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Liu Y, Lei F, Yao D, Zhang X, Huang X, Cai J, Deng KQ, Cheng B. Ill-fitting prosthesis is associated with an increased risk of elevated blood pressures. J Oral Rehabil 2024; 51:1123-1134. [PMID: 38491740 DOI: 10.1111/joor.13684] [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: 03/21/2023] [Revised: 12/08/2023] [Accepted: 03/02/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE Previous studies focused on the benefits of adequate prosthodontic treatment, while few studies have investigated the prosthodontic-related risks to health. As a modifiable oral health indicator, the association of ill-fitting prosthesis (IFP) with hypertension has not been fully explored. METHODS This cross-sectional study involved 158,659 adults in Beijing (2009-2017) receiving intra-oral examinations and blood pressure measurements. Logistic regression models were applied to assess the association of IFP with the prevalence of hypertension, systolic blood pressure (SBP) ≧ 140 mmHg and diastolic blood pressure (DBP) ≧ 90 mmHg, as well as subgroup analyses by different fixed IFP subgroups (according to involved teeth number) and removable IFP subgroup. We further investigated effect modifications among stratified populations. RESULTS 158,659 individuals were included for analysis, 346 (26.86%) in IFP group and 27,380 (17.40%) in non-IFP group (p < 0.001) were hypertensive. After adjustment of sex, age, obesity, dyslipidaemia, diabetes, hsCRP, family history of CVD, self-reported smoking, self-reported drinking and WC, ORs of hypertension, SBP ≧ 140 mmHg and DBP ≧ 90 mmHg were 1.330 (95% CI: 1.162-1.522), 1.277 (95% CI: 1.098-1.486) and 1.376 (95% CI: 1.186-1.596), respectively (p < 0.05). Furthermore, after full adjustment, the number of involved teeth showed a significant incremental trend with hypertension risk in the population with and without IFP (p for trend <0.001). The IFP-blood pressure associations were more pronounced in females, 18-60 years, non-obese and diabetic participants. CONCLUSION As a modifiable oral indicator, IFP was significantly associated with a higher risk of hypertension.
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Affiliation(s)
- Yang Liu
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fang Lei
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Dongai Yao
- Health Examination Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xingyuan Zhang
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xuewei Huang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ke-Qiong Deng
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bo Cheng
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Asher S, Suominen AL, Stephen R, Ngandu T, Koskinen S, Solomon A. Association of tooth location, occlusal support and chewing ability with cognitive decline and incident dementia. J Clin Periodontol 2024. [PMID: 38468379 DOI: 10.1111/jcpe.13970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/28/2023] [Accepted: 02/17/2024] [Indexed: 03/13/2024]
Abstract
AIM Emerging evidence suggests association of tooth loss with impaired cognition. However, the differential effects of anterior versus posterior tooth loss, occlusal support loss and chewing ability are not considered comprehensively. MATERIALS AND METHODS We conducted cross-sectional (N = 4036) and longitudinal analyses (N = 2787) on data from Health 2000 and 2011 Surveys for associations of posterior occlusal support loss, anterior versus posterior tooth loss, and chewing ability with baseline cognition and 11-year cognitive decline. Additionally, 15-year incident dementia risk was investigated (N = 4073). RESULTS After considering relevant confounders and potential reverse causality bias, posterior occlusal support loss significantly increased dementia risk across all categories indicative of posterior occlusal support loss (hazard ratios [HRs] between 1.99 and 2.89). Bilateral inadequate posterior occlusal support was associated with 11-year decline in overall cognition (odds ratio [OR] = 1.48:1.00-2.19), and unilateral inadequate posterior occlusal support with total immediate (OR = 1.62:1.14-2.30) and delayed recall decline (OR = 1.45:1.03-2.05). Moreover, posterior tooth loss was associated with dementia (HR = 2.23:1.27-3.91) and chewing ability with total immediate decline (OR = 1.80:1.04-3.13). CONCLUSIONS Posterior tooth and occlusal support loss significantly increases dementia risk. The impact of posterior occlusal support loss appears to be dose-dependent, and this effect is distinct from that of dentures. Dental healthcare services should be particularly attentive to the state of posterior dentition. Further studies exploring possible mechanisms are warranted.
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Affiliation(s)
- Sam Asher
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Teaching Unit, Kuopio University Hospital, Kuopio, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ruth Stephen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
| | - Seppo Koskinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Alina Solomon
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
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Kim K, Rosenberg MA. The impact of dentition status and barriers to dental care services on perceived oral health of medicare beneficiaries. J Public Health Dent 2024; 84:3-12. [PMID: 38031495 DOI: 10.1111/jphd.12592] [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: 08/08/2023] [Revised: 08/15/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To examine the association among barriers to dental care services, dentition groups, and self-reported oral health status for Medicare beneficiaries. METHODS We used data from the 2017 to 2018 National Health and Nutrition Examination Survey (NHANES), which included participants aged ≥65 years who were enrolled in Medicare and had completed the oral health exam. We created a dentition group variable using the detailed dental examination data to account for the presence of natural, replaced, removable, or missing teeth. Through bivariate and logistic analyses, we explored the relationship between barriers to receiving dental care services, dentition groups, and reported oral and general health statuses, along with other control variables. RESULTS For the total Medicare population as well as in the four subgroup analyses, we showed that those with barriers to dental care services were more likely to report fair or poor oral health status. Those who were edentulous, had complete dentures, or had less than a full mouth of teeth had greater barriers and worse oral and general health than did those with all-natural teeth. Among those who reported fair or poor general health, those with less than a full mouth of teeth showed similar levels of barriers to dental care services and worse perceived oral health than did those without any teeth. CONCLUSIONS Helping the 65 years and older population retain their teeth in good condition will improve their overall health. Investment in oral hygiene and health for the current and future Medicare populations could improve their overall health.
