scoping review was to determine health-related impacts of poor oral health among community-dwelling seniors. Using MeSH terms and keywords such as elderly, general health, geriatrics, 3 electronic databases-Medline, CINAHL, and Age Line were searched. Title and abstracts were independently screened by 3 reviewers, followed by full-texts review. A total of 131 articles met our inclusion criteria, the majority of these studies were prospective cohort (77%, n = 103), and conducted in Japan (42 %, n = 55). These studies were categorized into 16 general health outcomes, with mortality (24%, n = 34), and mental health disorders (21%, n = 30) being the most common outcomes linked with poor oral health. 90% (n = 120) of the included studies reported that poor oral health in seniors can subsequently lead to a higher risk of poor general health outcomes among this population. Improving access to oral healthcare services for elderly can help not only reduce the burden of oral diseases in this population group but also address the morbidity and mortality associated with other general health diseases and conditions caused due to poor oral health. Findings from this study can help identify shortcomings in existing oral healthcare programs for elderly and develop future programs and services to improve access and utilization of oral care services by elderly.
Collapse
Affiliation(s)
- Rana Badewy
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
| | | | - Carlos Quiñonez
- Faculty of Dentistry, Director of
Graduate Program in Dental Public Health, University of Toronto, Toronto, ON,
Canada
| | - Sonica Singhal
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON,
Canada
| |
Collapse
|
18
|
Chewing Discomfort According to Dental Prosthesis Type in 12,802 Adults: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010071. [PMID: 33374152 PMCID: PMC7795035 DOI: 10.3390/ijerph18010071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/14/2022]
Abstract
This study examined the prevalence of self-perceived chewing discomfort depending on the type of dental prosthesis used in South Korean adults. The subjects were 12,802 people over 20 years of age who participated in a health interview and dental examination. Chewing discomfort was examined using a self-assessed report with a structured questionnaire. Using multivariable logistic regression analysis, adjusted odds ratios were evaluated along with their 95% confidence intervals (α = 0.05). After adjusting for covariates, including age, gender, smoking, drinking, hypertension, diabetes, body mass index, education, income, and toothbrushing frequency, the odds ratios (95% confidence intervals) for chewing discomfort in groups without a dental prosthesis, with fixed dental prostheses, with removable partial dentures, and with removable complete dentures were 1 (reference), 1.363 (1.213-1.532), 2.275 (1.879-2.753), and 2.483 (1.929-3.197), respectively. The association between the prevalence of chewing discomfort and the type of dental prosthesis used was statistically significant even after adjusting for various confounders (p < 0.0001). The type of dental prosthesis was related to chewing discomfort among South Korean adults.
Collapse
|
19
|
Ishikawa S, Konta T, Susa S, Ishizawa K, Togashi H, Ueno Y, Yamashita H, Kayama T, Iino M. Association between presence of 20 or more natural teeth and all-cause, cancer-related, and cardiovascular disease-related mortality: Yamagata (Takahata) prospective observational study. BMC Oral Health 2020; 20:353. [PMID: 33267797 PMCID: PMC7709387 DOI: 10.1186/s12903-020-01346-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/23/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Several studies have surveyed the relationship between the presence of ≥ 20 natural teeth and mortality. However, very few have evaluated this association over a long-term follow-up of more than ten years within a large population in Japan. This study aimed to prospectively confirm the associations between mortality and the presence of ≥ 20 natural teeth within a community-based population in Japan. METHODS A prospective observational study including 2208 participants aged ≥ 40 years was conducted in Takahata Town, Japan, between May 2005 and December 2016. All participants answered a self-administered questionnaire to provide their background characteristics, including their number of teeth. The participants were classified into two categories based on their self-reported number of teeth (< 20 and ≥ 20 teeth). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional-hazards regression model to assess risk factors for all-cause, cancer-, and cardiovascular disease-related mortality. RESULTS The total follow-up period was 131.4 ± 24.1 months (mean ± SD). After adjusting for covariates, the risk of all-cause mortality was significantly higher in the group with < 20 teeth than in those with ≥ 20 teeth (HR = 1.604, 95% CI 1.007-2.555, p = 0.047). However, the risk of cancer- and cardiovascular disease-related mortalities was not statistically significant between the two groups. CONCLUSION In this study, participants with < 20 teeth had a significantly higher risk of all-cause mortality, although the difference was borderline significant. These results emphasize the importance of having ≥ 20 natural teeth for a healthy life expectancy.
Collapse
Affiliation(s)
- Shigeo Ishikawa
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan.
| | - Tsuneo Konta
- Department of Public Health and Hygiene, Yamagata University Graduate School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Shinji Susa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan.,Global Center of Excellence, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Hitoshi Togashi
- Yamagata University Health Administration Centre, 1-4-12 kojirakawa-machi, Yamagata, 990-8560, Japan
| | - Yoshiyuki Ueno
- Global Center of Excellence, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Hidetoshi Yamashita
- Global Center of Excellence, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Takamasa Kayama
- Global Center of Excellence, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| |
Collapse
|
20
|
Aldossri M, Farmer J, Saarela O, Rosella L, Quiñonez C. Oral Health and Cardiovascular Disease: Mapping Clinical Heterogeneity and Methodological Gaps. JDR Clin Trans Res 2020; 6:390-401. [PMID: 32886582 DOI: 10.1177/2380084420953121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Numerous studies have examined the associations between poor oral health and the incidence of cardiovascular disease (CVD) over the past 25 y. This long history of research has resulted in a broad and heterogenous epidemiological field whose implications are difficult to understand and whose methodological gaps are hard to track. OBJECTIVES This systematic mapping review aims to systematically map clinical heterogeneity and methodological gaps in assessing the relationship between poor oral health and CVD outcomes. METHODS Medline, Embase, and Cochrane Library were searched to identify longitudinal studies that examined the relationship between any oral health indicator and CVD outcomes. Each database was searched from its inception date and June 27, 2018. Extracted data assess the clinical heterogeneity (participants' characteristics, exposure and outcome measures, length of follow-up) and methodological gaps (availability of randomized controlled trials, utilization of time-varying exposures, propensity methods, mediation analysis, and competing risks analysis). RESULTS Eighty-five studies met the inclusion criteria. Clinical heterogeneity is evident in participants' characteristics (age, clinical status, and occupation) and in the definitions of oral health indicators and CVD outcomes. More important, a significant proportion of studies reported unclear definitions for CVD outcomes. The search strategy did not reveal any randomized controlled trials. Time-varying exposures, propensity methods, mediation analysis, and competing risks analysis are used infrequently in the identified studies. CONCLUSION There is a need for a universally accepted conceptual framework on the association between oral health and CVD to derive more consistent definitions for oral health and CVD outcomes that are aligned with the investigated research questions. There is also a need to use emerging research methods to maximize the impact of research in this area. KNOWLEDGE TRANSFER STATEMENT Clinical heterogeneity is evident in the definitions of oral health indicators and cardiovascular disease outcomes. Propensity methods, mediation analysis, and competing risks analysis are used infrequently in the identified studies. The identified clinical heterogeneity and methodological gaps interfere with summarizing existing evidence and understanding their practical implications. Advancing the current understanding of the associations between oral health and cardiovascular disease goes hand in hand with minimizing clinical heterogeneity and closing the identified methodological gaps.
