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Matsuyama Y. Complete Loss of Natural Teeth and Loneliness: A Fixed-Effect Analysis. J Dent Res 2024; 103:973-979. [PMID: 39101655 DOI: 10.1177/00220345241263265] [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] [Indexed: 08/06/2024] Open
Abstract
Psychosocial properties of oral health have been reported. The present study aimed to investigate the causal effect of complete loss of natural teeth on loneliness by using fixed-effects analysis to control for confounding factors, including unmeasured time-invariant factors. Data from older adults participating in at least 2 consecutive waves of the English Longitudinal Study of Ageing in waves 3 (2006/2007), 5 (2010/2011), and 7 (2014/2015) were analyzed (N = 18,682 observations from 7,298 individuals). The association between complete loss of natural teeth and loneliness score (ranging from 3 to 9) was examined using fixed-effect linear regression analysis adjusting for time-varying confounders, including sociodemographic and health characteristics. The prevalence of complete tooth loss was 12.7%, 12.8%, and 10.6% in waves 3, 5, and 7, respectively. Individuals who transitioned to complete tooth loss during any 2 consecutive waves had an increase in loneliness score by 0.27 (95% confidence interval [CI] 0.03, 0.52), which was greater than those who maintained natural teeth (-0.03; 95% CI -0.05, -0.01). Fixed-effects analysis adjusting for time-varying confounders revealed a significant association between complete loss of natural teeth and an increase in loneliness score by 0.31 (95% CI 0.17, 0.46). Complete loss of natural teeth among older adults in England was associated with loneliness, even after accounting for measured time-varying and (un)measured time-invariant confounders. Retaining natural teeth may reduce the risk of loneliness.
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Affiliation(s)
- Y Matsuyama
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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Kusama T, Takeuchi K, Kiuchi S, Aida J, Osaka K. The association between objective and subjective oral health conditions and the presence of anorexia of aging among Japanese older Adults 1. Appetite 2024; 198:107332. [PMID: 38582137 DOI: 10.1016/j.appet.2024.107332] [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: 01/04/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
Anorexia of aging is a risk factor for malnutrition among older adults. This study aimed to evaluate the association between objective and subjective oral health and anorexia among independent older adults. This cross-sectional study targeted independent older adults aged ≥65 years who participated in the Japan Gerontological Evaluation Study conducted in 2022. The outcome variable was the presence of anorexia, as assessed by the Simplified Nutritional Appetite Questionnaire. Exposure variables were dental status (≥20 teeth, 10-19 teeth with/without dentures, and 0-9 teeth with/without dentures) as objective oral health and oral health-related quality of life measured by five items of the short version of the Oral Impacts on Daily Performances (OIDP) (eating, speaking, smiling, emotional stability, and enjoying with others) as subjective oral health. We fitted the Poisson regression model, including possible confounders, and estimated prevalence ratios (PRs) and 95% confidence intervals. Among 19,787 participants (mean age: 74.6 years [1SD = 6.2], male: 48.5%), 9.0% were classified as having anorexia. After adjusting possible confounders, those with ≤19 teeth had a higher proportion of experiencing anorexia compared to those with ≥20 teeth; however, the association was less pronounced among those with dentures (0-9 teeth with dentures: PR = 1.48 [1.31-1.68], and 0-9 teeth without dentures: PR = 2.08 [1.65-2.63]). Even after adjusting for dental status, each item of OIDP was significantly associated with the presence of anorexia (all p < 0.05). The results showed that both objective and subjective poor oral health were significantly associated with a higher probability of developing anorexia of aging. Therefore, improving both objective and subjective oral health through appropriate dental care could contribute to maintaining appetite in later life.
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Affiliation(s)
- Taro Kusama
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Kenji Takeuchi
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan.
