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Beukers NGFM, Su N, Loos BG, van der Heijden GJMG. Lower Number of Teeth Is Related to Higher Risks for ACVD and Death-Systematic Review and Meta-Analyses of Survival Data. Front Cardiovasc Med 2021; 8:621626. [PMID: 34026863 PMCID: PMC8138430 DOI: 10.3389/fcvm.2021.621626] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/22/2021] [Indexed: 12/17/2022] Open
Abstract
Tooth loss reflects the endpoint of two major dental diseases: dental caries and periodontitis. These comprise 2% of the global burden of human diseases. A lower number of teeth has been associated with various systemic diseases, in particular, atherosclerotic cardiovascular diseases (ACVD). The aim was to summarize the evidence of tooth loss related to the risk for ACVD or death. Cohort studies with prospective follow-up data were retrieved from Medline-PubMed and EMBASE. Following the PRISMA guidelines, two reviewers independently selected articles, assessed the risk of bias, and extracted data on the number of teeth (tooth loss; exposure) and ACVD-related events and all-cause mortality (ACM) (outcome). A total of 75 articles were included of which 44 were qualified for meta-analysis. A lower number of teeth was related to a higher outcome risk; the pooled risk ratio (RR) for the cumulative incidence of ACVD ranged from 1.69 to 2.93, and for the cumulative incidence of ACM, the RR ranged from 1.76 to 2.27. The pooled multiple adjusted hazard ratio (HR) for the incidence density of ACVD ranged from 1.02 to 1.21, and for the incidence density of ACM, the HR ranged from 1.02 to 1.30. This systematic review and meta-analyses of survival data show that a lower number of teeth is a risk factor for both ACVD and death. Health care professionals should use this information to inform their patients and increase awareness on the importance of good dental health and increase efforts to prevent tooth loss.
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Affiliation(s)
- Nicky G F M Beukers
- Academic Centre for Dentistry Amsterdam, Department of Periodontology, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Naichuan Su
- Academic Centre for Dentistry Amsterdam, Department of Social Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bruno G Loos
- Academic Centre for Dentistry Amsterdam, Department of Periodontology, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Geert J M G van der Heijden
- Academic Centre for Dentistry Amsterdam, Department of Social Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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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: 81] [Impact Index Per Article: 20.3] [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; ••: ••-••.
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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
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Yuan JQ, Lv YB, Kraus VB, Gao X, Yin ZX, Chen HS, Luo JS, Zeng Y, Mao C, Shi XM. Number of natural teeth, denture use and mortality in Chinese elderly: a population-based prospective cohort study. BMC Oral Health 2020; 20:100. [PMID: 32276615 PMCID: PMC7147045 DOI: 10.1186/s12903-020-01084-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 03/25/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The associations between the number of natural teeth/denture use and all-cause mortality remain unclear due to lake of investigation for the potential interaction between tooth loss and denture use and for the potential changes in these exposures over time in older adults. We undertake this study to evaluate the associations of the number of natural teeth and/or denture use with mortality in Chinese elderly. METHODS This is a prospective cohort study of 36,283 older adults (median age: 90). The number of natural teeth and denture use were collected with structured questionnaire. We evaluated hazard ratios (HRs) and confidence intervals (CIs) using a Cox proportional hazards model adjusting for demographic factors, education, income, lifestyle factors, and comorbidities. RESULTS We documented 25,857 deaths during 145,947 person-years of observation. Compared to those with 20+ teeth, tooth loss was associated with a gradual increase in mortality, with an adjusted HR of 1.14 (95% CI, 1.06 to 1.23) for those with 10-19 teeth, 1.23 (95% CI, 1.15 to 1.31) for those with 1-9 teeth, and 1.35 (95% CI, 1.26 to 1.44) for those without natural teeth. Denture use was associated with lower risk of mortality (adjusted HR 0.81; 95% CI, 0.77 to 0.84). Subgroup analyses indicated that the benefit of denture use was greater in men than in women (P = 0.02) and tended to decrease with age (P < 0.001). The effects of denture use did not differ among various degrees of tooth loss (P = 0.17). CONCLUSIONS Tooth loss was associated with an increased risk of mortality in older adults. Denture use provided a protective effect against death for all degrees of tooth loss however, this effect appeared to be modified by sex and age.
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Affiliation(s)
- Jin-Qiu Yuan
- Clinical Research Center, The Seventh Affiliated Hospital; Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518107 Guangdong China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, #7 Panjiayuan Nanli, Chaoyang, Beijing, 100021 China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina USA
| | - Xiang Gao
- Nutritional Epidemiology Lab, Pennsylvania State University, Philadelphia, PA USA
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Shuai Chen
- Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, North Carolina USA
| | - Jie-Si Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zeng
- Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, North Carolina USA
- Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, China
| | - Chen Mao
- Division of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515 Guangdong China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, #7 Panjiayuan Nanli, Chaoyang, Beijing, 100021 China
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Lee JH, Han JS, Han K, Lee SY. Association between Diabetes and the Use of Removable Dental Prostheses among the Korean Population. J Korean Med Sci 2019; 34:e262. [PMID: 31650717 PMCID: PMC6813424 DOI: 10.3346/jkms.2019.34.e262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 09/03/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A balanced nutrient intake is important for patients with diabetes. Even if individuals have the same number of residual natural teeth, there are large differences in the masticatory performance between edentulous sites restored with a fixed dental prosthesis, including dental implants, and those restored with a removable dental prosthesis. This study assessed whether the prevalence and control of diabetes differed based on the use of removable dental prostheses through an analysis of nationally representative data. METHODS Overall, 8,155 individuals (3,525 men and 4,630 women) aged ≥ 50 years were included in this study and were classified into the following 3 groups: group 1, did not use any removable dental prostheses (NF); group 2, used removable partial dentures (RPD); and group 3, used removable complete dentures on at least 1 jaw (CD). The characterization of diabetic patients and glycemic control were analyzed and compared among groups. To determine the relationship between diabetes and the use of dental prostheses, multivariable logistic regression analysis was performed (P < 0.05). RESULTS The adjusted odds ratios and 95% confidence intervals for diabetes in men participants in groups NF, RPD, and CD were 1 (reference), 1.165 (0.878-1.544), and 1.491 (1.034-2.151), respectively, after adjusting for confounding factors. Diabetes and glycemic control were significantly associated with the use of removable dental prostheses among men. CONCLUSION The use of removable dental prostheses is a potential risk indicator for uncontrolled diabetes in Korean men adults, suggesting the need for a comprehensive approach to minimize the complications of diabetes mellitus.