Collapse
Affiliation(s)
- M Aldossri
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - J Farmer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - O Saarela
- Division of Biostatistics, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - L Rosella
- Division of Epidemiology, Dalla Lana School of Public Health, Toronto, ON, Canada.,Populations & Public Health Research Program, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Research and Ethics Program, Public Health Ontario, Toronto, ON, Canada
| | - C Quiñonez
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Populations & Public Health Research Program, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Division of Clinical Public Health, Dalla Lana School of Public Health, Toronto, ON, Canada
| |
Collapse
|
21
|
Nomura Y, Kakuta E, Okada A, Otsuka R, Shimada M, Tomizawa Y, Taguchi C, Arikawa K, Daikoku H, Sato T, Hanada N. Effects of self-assessed chewing ability, tooth loss and serum albumin on mortality in 80-year-old individuals: a 20-year follow-up study. BMC Oral Health 2020; 20:122. [PMID: 32316955 PMCID: PMC7175538 DOI: 10.1186/s12903-020-01113-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/13/2020] [Indexed: 12/16/2022] Open
Abstract
Background The association between dental status and mortality in community-dwelling older adults has been documented by several studies. The aim of this study was to analyze the contribution of self-assessed chewing ability, number of remaining teeth and serum albumin levels to mortality and the interactions between the three factors. Methods A 20-year follow-up study was conducted with 666 subjects aged 80 years (from 1996 to 2017) who resided in the 8 areas served by one health center in Iwate Prefecture. Health check-ups including physical fitness measurements were conducted at a meeting place or gymnasium. Medical interview and blood sampling were conducted by physician. Oral examination was examined by dentist. The number of remaining teeth, serum albumin levels, and self-assessed chewing ability were used as predictors of mortality. Results Among the 608 subjects (233 men and 375 women) included in this study, only 12 subjects (1.97%) survived after 20 years of follow-up. For men, dental status and serum levels of albumin were significantly associated with mortality. The hazard ratios of self-assessed chewing ability calculated by item response theory analysis and the inability to chew at least one food adjusted for serum albumin and tooth conditions were statistically significant in men. When adjusted by health status evaluated by blood tests, self-assessed chewing ability was statistically significant in men. According to path analysis, self-assessed chewing ability and serum albumin independently affected mortality in men. Conclusion Masticatory dysfunction may be an important risk factor for mortality in men, even though it was self-assessed. Retaining chewing ability might be a useful predictor of longevity in older male adults.
Collapse
Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
| | - Erika Kakuta
- Department of Oral bacteriology, Tsurumi University School of Dental Medicine, Kanagawa, Japan
| | - Ayako Okada
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Ryoko Otsuka
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Mieko Shimada
- Chiba Prefecture University of Health Sciences, Chiba, Japan
| | - Yasuko Tomizawa
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Chieko Taguchi
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | - Kazumune Arikawa
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | | | | | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| |
Collapse
|
22
|
Watanabe Y, Okada K, Kondo M, Matsushita T, Nakazawa S, Yamazaki Y. Oral health for achieving longevity. Geriatr Gerontol Int 2020; 20:526-538. [PMID: 32307825 DOI: 10.1111/ggi.13921] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/02/2020] [Accepted: 03/16/2020] [Indexed: 01/10/2023]
Abstract
Oral frailty is defined as a decrease in oral function accompanied by a decrease in mental and physical functions. Studies showing that people with oral frailty are at high risk of physical frailty, sarcopenia, severe conditions requiring nursing care and death have been reported in Japan. An increase in life expectancy and maintenance of teeth result in a decrease in the effect of the number of teeth. In contrast, a decrease in oral function as a result of aging has been suggested to have major effects on dysfunction and mortality risk. The present report is a narrative review of major clinical studies on the relationships of the number of teeth, dentures, occlusion and oral function with longevity, with the aim of providing information for future studies centered on oral function in Japan or overseas. This review clearly shows the relationships of the number of teeth, dentures, and occlusion with health and longevity. Recent studies have shown that, besides maintenance of the number of teeth, attempting to maintain or increase oral function, having a good diet and maintaining nutritional status are all linked to general health. Decreased oral function is a major risk factor for developing malnutrition and sarcopenia. Oral frailty, a new concept that has been recently introduced in Japan, is considered to have major effects on dental and oral health policies in Japan, in the old-age group, and is expected to be reflected in the dental and oral health policies of various countries, as they also predict increased life expectancies. Geriatr Gerontol Int 2020; ••: ••-••.
Collapse
Affiliation(s)
- Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kazutaka Okada
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Miyako Kondo
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Takae Matsushita
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Seitaro Nakazawa
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| |
Collapse
|
23
|
Lee HJ, Choi EK, Park JB, Han KD, Oh S. Tooth Loss Predicts Myocardial Infarction, Heart Failure, Stroke, and Death. J Dent Res 2020; 98:164-170. [PMID: 30782090 DOI: 10.1177/0022034518814829] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We investigated whether oral health, represented by missing teeth, was associated with an increased risk of cardiovascular disease, including myocardial infarction (MI), heart failure (HF), stroke, and all-cause mortality. Subjects who underwent routine dental examinations and health checkups provided by the Korean National Health Insurance from 2007 to 2008 ( n = 4,440,970) were followed up for incident MI, HF, stroke, and death until 2016. During follow-up of 7.56 y, 68,063 (1.5%) subjects died, and 31,868 (0.7%) were admitted for MI, 22,637 (0.5%) for HF, and 30,941 (0.7%) for stroke. Cardiovascular events and mortality increased in proportion to tooth loss. Tooth loss was an independent risk factor for cardiovascular events after multivariable analysis adjusted for cardiovascular risk, behavioral, and income factors. Each missing tooth was associated with an approximately 1% increase in MI (HR, 1.010; 95% CI, 1.007 to 1.014), 1.5% increase in HF (HR, 1.016; 95% CI, 1.013 to 1.019) and stroke (HR, 1.015; 95% CI, 1.012 to 1.018), and 2% increase in mortality (HR, 1.022; 95% CI, 1.020 to 1.023). Having ≥5 missing teeth substantially increased risk for cardiovascular outcomes, and even a small number of missing teeth (1 to 4) was associated with an increased risk for MI, stroke, and death. This association was consistent in subgroup analyses and especially strong among the younger subjects (age <65 y) and those with periodontitis. In this large Korean nationwide cohort study, we found that tooth loss showed a dose-dependent association with incident MI, HF, ischemic stroke, and all-cause death and was a good predictor of cardiovascular outcome. In clinical practice, the number of missing teeth can aid physicians in discriminating patients with a higher cardiovascular risk.