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan; Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Miyagi, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
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Matsuyama Y, Aida J, Kondo K, Shiba K. Heterogeneous Association of Tooth Loss with Functional Limitations. J Dent Res 2024; 103:369-377. [PMID: 38533640 DOI: 10.1177/00220345241226957] [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] [Indexed: 03/28/2024] Open
Abstract
Tooth loss is prevalent in older adults and associated with functional capacity decline. Studies on the susceptibility of some individuals to the effects of tooth loss are lacking. This study aimed to investigate the heterogeneity of the association between tooth loss and higher-level functional capacity in older Japanese individuals employing a machine learning approach. This is a prospective cohort study using the data of adults aged ≥65 y in Japan (N = 16,553). Higher-level functional capacity, comprising instrumental independence, intellectual activity, and social role, was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The scale ranged from 0 (lowest function) to 13 (highest function). Doubly robust targeted maximum likelihood estimation was used to estimate the population-average association between tooth loss (having <20 natural teeth) and TMIG-IC total score after 6 y. The heterogeneity of the association was evaluated by estimating conditional average treatment effects (CATEs) using the causal forest algorithm. The result showed that tooth loss was statistically significantly associated with lower TMIG-IC total scores (population-average effect: -0.14; 95% confidence interval, -0.18 to -0.09). The causal forest analysis revealed the heterogeneous associations between tooth loss and lower TMIG-IC total score after 6 y (median of estimated CATEs = -0.13; interquartile range = 0.12). The high-impact subgroup (i.e., individuals with estimated CATEs of the bottom 10%) were significantly more likely to be older and male, had a lower socioeconomic status, did not have a partner, and had poor health conditions compared with the low-impact subgroup (i.e., individuals with estimated CATEs of the top 10%). This study found that heterogeneity exists in the association between tooth loss and lower scores on functional capacity. Implementing tooth loss prevention policy and clinical measures, especially among vulnerable subpopulations significantly affected by tooth loss, may reduce its burden more effectively.
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Affiliation(s)
- Y Matsuyama
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - J Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - K Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Chiba, Japan
| | - K Shiba
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Kusama T, Takeuchi K, Kiuchi S, Aida J, Osaka K. Poor oral health and dementia risk under time-varying confounding: A cohort study based on marginal structural models. J Am Geriatr Soc 2024; 72:729-741. [PMID: 38064294 DOI: 10.1111/jgs.18707] [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: 07/11/2023] [Revised: 10/09/2023] [Accepted: 11/09/2023] [Indexed: 03/19/2024]
Abstract
BACKGROUND Bidirectional association between oral health, including tooth loss and oral hypofunction, and cognitive impairment can induce time-varying confounding in association with dementia. This study aimed to investigate the association between oral health and the development of dementia among older adults, considering cognitive impairment as a time-varying confounder. METHODS This nine-year follow-up cohort study targeted independent older adults aged ≥65 years who participated in the Japan Gerontological Evaluation Study. The exposure variables were self-reported poor oral health (≤19 remaining teeth, edentulousness, chewing difficulty, swallowing problems, and xerostomia), which were assessed in 2010 and 2013. The outcome variable was the incidence of dementia between 2013 and 2019, which was obtained from the municipalities' administrative database. Furthermore, in 2010 and 2013, we considered cognitive impairment as a time-varying confounder and treated it based on a marginal structural model (MSM), including possible baseline confounders. Oral health and cognitive impairment were assessed using the items of Kihon checklist. We employed a Cox proportional hazards model with a stabilized inverse probability weight and estimated hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Among 37,556 participants (mean age: 72.8 years [1 SD = 5.5], males: 46.8%), the dementia incidence rate was 2.2/100 person-year. The proportions of those with ≤19 remaining teeth, edentulousness, chewing difficulty, swallowing problems, and xerostomia were 61.3%, 11.0%, 24.4%, 14.7%, and 19.2%, respectively. From the regression analysis based on MSM, ≤19 remaining teeth (HR = 1.12, 95% CI = 1.03-1.23), edentulousness (HR = 1.20, 95% CI = 1.09-1.32), chewing difficulty (HR = 1.11, 95% CI = 1.02-1.21), and xerostomia (HR = 1.10, 95% CI = 1.01-1.20) were significantly associated with an increased risk of dementia; however, swallowing problems were not significantly associated with dementia onset (p > 0.05). CONCLUSIONS Even after considering time-varying confounding by cognitive function at baseline and follow-up, we observed significant associations between poor oral health and increased risk of dementia among older adults.