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Affiliation(s)
- Jae Hyun Lee
- Department of Prosthodontics, One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Jung Suk Han
- Department of Prosthodontics and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Su Young Lee
- Department of Prosthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Abstract
The pace of technological advance across science is staggeringly fast. Our ability to translate some of the potential developments in technology into concepts/products/devices that can assist dentists in caring for patients is key to ensuring that both the profession and the people we care for derive full benefit from these new technologies. This overview will focus in four areas: research and how we gather and interpret data to inform health care; the diagnosis and prevention of disease; planning care; and new concepts in terms of achieving desired health outcomes for patients. Some of the technological advances will be in their infancy and others close to or indeed clinical reality. The objective of this overview is to show where we are in terms of the cutting edge of technology and to whet the appetite for things to come.
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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.
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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
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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.
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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.
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Le Bars P, Kouadio AA, N'goran JK, Badran Z, Soueidan A. Relationship between removable prosthesis and some systemics disorders. J Indian Prosthodont Soc 2016; 15:292-9. [PMID: 26929530 PMCID: PMC4762353 DOI: 10.4103/0972-4052.171828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This article reviews the dental literature concerning the potential impact of the removable prosthesis (RP) on the health status of patients with certain systemic diseases. Literature was surveyed using Medline/PubMed database resources, as well as a manual search, up to 2015 to identify appropriate articles that addressed the aim of this review. The research used keywords about associations between RP and six pathologies: Human immunodeficiency virus infection, diabetes mellitus, pulmonary diseases, gastric-Helicobacter pylori, cancer, and cardiovascular diseases. Analysis of literature showed that in patients with dentures having one or more of the six general conditions listed, Candida albicans organism is more frequently found in the oral flora compared to healthy denture wearer. Although causality has not been established and pending further research on this topic, the hygienic practices necessary to minimize the risk of numerous pathologies should be strengthened in the case of these patients, all the more in the presence of physical or psychological disability. The relationship between the general diseases and increasing of oral candidiasis denture patients is not explained. Therefore, attention to oral hygiene and professional care for removing C. albicans may be beneficial in these medically compromised patients.
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Affiliation(s)
- Pierre Le Bars
- Department of Prosthodonthics, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
| | - Alain Ayepa Kouadio
- Department of Prosthodonthics, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France; Department of Prosthodonthics, Faculty of Dentistry, CHU, Abidjan 22 BP 612, Abidjan, Cote d'Ivoire
| | - Justin Koffi N'goran
- Department of Prosthodonthics, Faculty of Dentistry, CHU, Abidjan 22 BP 612, Abidjan, Cote d'Ivoire
| | - Zahi Badran
- Department of Periodontology, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
| | - Assem Soueidan
- Department of Periodontology, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
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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: 70] [Impact Index Per Article: 7.8] [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.
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Affiliation(s)
- David A Felton
- Department of Restorative Dentistry, West Virginia University School of Dentistry, Morgantown, WV
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Janket SJ, Baird AE, Jones JA, Jackson EA, Surakka M, Tao W, Meurman JH, Van Dyke TE. Number of teeth, C-reactive protein, fibrinogen and cardiovascular mortality: a 15-year follow-up study in a Finnish cohort. J Clin Periodontol 2013; 41:131-40. [PMID: 24354534 DOI: 10.1111/jcpe.12192] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 10/20/2013] [Accepted: 10/31/2013] [Indexed: 12/25/2022]
Abstract
AIM To test whether the number of teeth, an inverse proxy for composite oral infection scores is associated with better survival. MATERIALS AND METHODS The Kuopio Oral Health and Heart study initiated a case-control study in 1995-1996 consisting of 256 consecutive coronary artery disease patients and 250 age and gender-matched controls. We appended the mortality data and formulated a longitudinal study. By May 31st, 2011, 124 mortalities had occurred and 80 of which were of cardiovascular origin. Using Cox proportional hazards models, we assessed the association of the teeth group (Teethgrp) - consisting of 10 teeth - with cardiovascular and all-cause mortality after 15.8 years of median follow-up. RESULTS In multivariate models, with the edentulous state as reference, one level increase in Teethgrp was associated with significantly increased survival from cardiovascular disease (CVD) mortality with a Hazard Ratio (HR) 0.73, p-value = 0.02 but not with all-cause mortality (HR = 0.87, p = 0.13). The findings were not mediated by C-reactive protein (CRP) levels ≥3 mg/L or by median fibrinogen levels, but were mediated by CRP levels >5 mg/L. CONCLUSION Each increment of 10 teeth from the edentulous state was associated with a 27% improved CVD survival, independent of low-grade systemic inflammation.
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Affiliation(s)
- Sok-Ja Janket
- Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
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