Collapse
Affiliation(s)
- H J Lee
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - E K Choi
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - J B Park
- 2 Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K D Han
- 3 Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S Oh
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| |
Collapse
|
24
|
Darnaud C, Thomas F, Danchin N, Boutouyrie P, Bouchard P. Masticatory Capacity and Mortality: The Preventive and Clinical Investigation Center (IPC) Cohort Study. J Dent Res 2019; 99:152-158. [PMID: 31765573 DOI: 10.1177/0022034519889021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Poor oral health (OH) has been associated with mortality, but the association between OH components and mortality remains imprecise. The present observational study aimed to investigate if there is an association between oral masticatory efficiency and cardiovascular (CV) mortality in a large French subject cohort. The study was based on a cohort of 85,830 subjects aged between 16 and 94 y at recruitment. The follow-up extended from 2001 to 2014 and the mean follow-up was 8.06 ± 2.73 y. The number of deaths totaled 1,670. Full-mouth examinations were performed. Dental plaque, dental calculus, gingival inflammation, missing teeth, and masticatory units were recorded. Masticatory units represent the number of natural or prosthetic opposing premolars and molar pairs and can be considered an accurate indicator for masticatory efficiency. Causes of death were ascertained from death certificates. Cox regression analyses were used to calculate hazard ratios (HRs). In the fully adjusted model, the number of masticatory units <5 is associated with an HR of 1.72 (95% confidence interval [CI], 1.54 to 1.91) for all-cause mortality, HR of 1.41 (95% CI, 1.01 to 1.99) for CV mortality, HR of 1.76 (95% CI, 1.44 to 2.15) for cancer mortality, and HR of 1.85 (95% CI, 1.55 to 2.20) for non-CV and noncancer mortality. Significant statistical associations with the other oral variables were also found for all-cause mortality, cancer mortality, and non-CV and noncancer mortality in the adjusted models. Our study indicates that after full adjustment, all oral parameters are associated with all-cause, cancer, and non-CV and noncancer mortality. However, the low number of masticatory units is associated with an increased risk of CV mortality. We highlight the association of masticatory units and CV mortality.
Collapse
Affiliation(s)
- C Darnaud
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7, Denis Diderot University, U.F.R. of Odontology, Paris, France.,Paris Cardiovascular Research Center, UMR-S970, Department of Epidemiology, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | - N Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France.,Department of Cardiology, Georges Pompidou European Hospital, AP-HP, Paris 5, Descartes University, Medicine Faculty, Paris, France
| | - P Boutouyrie
- Paris Cardiovascular Research Center, UMR-S970, Department of Epidemiology, Paris, France.,Paris Descartes, Sorbonne Paris Cité University, Medicine Faculty, Paris, France.,Paris 5, Descartes University, AP-HP, Georges Pompidou European Hospital, INSERM U970, Pharmacology Department, Paris, France
| | - P Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7, Denis Diderot University, U.F.R. of Odontology, Paris, France.,EA 2496, Paris 5, Descartes University, U.F.R. of Odontology, Paris, France
| |
Collapse
|
25
|
The relationship between tooth loss and mortality from all causes, cardiovascular diseases, and coronary heart disease in the general population: systematic review and dose-response meta-analysis of prospective cohort studies. Biosci Rep 2019; 39:BSR20181773. [PMID: 30530864 PMCID: PMC6328868 DOI: 10.1042/bsr20181773] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/12/2018] [Accepted: 11/26/2018] [Indexed: 12/20/2022] Open
Abstract
Background: The association of tooth loss with mortality from all causes, cardiovascular diseases (CVD), and coronary heart disease (CHD) has been studied for many years; however, the results are inconsistent. Method: PubMed, Embase, Web of Knowledge, and Cochrane Oral Health Group’s Trials Register databases were searched for papers published from 1966 to August 2018. We conducted dose–response meta-analysis to quantitatively evaluate the relation between tooth loss and risk of mortality from all causes, CVD, and CHD. Results: In the present study, 18 prospective studies conducted until August 2018 were considered eligible for analysis. In the analysis of linear association, the summarized relative risk (RR) values for each 10-, 20-, and 32-tooth loss for all-cause mortality were 1.15 (1.11–1.19), 1.33 (1.23–1.29), and 1.57 (1.39–1.51), respectively. Subgroup and sensitivity analyses showed consistent results. A linear relationship was found among all-cause mortality, with Pnonlinearity = 0.306. The susceptibility to all-cause mortality increased by almost 1.48 times at very high tooth loss (28–32), and slight flattening of the curve was noted. However, the summarized RR values for increment for 10-, 20-, and 32-tooth loss were not or were marginally related to increased risk of mortality from CVD/CHD. Subgroup and sensitivity analyses revealed inconsistent results. Tooth loss showed linear association with CHD mortality but not with CVD mortality. The susceptibility to all-cause mortality increased by almost 1.48 and 1.70 times for CVD and CHD, respectively, at very high tooth loss (28–32). The curve exhibited slight flattening; however, no statistical significance was detected. Conclusion: In the meta-analysis, our findings confirmed the positive relationship between tooth loss and susceptibility to all-cause mortality, but not for circulatory mortality. However, the finding that tooth loss might play a harmful role in the development of all-cause mortality remains inconclusive. Tooth loss may be a potential risk marker for all-cause mortality: however, their association must be further validated through large prospective studies.
Collapse
|
26
|
Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
Collapse
Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
| |
Collapse
|
27
|
Chen MY. Misperception of Oral Health among Adults in Rural Areas: A Fundamental but Neglected Issue in Primary Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102187. [PMID: 30301250 PMCID: PMC6211001 DOI: 10.3390/ijerph15102187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 09/30/2018] [Accepted: 10/02/2018] [Indexed: 11/27/2022]
Abstract
Background: Poor oral hygiene is associated with metabolic syndrome, systemic diseases, mortality and many chronic diseases. Misperception means a wrong or incorrect understanding or interpretation. Few studies have examined the subjective perception and objective condition of oral health among community adults in rural areas. Methods: This was a cross-sectional, community-based study. Participants were recruited via convenience samples from December 2015 to July 2016. One thousand six (1006) community residents participated in the project, of which 973 fulfilled the inclusion criteria. The average age was 42.8 (SD = 12.3) years, range 20–64, selected from a collaboration local hospital. Results: Most of the participants reported brushing their teeth every day, however, 72% reported seldom brushing their teeth after meals, 54% seldom used dental floss, 64% seldom received dental scaling, 29.5% had experienced a toothache within 6 months, and 30.5% demonstrated significant tooth loss. However, most of them perceived their oral health as good. Misperception of oral health was common, 21.5% among whose number of remaining teeth <25 under-assess their actual oral health. The more number of remaining teeth (p < 0.001) and regular dental check-up (p < 0.01) were positively associated with feeling good about their oral health. After adjusting for potential confounders, clinically significant findings indicated that number of remaining teeth (OR = 3.03, p < 0.001), age (OR = 0.99, p < 0.001), regular dental check-ups/scaling (OR = 1.85, p < 0.001), education (OR = 1.45, p < 0.05), and water consumption (OR = 1.38, p < 0.05) were independently associated with good perceived oral health. Conclusions: The findings showed that subjective self-perception of oral health was not matched with their objective oral condition. Excluding the unmodifiable factors, the clinical implications indicated that oral health promotion programs, particularly for adopting regular dental check-up, healthy diet and oral hygiene habits are urgent in rural areas.
Collapse
Affiliation(s)
- Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi 613, Taiwan.
- Department of Nursing, Chang Gung University, Taoyuan 333, Taiwan.