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Affiliation(s)
- Kyeonghee Kim
- Dr. William T. Hold/The National Alliance Program of Risk Management & Insurance, College of Business, Florida State University, Tallahassee, Florida, USA
| | - Marjorie A Rosenberg
- Department of Risk and Insurance, Wisconsin School of Business, University of Wisconsin, Madison, Wisconsin, USA
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Xu K, Ma S, Gu J, Liu Q, He Z, Li Y, Jia S, Ji Z, Tay F, Zhang T, Niu L. Association between dental visit behavior and mortality: a nationwide longitudinal cohort study from NHANES. Clin Oral Investig 2023; 28:37. [PMID: 38148418 DOI: 10.1007/s00784-023-05471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/20/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVES The benefits of professional dental treatment for oral diseases have been widely investigated. However, it is unclear whether professional dental treatment provides additional benefits for improving general health. MATERIALS AND METHODS Data were obtained from the US National Health and Nutrition Examination Survey (NHANES) 1999 to 2004 and 2011 to 2018 cycles. A total of 36,174 participants were included and followed-up for mortality until December 31, 2019. Dental visit behavior was defined as the time interval of last dental visit (TIDV, < 0.5 year, 0.5-1 year, 1-2 years, 2-5 years, and > 5 years) and the main reasons of the last dental visit (treatment, examination, and other reasons). The Cox proportional risk model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS Compared with participants with time interval of less than 0.5 year, the multivariate-adjusted HRs and 95%CI for participants with time interval of more than 5 years were 1.45 (1.31, 1.61) for all-cause mortality (P trend < 0.0001), 1.49 (1.23, 1.80) for cardiovascular diseases mortality (P trend = 0.0009) and 1.53 (1.29, 1.81) for cancer mortality (P trend = 0.013). Compared with dental visit for examination, participants who had their dental visit for treatment had higher risk for mortality. For participants with dental visit for examination, TIDV of less than 1 year showed lower risk for mortality, whereas TIDV of less than 0.5 year is recommend for population with dental visit for treatment. CONCLUSIONS Poor dental visit behavior is associated with an increased risk of mortality. Further well-designed studies are needed to confirm the association between professional dental visit and mortality. CLINICAL RELEVANCE This study highlights the potential benefits of regular dental visits in maintaining general health.
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Affiliation(s)
- Kehui Xu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Sai Ma
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Junting Gu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Qing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Zikang He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Yuanyuan Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
- Department of General Dentistry, Chenggong Hospital Affiliated to Medical School of Xiamen University, Xiamen, 361000, Fujian, China
| | - Shuailin Jia
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453003, Hena, China
| | - Zhaohua Ji
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, the Fourth Military Medical University, Xi'an, 710032, China
| | - Franklin Tay
- The Graduate School, Augusta University, Augusta, GA, 30912, USA
| | - Tong Zhang
- Department of Stomatology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Lina Niu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
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Wu B, Luo H, Tan C, Qi X, Sloan F, Kamer A, Schwartz M, Martinez M, Plassman B. Diabetes, Edentulism, and Cognitive Decline: A 12-Year Prospective Analysis. J Dent Res 2023; 102:879-886. [PMID: 36908186 PMCID: PMC10399080 DOI: 10.1177/00220345231155825] [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] [Indexed: 03/14/2023] Open
Abstract
Diabetes mellitus (DM) is a recognized risk factor for dementia, and increasing evidence shows that tooth loss is associated with cognitive impairment and dementia. However, the effect of the co-occurrence of DM and edentulism on cognitive decline is understudied. This 12-y cohort study aimed to assess the effect of the co-occurrence of DM and edentulism on cognitive decline and examine whether the effect differs by age group. Data were drawn from the 2006 to 2018 Health and Retirement Study. The study sample included 5,440 older adults aged 65 to 74 y, 3,300 aged 75 to 84 y, and 1,208 aged 85 y or older. Linear mixed-effect regression was employed to model the rates of cognitive decline stratified by age cohorts. Compared with their counterparts with neither DM nor edentulism at baseline, older adults aged 65 to 74 y (β = -1.12; 95% confidence interval [CI], -1.56 to -0.65; P < 0.001) and those aged 75 to 84 y with both conditions (β = -1.35; 95% CI, -2.09 to -0.61; P < 0.001) had a worse cognitive function. For the rate of cognitive decline, compared to those with neither condition from the same age cohort, older adults aged 65 to 74 y with both conditions declined at a higher rate (β = -0.15; 95% CI, -0.20 to -0.10; P < 0.001). Having DM alone led to an accelerated cognitive decline in older adults aged 65 to 74 y (β = -0.09; 95% CI, -0.13 to -0.05; P < 0.001); having edentulism alone led to an accelerated decline in older adults aged 65 to 74 y (β = -0.13; 95% CI, -0.17 to -0.08; P < 0.001) and older adults aged 75 to 84 (β = -0.10; 95% CI, -0.17 to -0.03; P < 0.01). Our study finds the co-occurrence of DM and edentulism led to a worse cognitive function and a faster cognitive decline in older adults aged 65 to 74 y.
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Affiliation(s)
- B. Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - H. Luo
- Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - C. Tan
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - X. Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - F.A. Sloan
- Department of Economics, Duke University, Durham, NC, USA
| | - A.R. Kamer
- College of Dentistry, New York University, New York, NY, USA
| | - M.D. Schwartz
- Grossman School of Medicine, New York University, New York, NY, USA
| | - M. Martinez
- Department of Biology, Duke University, Durham, NC, USA
| | - B.L. Plassman
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
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