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Affiliation(s)
- Taro Kusama
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Kenji Takeuchi
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Sakura Kiuchi
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
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Kusama T, Takeuchi K, Kiuchi S, Tamada Y, Tabuchi T, Osaka K. Tooth loss mediates the association between smoking and an increased risk of dementia among older adults: The JAGES prospective cohort study. J Clin Periodontol 2024. [PMID: 38323671 DOI: 10.1111/jcpe.13959] [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: 03/30/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
AIM Tooth loss has various causes; however, its cause-specific effects on health outcomes remain unclear. This study evaluated whether the association between past/current smoking and risk of dementia was mediated by tooth loss. MATERIALS AND METHODS This 9-year-follow-up prospective cohort study targeted adults aged ≥65 years. Dementia incidence during 2013-2019, smoking status (never, past/current) in 2010 and the number of remaining teeth (≤19, ≥20) in 2013 were the outcome, exposure and mediator, respectively. We used causal mediation analysis to fit the Cox proportional hazards model and estimated the hazard ratio (HR) and 95% confidence interval (CI) of the natural indirect effect (NIE) of smoking on dementia incidence through tooth loss and their mediated proportions. RESULTS Among 32,986 participants (mean age 72.6 years [1 SD = 5.4]; men 48.4%), the dementia incidence during follow-up was 2.11/100 person-years. Tooth loss significantly mediated the association between past/current smoking and dementia incidence; the NIE of fewer remaining teeth for past/current smokers compared to never smokers was HR = 1.03 (95% CI: 1.02-1.05), and the mediated proportion was 18.0%. CONCLUSIONS Tooth loss significantly mediates the association between past/current smoking and an increased risk of dementia among older adults.
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Affiliation(s)
- Taro Kusama
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Takeuchi
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Japan
| | - Yudai Tamada
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Campos FL, Rodrigues LG, Campos JR, Rhodes GAC, Morais GF, Chalub LLFH, Ferreira RC. Association between shortened dental configurations and health outcomes: a scoping review. BMC Oral Health 2024; 24:111. [PMID: 38243284 PMCID: PMC10799365 DOI: 10.1186/s12903-023-03714-4] [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: 07/10/2023] [Accepted: 11/25/2023] [Indexed: 01/21/2024] Open
Abstract
This study mapped definitions of shortened dental configurations and health outcomes employed in association studies. A scoping review was conducted using the PubMed/Medline, Scopus, Web of Science, SciELO and Cochrane databases. Two trained researchers selected studies and extracted data. Studies that investigated the association between shortened dental configurations (exposure) and person-centered outcomes (general and oral health) related to health behavior (dietary patterns). Clinical outcomes were classified according to the International Classification of Functioning, Disability and Health and the International Classification of Diseases of the World Health Organization (WHO). Shortened dental configurations were defined as at least 20/21 teeth or the position of the teeth, including esthetics, dental occlusion and periodontal status (Eichner Index, Shortened Dental Arches, Functional Dentition Classification System, Posterior Occluding Pairs, Functional Tooth Units). The initial search resulted in 12,525 records in English, Portuguese and Spanish, 432 of which addressed the association of interest. General health (n = 203) and oral health (n = 201) were addressed in a similar number of studies. Most outcomes were related to general health (n = 184), the most frequent of which were endocrine, nutritional or metabolic diseases (n = 57) and mental functions (n = 26). Person-centered measures were addressed in 153 studies, most of which were about oral health and oral health-related quality of life (n = 62). Oral health outcomes were predominantly related to intake functions (n = 44) and diseases or disorders of the orofacial complex (n = 24). Dietary patterns (n = 43) and mortality (n = 38) were also studied. The cross-sectional design (n = 257) and non-probabilistic sampling (n = 218) were more frequent. The shortened dental configurations defined by the WHO were the most frequent in the studies (n = 206). The effects of shortened dental configurations have been investigated mainly in relation to endocrine, nutritional or metabolic diseases and measures of oral health-related quality of life. The findings point to a diversity of health outcomes assessed and substantial methodological variability.