- Department of Cardiology, Chang Gung Memorial Hospital, Yunlin 638, Taiwan.
| |
Collapse
|
28
|
Cheng F, Zhang M, Wang Q, Xu H, Dong X, Gao Z, Chen J, Wei Y, Qin F. Tooth loss and risk of cardiovascular disease and stroke: A dose-response meta analysis of prospective cohort studies. PLoS One 2018; 13:e0194563. [PMID: 29590166 PMCID: PMC5874035 DOI: 10.1371/journal.pone.0194563] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 03/06/2018] [Indexed: 12/16/2022] Open
Abstract
Conflicting results identifying the association between tooth loss and cardiovascular disease and stroke have been reported. Therefore, a dose-response meta-analysis was performed to clarify and quantitatively assess the correlation between tooth loss and cardiovascular disease and stroke risk. Up to March 2017, seventeen cohort studies were included in current meta-analysis, involving a total of 879084 participants with 43750 incident cases. Our results showed statistically significant increment association between tooth loss and cardiovascular disease and stroke risk. Subgroups analysis indicated that tooth loss was associated with a significant risk of cardiovascular disease and stroke in Asia and Caucasian. Furthermore, tooth loss was associated with a significant risk of cardiovascular disease and stroke in fatal cases and nonfatal cases. Additionally, a significant dose-response relationship was observed between tooth loss and cardiovascular disease and stroke risk. Increasing per 2 of tooth loss was associated with a 3% increment of coronary heart disease risk; increasing per 2 of tooth loss was associated with a 3% increment of stroke risk. Subgroup meta-analyses in study design, study quality, number of participants and number of cases showed consistent findings. No publication bias was observed in this meta-analysis. Considering these promising results, tooth loss might provide harmful health benefits.
Collapse
Affiliation(s)
- Fei Cheng
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Mi Zhang
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Quan Wang
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Haijun Xu
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Xiao Dong
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Zhen Gao
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jiajuan Chen
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yunjie Wei
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Fen Qin
- Department of Obstetrics and Gynecology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| |
Collapse
|
29
|
Gupta A, Felton DA, Jemt T, Koka S. Rehabilitation of Edentulism and Mortality: A Systematic Review. J Prosthodont 2018; 28:526-535. [DOI: 10.1111/jopr.12792] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Avni Gupta
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical SchoolHarvard T.N. Chan School of Public Health Boston MA
| | - David A. Felton
- School of Dentistry at the University of Mississippi Medical Center Jackson MS
| | - Torsten Jemt
- Department of Prosthetic Dentistry/Dental Material ScienceInstitute of Odontology, Sahlgrenska Academy at Göteborg University Göteborg Sweden
- Brånemark Clinic, Public Dental Health ServiceRegion of Västra Götaland Sweden
| | - Sreenivas Koka
- Department of ProsthodonticsLoma Linda University Loma Linda CA
- Department of Restorative DentistryUCLA Los Angeles CA
- Private practice limited to removable and implant prosthodonticsKoka Dental Clinic San Diego CA
| |
Collapse
|
30
|
Merchant AT, Virani SS. Evaluating Periodontal Treatment to Prevent Cardiovascular Disease: Challenges and Possible Solutions. Curr Atheroscler Rep 2018; 19:4. [PMID: 28120314 DOI: 10.1007/s11883-017-0640-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Periodontal disease is correlated with cardiovascular disease (CVD) in observational studies, but a causal connection has not been established. The empirical evidence linking periodontal disease and CVD consists of a large body of observational and mechanistic studies, but a limited number of clinical trials evaluating the effects of periodontal treatment on surrogate CVD endpoints. RECENT FINDINGS No randomized controlled trial has been conducted to evaluate the effect of periodontal treatment on CVD risk. In this review, we have summarized these data, described possible biological mechanisms linking periodontal disease and CVD, discussed barriers to conducting a randomized controlled trial to evaluate this hypothesis, and provided an alternative analytical approach using causal inference methods to answer the question. The public health implications of addressing this question can be significant because periodontal disease is under-treated, and highly prevalent among adults at risk of CVD. Even a small beneficial effect of periodontal treatment on CVD risk can be important.
Collapse
Affiliation(s)
- Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA. .,WJB Dorn VA Medical Center, Columbia, SC, USA.
| | - Salim S Virani
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
31
|
Miquel S, Aspiras M, Day JEL. Does reduced mastication influence cognitive and systemic health during aging? Physiol Behav 2018; 188:239-250. [PMID: 29452151 DOI: 10.1016/j.physbeh.2018.02.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 02/03/2018] [Accepted: 02/10/2018] [Indexed: 12/27/2022]
Abstract
There is a growing body of literature which suggests that oral health and mastication can influence cognitive and systemic health during aging. However, it is currently unclear whether oral health, masticatory efficiency, cognitive health and systemic health merely deteriorate independently with age, or whether mechanisms exist linking mastication to cognitive and systemic health directly. The aim of this paper is to review the extent to which reduced mastication influences cognitive and systemic health during aging because this knowledge may underpin future interventions that improve quality of life. Current evidence suggests that a deterioration in mastication and oral health during aging can have: 1) direct effects on systemic health through mechanisms such as the migration of the oral microbiota into the systemic environment, and 2) indirect effects on systemic health through changes nutrient intake. A loss of teeth and reduction in masticatory efficiency during aging can have: 1) direct effects on cognitive performance and potentially impact cognitive health through mechanisms such as enhanced adult hippocampal neurogenesis, and 2) indirect effects on cognitive health through changes in nutrient intake. It is concluded that oral health and masticatory efficiency are modifiable factors which influence the risk poor cognitive and systemic health during aging, although it is currently premature to propose chewing-based interventions to slow the rate of cognitive decline and improve cognitive health during aging. Future research should include large-scale longitudinal studies which control for the types of confounding factors which concurrently influence the association between mastication and cognitive and systemic health.
Collapse
Affiliation(s)
- Sophie Miquel
- Mars Wrigley Confectionery, 1132 West Blackhawk Street, Chicago, IL 60642, USA.
| | - Marcelo Aspiras
- Mars Wrigley Confectionery, 1132 West Blackhawk Street, Chicago, IL 60642, USA
| | - Jon E L Day
- Cerebrus Associates, The White House, 2 Meadrow, Godalming, Surrey GU7 3HN, United Kingdom
| |
Collapse
|
32
|
Sato Y, Kitagawa N, Isobe A. Implant treatment in ultra-aged society. JAPANESE DENTAL SCIENCE REVIEW 2018; 54:45-51. [PMID: 29755614 PMCID: PMC5944061 DOI: 10.1016/j.jdsr.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 10/23/2017] [Accepted: 12/09/2017] [Indexed: 11/17/2022] Open
Abstract
Implant therapy is gaining presence as a prosthodontic treatment option. However, the graying of the population has led to an increase in the number of older adults requiring special consideration in implant treatment because of their systemic health problems. Additionally, with the growth of the elderly population in need of long-term care, a greater number of older adults who have received implant treatment are receiving long-term care, raising various issues that need to be addressed. In the present review article, we describe the significance of implant treatment in older adults, issues when performing implant treatment in geriatric patients, and measures to be taken when implant patients have lapsed into a state of requiring long-term care. In addition, in view of population aging, we propose an approach for applying implant treatment to older adults. This approach includes using an appropriate type of implant system depending on the remaining life expectancy and the patient's general condition, performing less invasive surgery, providing treatment using prosthetic appliances that are easy to manage and can be modified, and ensuring oral health management by providing an Implant Card to patients when the treatment is completed.