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Affiliation(s)
- Fernanda Lamounier Campos
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Lorrany Gabriela Rodrigues
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Julya Ribeiro Campos
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Gabriela Aparecida Caldeira Rhodes
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Gabrielli Flores Morais
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Loliza Luiz Figueiredo Houri Chalub
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, Brazil.
| | - Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, Brazil
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Al-Maweri SA, Alhajj MN, Halboub E, Tamimi F, Salleh NM, Al-Ak'hali MS, Kassim S, Abdulrab S, Anweigi L, Mohammed MMA. The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis. BMC Oral Health 2023; 23:658. [PMID: 37689665 PMCID: PMC10493030 DOI: 10.1186/s12903-023-03378-0] [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: 06/21/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes. MATERIALS AND METHODS PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software. RESULTS A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001). CONCLUSIONS The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.
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Affiliation(s)
| | - Mohammed Nasser Alhajj
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Federal Territory of Kuala Lumpur, Kuala Lumpur, Malaysia
- Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Nosizana Mohd Salleh
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Federal Territory of Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Saba Kassim
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Saleem Abdulrab
- Al Khor Health Center, Primary Health Care Corporation, Doha, Qatar
| | - Lamyia Anweigi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Marwan Mansoor Ali Mohammed
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Lu EMC. The role of vitamin D in periodontal health and disease. J Periodontal Res 2023; 58:213-224. [PMID: 36537578 DOI: 10.1111/jre.13083] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/20/2022] [Accepted: 11/27/2022] [Indexed: 12/24/2022]
Abstract
Vitamin D plays an essential role in calcium and bone metabolism, immune regulation and possesses profound anti-inflammatory effects. Evidence suggests that low serum vitamin D is associated with increased severity of periodontitis, a chronic inflammatory condition characterised by destruction of the supporting tissues surrounding the tooth, which has several shared risk factors with other chronic non-communicable diseases. The biological functions of vitamin D are mediated by its strong anti-microbial, anti-inflammatory, and host modulatory properties. Experimental periodontitis models involving targeted deletion of 1α-hydroxylase, the enzyme responsible for the conversion of inactive substrate to active 1,25(OH)2 D3 (calcitriol), showed augmented alveolar bone loss and gingival inflammation. Vitamin D receptor (VDR) gene polymorphisms have also been associated with increased severity of periodontitis. Thus, the involvement of vitamin D in the pathogenesis of periodontitis is biological plausible. Clinical studies have consistently demonstrated an inverse relationship between serum 25OHD3 and periodontal disease inflammation. However, due to the paucity of well-designed longitudinal studies, there is less support for the impact of vitamin D status on periodontal disease progression and tooth loss. The evidence emphasises the importance of maintaining vitamin D sufficiency in supporting periodontal health. This review aims to first examine the biological mechanisms by which vitamin D might influence the pathogenesis of periodontal disease and second, discuss the clinical evidence which implicate the role of vitamin D in periodontal disease.
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Affiliation(s)
- Emily Ming-Chieh Lu
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, London, UK
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Faulks D, Scambler S, Daly B, Jamieson L, Hennequin M, Tsakos G. Measuring oral health-How can the International Classification of Functioning help? Community Dent Oral Epidemiol 2023; 51:153-164. [PMID: 35112389 DOI: 10.1111/cdoe.12732] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 01/07/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Abstract
There is a need for a theoretically informed, contextualized approach to measuring oral health from a multidisciplinary perspective that goes beyond the commonly used clinical indices and sociodental measures. This commentary aims to discuss the potential for the WHO's International Classification of Functioning, Disability and Health (ICF) to provide a model for the development of indicators for oral health. It is suggested that the ICF might provide both a theoretical model and an operational classification for indicators of oral health. The ICF model states that human experience of physical, cognitive and social functioning is universal and, thus, can be described and qualified. Human function is given social and environmental context within the model at both an individual and population level. The ICF can not only capture data regarding oral health and function at the physiological level (e.g. chewing) but also at the social level (e.g. sharing meals). It is able not only to capture aspects of preventive behaviour (e.g. caring for teeth) but also aspects of social facilitation (e.g. economic self-sufficiency) or ability to fulfil a social role (e.g. remunerative employment). It also includes aspects of social environment, such as healthcare services or political, economic and legal systems. Case studies are given as examples of the potential use of the ICF in the oral health domain. Examples are also given of the first steps that have been made towards operationalization of the ICF in data collection and oral health research. The challenges of encompassing such a comprehensive model into a practical oral health measure are discussed.