Collapse
Affiliation(s)
- Yuji Sato
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1, Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Noboru Kitagawa
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1, Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Akio Isobe
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1, Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| |
Collapse
|
33
|
Impact of prosthodontic rehabilitation on the masticatory performance of partially dentate older patients: Can it predict nutritional state? Results from a RCT. J Dent 2018; 68:66-71. [DOI: 10.1016/j.jdent.2017.11.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 01/14/2023] Open
|
34
|
Al-Harbi F, El Tantawi M. Normative prosthodontic care need: does it impact the daily life of young Saudis with high level of oral diseases? A cross sectional study. BMC Oral Health 2017; 17:128. [PMID: 29061111 PMCID: PMC5653980 DOI: 10.1186/s12903-017-0418-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Assessing the need for prosthodontic care previously included older age groups. There is less information about younger populations who may need this care because of high disease levels. The aim of this study was to assess the normative need for prosthodontic care in a young Saudi population with high oral disease levels, the associated factors and its impact on daily life. METHODS A cross sectional study included Saudi adults in the Eastern Province in 2016. A questionnaire was used to assess personal background (confounders), risk factors affecting oral diseases (exposures) and the impact of oral problems on daily life. A clinical examination assessed tooth loss, the presence of prosthodontic appliances, the presence of untreated decay and need for periodontal care. Directed acyclic graphs identified the confounders to be included in regression models with separate outcomes: normative need for prosthodontic care (binary logistic model) and impact on 6 daily life aspects (ordinal regression models). RESULTS Complete data were available for 574/ 700 = 82% and 46.7% needed prosthodontic care with 2 lost teeth on average among adults of mean age = 33.2 years. The confounders controlled for the need for prosthodontic care included socioeconomic status (SES), dental visits last year and health insurance. The confounders for the impact on daily life included age and SES. In adjusted models, normative need for prosthodontic care was significantly associated with untreated decay (OR = 2.09, 95% C.I. = 1.37, 3.19). The impact on daily life was not significantly associated with prosthodontic care need but with untreated decay, especially sleeplessness (regression coefficient = 0.53, 95% C.I. = 0.02, 1.04) and dropping daily activities (regression coefficient = 0.79, 95% C.I. = 0.13, 1.46). In addition, the need for periodontal care was associated with food avoidance (regression coefficient = 0.73, 95% C.I. = 0.28, 1.18). CONCLUSIONS In Saudi adults in the Eastern Province, there was a considerable normative need for prosthodontic care due to untreated decay. The impact on daily life was related to the underlying oral diseases rather than the need for prosthodontic care itself.
Collapse
Affiliation(s)
- Fahad Al-Harbi
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O.Box 1982, Dammam, 31441, Saudi Arabia
| | - Maha El Tantawi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O.Box 1982, Dammam, 31441, Saudi Arabia.
| |
Collapse
|
35
|
Koka S, Gupta A. Association between missing tooth count and mortality: A systematic review. J Prosthodont Res 2017; 62:134-151. [PMID: 28869174 DOI: 10.1016/j.jpor.2017.08.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 06/29/2017] [Accepted: 08/04/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this review was to analyze existing literature on the relationship between tooth count and mortality by evaluating the findings in the context of methodological variations. We aimed at addressing the question of whether preserving natural teeth can impact mortality. STUDY SELECTION PubMed, Web of Science and CINAHL databases were systematically searched using various combinations of related and synonymous keywords for "tooth count" and "mortality". The references of included articles were also evaluated for inclusion. Overall 49 studies found to be eligible were critically evaluated and their key findings were summarized. RESULTS Studies were conducted in various continents and differed substantially in regards to their sample size, population, methodology, the definition of the tooth count variable, the confounders as well as the mediators accounted for in the analysis. Follow-up period ranged from 1 to 56 years. CONCLUSIONS Although high variability in the studies precludes a definite conclusion about the relationship between number of teeth and mortality, the overall finding from this review is that reduced tooth count is associated with higher mortality. However the impact of factors such as smoking, health-care access, baseline co-morbidity and risk profile, dental and periodontal health, the presence of dental prosthesis as well as socio-economic status, in mediating whole or part of the association cannot be overlooked and needs further investigation using more standard methodologies. Any differences in males vs. females, as well as among different age groups, will also need further consideration in the future studies.
Collapse
Affiliation(s)
- Sreenivas Koka
- Clinical Professor, Advanced Prosthodontics, Loma Linda University, Loma Linda, USA; Interim Chair, Restorative Dentistry, UCLA, Los Angeles, USA; Private Practice Limited to Removable and Implant Prosthodontics, Koka Dental Clinic, San Diego, USA
| | - Avni Gupta
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Harvard T.N. Chan School of Public Health, One Brigham Circle, 1620 Tremont Street 4-020, Boston, MA 02120, USA.
| |
Collapse
|
36
|
Bidinotto AB, D'Ávila OP, Martins AB, Hugo FN, Neutzling MB, Bairros FDS, Hilgert JB. Oral health self-perception in quilombola communities in Rio Grande do Sul: a cross-sectional exploratory study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20:91-101. [PMID: 28513797 DOI: 10.1590/1980-5497201700010008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/08/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: There's a shortage of evidence on the oral health of quilombolas. This study aims to describe oral health self-perception, as well as to verify its associated factors in quilombola communities in the state of Rio Grande do Sul. Methods: The data for this cross-sectional health survey were collected by application of a questionnaire. Since this study was part of a survey on nutritional security, the probabilistic cluster sample was estimated for the outcome of nutritional insecurity, comprising 583 individuals across quilombola communities in Rio Grande do Sul. The association between the outcome of negative oral health self-perception and sociodemographic, general health, and oral health variables was measured by prevalence ratios obtained through Poisson regressions with robust variance and 95% confidence intervals. Results: Negative self-rated oral health was reported by 313 (53.1%) of the individuals. Satisfaction with chewing ability and satisfaction with oral appearance were associated with a higher prevalence of negative perception of oral health, while there was no association between the outcome and number of teeth. Use of alcohol had a borderline association with the outcome. Conclusion: Satisfaction with appearance and chewing ability are factors associated with oral-health self-perception of the quilombolas in Rio Grande do Sul.
Collapse
Affiliation(s)
- Augusto Bacelo Bidinotto
- Programa de Pós-graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Otávio Pereira D'Ávila
- Programa de Pós-graduação em Odontologia da Universidade Federal de Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Aline Blaya Martins
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Fernando Neves Hugo
- Centro de Pesquisa em Odontologia Social da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Marilda Borges Neutzling
- Programa de Pós-graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Fernanda de Souza Bairros
- Programa de Pós-graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Juliana Balbinot Hilgert
- Programa de Pós-graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| |
Collapse
|
37
|
Han DH, Khang YH. Lifecourse socioeconomic position indicators and tooth loss in Korean adults. Community Dent Oral Epidemiol 2016; 45:74-83. [DOI: 10.1111/cdoe.12262] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/07/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry; Seoul National University School of Dentistry; Seoul South Korea
- Dental Research Institute; Seoul National University; Seoul South Korea
| | - Young-Ho Khang
- Department of Health Policy and Management; Seoul National University College of Medicine; Seoul South Korea
- Institute of Health Policy and Management; Seoul National University Medical Research Center; Seoul South Korea
| |
Collapse
|
38
|
Kebede T, Holtfreter B, Kocher T, Meisel P, Dietrich T, Biffar R, Dörr M, Völzke H, Pink C. Association of Periodontal Destruction and Diabetes with Mortality. J Dent Res 2016; 96:56-63. [DOI: 10.1177/0022034516668839] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- T.G. Kebede
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - B. Holtfreter
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - T. Kocher
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - P. Meisel
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - T. Dietrich
- Department of Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK
| | - R. Biffar
- Department of Prosthodontics, Gerodontolgy and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - M. Dörr
- DZHK (German Center for Cardiovascular Research), Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - H. Völzke
- Institute for Community Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - C. Pink
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| |
Collapse
|
39
|
Schwahn C, Mundt T, Biffar R. Letter to the Editor: "Directed Acyclic Graphs for Oral Disease Research". J Dent Res 2016; 95:1314. [PMID: 27651432 DOI: 10.1177/0022034516659871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- C Schwahn
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University of Greifswald, Greifswald, Germany
| | - T Mundt
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University of Greifswald, Greifswald, Germany
| | - R Biffar
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University of Greifswald, Greifswald, Germany
| |
Collapse
|
40
|
Matsui D, Yamamoto T, Nishigaki M, Miyatani F, Watanabe I, Koyama T, Ozaki E, Kuriyama N, Kanamura N, Watanabe Y. Validity of self-reported number of teeth and oral health variables. BMC Oral Health 2016; 17:17. [PMID: 27422287 PMCID: PMC4947278 DOI: 10.1186/s12903-016-0248-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 07/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral condition and number of teeth were investigated by questionnaire in the Japan Multi-Institutional Collaborative Cohort (J-MICC Study). The aim of the present study was to assess the validity of the tooth number measure by comparing the self-reported number of teeth with the number of teeth determined at clinical dental examination. METHODS A self-administered questionnaire and dental examination were performed by 1275 participants of a company medical examination who requested dental check-up and 377 subjects of the J-MICC study. The validity of the tooth number measure was assessed by comparing the self-reported number of teeth with that determined at clinical examination. Spearman's rank correlation coefficient was calculated to quantitatively evaluate the validity. RESULTS In males, the mean clinically-examined and self-reported numbers of teeth were 26.5 and 24.8 teeth, respectively. In females, the mean clinically-examined and self-reported numbers of teeth were 26.4 and 25.5 teeth, respectively. There was a tendency toward underestimation of the number of natural teeth by self-reporting. A significant correlation was observed between the clinically-examined and self-reported numbers of teeth in total (ρ = 0.69) and both males (ρ = 0.70) and females (ρ = 0.67). CONCLUSIONS The self-reported oral health variables were valid and reflected clinical status. Further revision of the question on the remaining tooth in the questionnaire improves the validity of self-reported number of teeth.
Collapse
Affiliation(s)
- Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan.
| | - Toshiro Yamamoto
- Department of Dental Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Masaru Nishigaki
- Department of Dental Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Fumitaro Miyatani
- Department of Dental Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Isao Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Narisato Kanamura
- Department of Dental Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Yoshiyuki Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-0841, Japan
| |
Collapse
|
41
|
Takeuchi K, Izumi M, Furuta M, Takeshita T, Shibata Y, Kageyama S, Ganaha S, Yamashita Y. Association between posterior teeth occlusion and functional dependence among older adults in nursing homes in Japan. Geriatr Gerontol Int 2016; 17:622-627. [DOI: 10.1111/ggi.12762] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/13/2016] [Accepted: 01/31/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health Growth and Development; Faculty of Dental Science Kyushu University; Fukuoka Fukuoka Japan
| | - Maya Izumi
- Section of Preventive and Public Health Dentistry, Division of Oral Health Growth and Development; Faculty of Dental Science Kyushu University; Fukuoka Fukuoka Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health Growth and Development; Faculty of Dental Science Kyushu University; Fukuoka Fukuoka Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health Growth and Development; Faculty of Dental Science Kyushu University; Fukuoka Fukuoka Japan
| | - Yukie Shibata
- Section of Preventive and Public Health Dentistry, Division of Oral Health Growth and Development; Faculty of Dental Science Kyushu University; Fukuoka Fukuoka Japan
| | - Shinya Kageyama
- Section of Preventive and Public Health Dentistry, Division of Oral Health Growth and Development; Faculty of Dental Science Kyushu University; Fukuoka Fukuoka Japan
| | - Seijun Ganaha
- Kizuna-kai, Aso-kizuna Dental Clinic; Aso Kumamoto Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health Growth and Development; Faculty of Dental Science Kyushu University; Fukuoka Fukuoka Japan
| |
Collapse
|
42
|
Pussinen PJ, Könönen E. Oral health: A modifiable risk factor for cardiovascular diseases or a confounded association? Eur J Prev Cardiol 2016; 23:834-8. [PMID: 26915578 DOI: 10.1177/2047487316636506] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
| | - Eija Könönen
- Department of Periodontology, Institute of Dentistry, University of Turku and City of Turku, Welfare Division, Turku, Finland
| |
Collapse
|
43
|
Tsai SJ, Lin MS, Chiu WN, Jane SW, Tu LT, Chen MY. Factors associated with having less than 20 natural teeth in rural adults: a cross-sectional study. BMC Oral Health 2015; 15:158. [PMID: 26654530 PMCID: PMC4676875 DOI: 10.1186/s12903-015-0147-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 12/03/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Some systematic reviews have consistently indicated a positive link between Metabolic syndrome, impairedfasting glucose, all-cause or circulatory disease-related mortality, general health, periodontitis, and toothloss. This study was to examine the prevalence of number of remaining teeth <20 and associated risk factors among adults in a rural area of Taiwan. METHODS A community-based, cross-sectional study was conducted in southwestern coastal Taiwan in 2013; 6680 residents aged 20-64 years were studied. Oral hygiene, substance use, dietary habits, and metabolic syndrome were explored as potential risk factors for number of remaining teeth <20 using logistic regression analysis. RESULTS The mean number of remaining teeth was 24.6 (SD = 7.4), and 16.3 % (n = 1085) of the participants had number of remaining teeth <20. Men had significantly less frequent use of dental floss, unhealthy dietary habits, more substance use and metabolic syndrome than did women (p <0.001). However, women tended to have fewer teeth than men (p <0.001). After adjusting for potential confounders, older age (odds ratio [OR] = 4.56, 95 % confidence interval [CI]: 3.74-5.55), female (OR = 1.88, 95 % CI: 1.56-2.25), less education (OR = 2.40, 95 % CI: 1.90-3.02), infrequent use of dental floss (OR = 1.94, 95 % CI: 1.66-2.27), substance use (OR = 1.32, 95 % CI: 1.09-1.59), and number of metabolic syndrome components (OR = 1.10, 95 % CI: 1.04-1.16) were independently associated with a higher risk of number of remaining teeth <20. CONCLUSIONS Number of remaining teeth <20 was highly prevalent among rural adults. In addition to unmodifiable factors, infrequent use of dental floss, substance use, and metabolic syndrome were risk factors associated with tooth loss.