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Affiliation(s)
- Denise Faulks
- Service d'Odontologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Centre de Recherche en Odontologie Clinique (CROC) EA4847, Université Clermont Auvergne, UFR d'Odontologie, Clermont-Ferrand, France
| | - Sasha Scambler
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Tower Wing, Guy's Campus, London, UK
| | - Blánaid Daly
- Trinity College Dublin, School of Dental Sciences and Dublin Dental University Hospital, Dublin 2, Ireland
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Martine Hennequin
- Service d'Odontologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Centre de Recherche en Odontologie Clinique (CROC) EA4847, Université Clermont Auvergne, UFR d'Odontologie, Clermont-Ferrand, France
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, UCL, London, UK
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Peres MA, Peres KG, Chan A, Wu B, Mittinty M. Investigating the causal effect of cognition on the self-reported loss of functional dentition using marginal structural models: The Panel on Health and Ageing of Singaporean Elderly study. J Clin Periodontol 2023; 50:408-417. [PMID: 36384159 DOI: 10.1111/jcpe.13752] [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: 12/06/2021] [Revised: 09/02/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
AIM To assess the effect of cognition on the loss of functional dentition. MATERIALS AND METHODS We used data from the three waves of the Panel on Health and Ageing of Singaporean Elderly study (n = 4990 at baseline, 774 complete cases analysed) over 6 years (2009-2015). The outcome was the loss of functional dentition (<21 teeth). The exposure was cognitive impairment, while baseline confounders included age, sex, education, and ethnicity. Time-varying confounders included income, living arrangements, smoking, diabetes, depressive symptoms, cardiovascular disease, and body mass index. We used marginal structural mean models with inverse probability treatment weighted. RESULTS The mean age of the participants was 70.2 years at baseline. The proportion of participants with loss of functional dentition increased from 74.6% to 89.9% over 6 years. Women, ethnic Chinese, less educated, smokers, people with diabetes, and individuals with depression had a higher proportion of loss of functional dentition than their counterparts. Loss of functional dentition was 1.8 times higher (odds ratio 1.80; 95% confidence interval 0.88-3.69) among those with cognitive impairment after taking well-known confounders into account. CONCLUSIONS After accounting for the time-varying exposure and confounding evidence, the association between cognition and functional dentition among the elderly in Singapore remains uncertain.
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Affiliation(s)
- Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Angelique Chan
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Bei Wu
- Hartford Institute for Geriatric Nursing, Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Murthy Mittinty
- Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Kiuchi S, Aida J, Cooray U, Osaka K, Chan A, Malhotra R, Peres MA. Education-related inequalities in oral health among older adults: Comparing Singapore and Japan. Community Dent Oral Epidemiol 2023. [PMID: 36892466 DOI: 10.1111/cdoe.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES Oral health inequalities exist worldwide, and cross-country comparisons can provide valuable insights into country-level characteristics contributing to such inequalities. However, comparative studies in Asian countries are limited. This study examined the magnitude of education-related oral health inequalities in older adults in Singapore and Japan. METHODS Longitudinal data for older adults, aged ≥65 years, from the Panel on Health and Ageing of Singaporean Elderly (PHASE; 2009, 2011-2012, and 2015) and Japan Gerontological Evaluation Study (JAGES; 2010, 2013, and 2016) were used. Dependent variables were being edentate and having a minimal functional dentition (MFD; i.e. ≥20 teeth). The absolute and relative inequalities were calculated using the slope index of inequality (SII) and relative index of inequality (RII) for educational level [low (<6 years); middle (6-12 years); high (>12 years)] in each country. RESULTS A total of 1032 PHASE participants and 35 717 JAGES participants were included. At baseline among PHASE participants, 35.9% were edentate and 24.4% had MFD, while among JAGES participants, 8.5% were edentate and 42.4% had MFD. The prevalence of low, middle and high educational levels for PHASE was 76.5%, 18.0% and 5.5%, and for JAGES were 0.9%, 78.1% and 19.7%, respectively. Older adults in Japan had lower education-related inequalities for being edentate [for both SII (-0.53, 95% CI = -0.55 to -0.50) and RII (0.40, 95% CI = 0.33-0.48)] and for not having MFD for both SII (-0.24, 95% CI = -0.27 to -0.20) and RII (0.83, 95% CI = 0.79-0.87) compared to Singapore. CONCLUSIONS Education-related inequalities for being edentate and not having MFD were higher among older adults in Singapore compared to Japan.