Collapse
Affiliation(s)
- Su-Jen Tsai
- College of Nursing, Chang Gung University of Science and Technology, Taoyuan city, Taiwan, Republic of China.
| | - Ming-Shyan Lin
- Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin County, Taiwan, Republic of China.
| | - Wen-Nan Chiu
- Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin County, Taiwan, Republic of China.
| | - Su-Whi Jane
- Nursing Department, Chang Gung University of Science and Technology, Taoyuan city, Taiwan, Republic of China.
| | - Liang-Tse Tu
- Division of Dentistry, Chang Gung Memorial Hospital, Yunlin County, Taiwan, Republic of China.
| | - Mei-Yen Chen
- College of Nursing, Chang Gung University of Science and Technology, Taoyuan city, Taiwan, Republic of China.
| |
Collapse
|
44
|
Felton DA. Complete Edentulism and Comorbid Diseases: An Update. J Prosthodont 2015; 25:5-20. [PMID: 26371954 DOI: 10.1111/jopr.12350] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2015] [Indexed: 12/29/2022] Open
Abstract
The relationship between complete edentulism, which is the terminal outcome of a multifactorial oral disease process and other comorbid diseases, was first reported in 2009. Although the relationship between edentulism and a multitude of systemic diseases was reported, none of the publications studied could determine causality of tooth loss on the incidence of any comorbid disease. Since that publication, there has been a renewed interest in this relationship, and a plethora of new articles have been published. This article will provide an update on articles published since 2008 on the relationship between edentulism and comorbid diseases, and will include the relationship between complete edentulism and such comorbid conditions as malnutrition, obesity, cardiovascular disease, rheumatoid arthritis, pulmonary diseases (including chronic obstructive pulmonary disease), cancer, and even mortality.
Collapse
Affiliation(s)
- David A Felton
- Department of Restorative Dentistry, West Virginia University School of Dentistry, Morgantown, WV
| |
Collapse
|
45
|
Hu HY, Lee YL, Lin SY, Chou YC, Chung D, Huang N, Chou YJ, Wu CY. Association Between Tooth Loss, Body Mass Index, and All-Cause Mortality Among Elderly Patients in Taiwan. Medicine (Baltimore) 2015; 94:e1543. [PMID: 26426618 PMCID: PMC4616854 DOI: 10.1097/md.0000000000001543] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
To date, the effect of tooth loss on all-cause mortality among elderly patients with a different weight group has not been assessed. This retrospective cohort study evaluated the data obtained from a government-sponsored, annual physical examination program for elderly citizens residing in Taipei City during 2005 to 2007, and follow-up to December 31, 2010. We recruited 55,651 eligible citizens of Taipei City aged ≥ 65 years, including 29,572 men and 26,079 women, in our study. Their mortality data were ascertained based on the national death files. The number of missing teeth was used as a representative of oral health status. We used multivariate Cox proportional hazards regression analysis to determine the association between tooth loss and all-cause mortality. After adjustment for all confounders, the hazard ratios (HRs) of all-cause mortality in participants with no teeth, 1 to 9 teeth, and 10 to 19 teeth were 1.36 [95% confidence interval (CI): 1.15-1.61], 1.24 (95% CI: 1.08-1.42), and 1.19 (95% CI: 1.09-1.31), respectively, compared with participants with 20 or more teeth. A significant positive correlation of body mass index (BMI) with all-cause mortality was found in underweight and overweight elderly patients and was represented as a U-shaped curve. Subgroup analysis revealed a significant positive correlation in underweight (no teeth: HR = 1.49, 95% CI: 1.21-1.83; 1-9 teeth: HR = 1.23, 95% CI: 1.03-1.47; 10-19 teeth: HR = 1.20, 95% CI: 1.06-1.36) and overweight participants (no teeth: HR = 1.37, 95% CI: 1.05-1.79; 1-9 teeth: HR = 1.27, 95% CI: 1.07-1.52). The number of teeth lost is associated with an increased risk of all-cause mortality, particularly for participants with underweight and overweight.
Collapse
Affiliation(s)
- Hsiao-Yun Hu
- From the Institute of Public Health & Department of Public Health, National Yang Ming University, Taipei, Taiwan (H-YH, Y-LL, Y-JC, C-YW); Department of Education and Research, Taipei City Hospital, Taipei, Taiwan (H-YH, S-YL, Y-CC); Department of Dentistry, Taipei City Hospital, Taipei, Taiwan (Y-LL); Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan (Y-LL); College of Health Sciences: Public Health, University of California, Irvine, USA (DC); Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan (NH); and Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan (C-YW)
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Singh A, Peres MA, Peres KG, Bernardo CDO, Xavier A, D'Orsi E. Gender differences in the association between tooth loss and obesity among older adults in Brazil. Rev Saude Publica 2015; 49:44. [PMID: 26270016 PMCID: PMC4544688 DOI: 10.1590/s0034-8910.2015049005590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 04/17/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze if differences according to gender exists in the association between tooth loss and obesity among older adults. METHODS We analyzed data on 1,704 older adults (60 years and over) from the baseline of a prospective cohort study conducted in Florianopolis, SC, Southern Brazil. Multivariable logistic regression models were used to assess the association between tooth loss and general and central obesity after adjustment for confounders (age, gender, skin color, educational attainment, income, smoking, physical activity, use of dentures, hypertension, and diabetes). Linear regressions were also assessed with body mass index and waist circumference as continuous outcomes. Interaction between gender and tooth loss was further assessed. RESULTS Overall mean body mass index was 28.0 kg/m2. Mean waist circumference was 96.8 cm for males and 92.6 cm for females. Increasing tooth loss was positively associated with increased body mass index and waist circumference after adjustment for confounders. Edentates had 1.4 (95%CI 1.1;1.9) times higher odds of being centrally obese than individuals with a higher number of teeth; however, the association lost significance after adjustment for confounders. In comparison with edentate males, edentate females presented a twofold higher adjusted prevalence of general and central obesity. In the joint effects model, edentate females had a 3.8 (95%CI 2.2;6.6) times higher odds to be centrally obese in comparison with males with more than 10 teeth present in both the arches. Similarly, females with less than 10 teeth in at least one arch had a 2.7 (95%CI 1.6;4.4) times higher odds ratio of having central obesity in comparison with males with more than 10 teeth present in both the arches. CONCLUSIONS Central obesity was more prevalent than general obesity among the older adults. We did not observe any association between general obesity and tooth loss. The association between central obesity and tooth loss depends on gender – females with tooth loss had greater probability of being obese.
Collapse
Affiliation(s)
- Ankur Singh
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Marco Aurélio Peres
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | | | - Andre Xavier
- Centro de ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Eleonora D'Orsi
- Centro de ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| |
Collapse
|
47
|
Han DH, Khang YH, Choi HJ. Association of parental education with tooth loss among Korean Elders. Community Dent Oral Epidemiol 2015; 43:489-99. [PMID: 26012559 DOI: 10.1111/cdoe.12172] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 04/30/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE There are few reports showing an association between childhood socioeconomic circumstances and tooth loss among the elderly. The purpose of this study was (i) to examine the association between early childhood socioeconomic position (parental education level) and tooth loss and (ii) to determine the relative effects of the subjects' education level, occupation, and income on tooth loss in Korean elders. MATERIAL AND METHODS Data from the fourth and fifth Korea National Health and Nutritional Examination Survey on 8814 Korean elders (age ≥65 years) were analyzed. Demographic factors (age, survey year, marital status, and residence area), health behaviors (dental check-up during the past year and cigarette smoking), and the presence of a somatic health problem (diabetes) were included in our gender-specific analyses. Tooth loss was defined as edentulism or severe tooth loss (<20 teeth). For our analyses, chi-square test and Student's t-tests and multiple logistic regressions were performed. RESULTS A low parental education level was associated with elevated odds of edentulism (OR = 1.87 for father's education and 1.52 for mother's education among male elders and OR = 1.73 for father's education and 1.55 for mother's education among female elders) and with severe tooth loss (OR = 1.58 for father's education and 1.53 for mother's education among male elders and OR = 1.25 for father's education and 1.48 for mother's education among female elders). The association between parental education level and tooth loss was attenuated after adjusting for the subject's education level, occupation, and income. Relative magnitude of attenuation varied with personal factors (education > income > occupation). In a fully adjusted model, father's education level was significantly associated with edentate status (OR = 1.96 for male elders and 1.46 for female elders), but not with severe tooth loss. CONCLUSION Our results indicate that early life socioeconomic circumstances measured by the father's education level were independently associated with the edentate status of Korean elders.
Collapse
Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Young-Ho Khang
- Department of Health Policy and Management, Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Ho-Jun Choi
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea
| |
Collapse
|
48
|
Liljestrand J, Havulinna A, Paju S, Männistö S, Salomaa V, Pussinen P. Missing Teeth Predict Incident Cardiovascular Events, Diabetes, and Death. J Dent Res 2015; 94:1055-62. [DOI: 10.1177/0022034515586352] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Periodontitis, the main cause of tooth loss in the middle-aged and elderly, associates with the risk of atherosclerotic vascular disease. The objective was to study the capability of the number of missing teeth in predicting incident cardiovascular diseases (CVDs), diabetes, and all-cause death. The National FINRISK 1997 Study is a Finnish population–based survey of 8,446 subjects with 13 y of follow-up. Dental status was recorded at baseline in a clinical examination by a trained nurse, and information on incident CVD events, diabetes, and death was obtained via national registers. The registered CVD events included coronary heart disease events, acute myocardial infarction, and stroke. In Cox regression analyses, having ≥5 teeth missing was associated with 60% to 140% increased hazard for incident coronary heart disease events ( P < 0.020) and acute myocardial infarction ( P < 0.010). Incident CVD ( P < 0.043), diabetes ( P < 0.040), and death of any cause ( P < 0.019) were associated with ≥9 missing teeth. No association with stroke was observed. Adding information on missing teeth to established risk factors improved risk discrimination of death ( P = 0.0128) and provided a statistically significant net reclassification improvement for all studied end points. Even a few missing teeth may indicate an increased risk of CVD, diabetes, or all-cause mortality. When individual risk factors for chronic diseases are assessed, the number of missing teeth could be a useful additional indicator for general medical practitioners.
Collapse
Affiliation(s)
- J.M. Liljestrand
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - A.S. Havulinna
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - S. Paju
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - S. Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - V. Salomaa
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - P.J. Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| |
Collapse
|
49
|
Unell L, Johansson A, Ekbäck G, Ordell S, Carlsson GE. Dental status and self-assessed chewing ability in 70- and 80-year-old subjects in Sweden. J Oral Rehabil 2015; 42:693-700. [PMID: 25882481 DOI: 10.1111/joor.12299] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2015] [Indexed: 11/28/2022]
Abstract
The objective was to compare two cohorts of elderly people, 70 and 80 years old, with respect to dental status and self-assessed chewing ability. The hypotheses were as follows: (i) dental status is associated with self-assessed chewing ability; (ii) chewing ability is poorer among the 80- than the 70-year-old subjects. Identical questionnaires were in 2012 sent to all subjects born in 1942 and 1932, living in two Swedish counties. The response rate was 70.1% resulting in samples of 5697 70- and 2922 80-year-old subjects. Answers to questions on self-assessed chewing ability, dental status and some other factors have been analysed. Dental status varied but was in general good; 72% of the 70- and 60% of the 80-year-old subjects reported that they had all or only few missing teeth. Rate of edentulism was 3% and 7%, respectively. Removable partial dentures were reported by 6% and 10%, respectively, implant treatment by 13% in both cohorts. Self-assessed chewing ability was mostly good and correlated with the number of teeth (Spearman rho = 0.46). A majority of the edentulous subjects assessed their chewing ability as very or fairly good. Logistic regression showed that self-assessed chewing ability was significantly associated with a number of dental variables but also with general health. In conclusion, dental status was relatively good at both ages but somewhat poorer in the older cohort. Dental status, some other dental variables and being healthy were in both age groups significantly associated with self-assessed chewing ability.
Collapse
Affiliation(s)
- L Unell
- Post Graduate Dental Education Centre, Örebro County Council, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - A Johansson
- Department of Clinical Dentistry - Prosthodontics, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - G Ekbäck
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden.,Department of Dentistry, Örebro County Council, Örebro, Sweden
| | - S Ordell
- Dental Commissioning Unit, Linköping University, Linköping, Sweden.,Department of Oral Public Health, Malmö University, Malmö, Sweden
| | - G E Carlsson
- Department of Prosthetic Dentistry/Dental Materials Science, University of Gothenburg, Göteborg, Sweden
| |
Collapse
|
50
|
Natto ZS, Aladmawy M, Alasqah M, Papas A. Is There a Relationship Between Periodontal Disease and Causes of Death? A Cross Sectional Study. Braz Dent J 2015; 26:33-8. [DOI: 10.1590/0103-6440201300117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 12/13/2014] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate whether there is any correlation between periodontal disease and mortality contributing factors, such as cardiovascular disease and diabetes mellitus in the elderly population. A dental evaluation was performed by a single examiner at Tufts University dental clinics for 284 patients. Periodontal assessments were performed by probing with a manual UNC-15 periodontal probe to measure pocket depth and clinical attachment level (CAL) at 6 sites. Causes of death abstracted from death certificate. Statistical analysis involved ANOVA, chi-square and multivariate logistic regression analysis. The demographics of the population sample indicated that, most were females (except for diabetes mellitus), white, married, completed 13 years of education and were 83 years old on average. CAL (continuous or dichotomous) and marital status attained statistical significance (p<0.05) in contingency table analysis (Chi-square for independence). Individuals with increased CAL were 2.16 times more likely (OR=2.16, 95% CI=1.47-3.17) to die due to CVD and this effect persisted even after control for age, marital status, gender, race, years of education (OR=2.03, 95% CI=1.35-3.03). CAL (continuous or dichotomous) was much higher among those who died due to diabetes mellitus or out of state of Massachusetts. However, these results were not statistically significant. The same pattern was observed with pocket depth (continuous or dichotomous), but these results were not statistically significant either. CAL seems to be more sensitive to chronic diseases than pocket depth. Among those conditions, cardiovascular disease has the strongest effect.
Collapse
Affiliation(s)
- Zuhair S. Natto
- Tufts University, USA; King Abdualziz University, Saudi Arabia
| | | | | | | |
Collapse
|