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Affiliation(s)
- Sakura Kiuchi
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Angelique Chan
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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12
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Yamamoto-Kuramoto K, Kiuchi S, Takeuchi K, Kusama T, Nakazawa N, Tamada Y, Aida J, Kondo K, Osaka K. Oral status and incident functional disability: a 9-year prospective cohort study from the JAGES. Arch Gerontol Geriatr 2023; 111:105009. [PMID: 37031655 DOI: 10.1016/j.archger.2023.105009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/18/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION The population-attributable risk of oral status for incident functional disability remains unknown. We investigated the impact of a range of oral statuses (number of remaining teeth, chewing difficulty, dry mouth, and choking) on incident functional disability. METHODS Participants (n = 44,083) aged ≥ 65 years from the Japan Gerontological Evaluation Study were evaluated. The outcome variable was incident functional disability, and the explanatory variables were four select oral statuses. The possible confounders were included as covariates. Using the Cox proportional hazards model, we calculated hazard ratios (HRs), 95% confidence intervals (CIs), and their population-attributable fractions (PAFs). RESULTS The mean age of the participants was 73.7 (standard deviation=6.0) years at baseline, and 53.2% were women. A total of 8,091 participants (18.4%) developed functional disabilities during the follow-up period. Among the four oral statuses, the incidence rate of functional disability was the highest in those with chewing difficulty (3.27/100 person-years), followed by those with dry mouth (3.20/100 person-years), choking (3.10/100 person-years), and ≤19 remaining teeth (2.89/100 person-years). After adjusting for all covariates, chewing difficulty showed the highest risk of functional disability (HR=1.22, 95%CI=1.16-1.28), followed by ≤19 remaining teeth (HR=1.18, 95%CI=1.12-1.25), dry mouth (HR=1.18, 95%CI=1.12-1.24), and choking (HR=1.10, 95%CI=1.04-1.17). Regarding PAF, ≤19 remaining teeth (12.0%) were the largest, followed by chewing difficulty (7.2%), dry mouth (4.6%), and choking (1.9%). CONCLUSIONS Maintaining a good oral status may reduce the risk of functional disability later in life. Given its population contribution, tooth loss had the largest impact among the four oral conditions.
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13
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Cascaes AM, Constante HM, Vaz JDS, Ferreira de Mello ALS, Bomfim RA. Tooth loss severity and core and non-core food consumption among older Brazilian adults. Gerodontology 2023; 40:127-134. [PMID: 35332939 DOI: 10.1111/ger.12630] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 02/01/2022] [Accepted: 03/09/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate the association between tooth loss severity and core and non-core food consumption in the older Brazilian population. METHODS We analysed data from 20 756 people aged 60 years or older who participated in the 2019 Brazilian National Health Survey. The average consumption days a week of core (8-item) and non-core (4-item) foods were the outcomes, measured using a Food Frequency Questionnaire. Tooth loss severity was the main exposure, using a four-category ordinal variable: mild (1-12 teeth missing), moderate (13-22), severe (23-31) and edentulous (all 32). Sociodemographic, tobacco smoking, use of dental prosthesis, difficulty in chewing and systemic conditions were among the covariates. Linear regression models estimated the association between tooth loss and food consumption. RESULTS Almost two-thirds of participants had moderate or worse levels of tooth loss. Older adults with more severe tooth loss reported an overall lower consumption of core and higher non-core foods than those with mild tooth loss. Worse tooth loss severity was associated with lower consumption of vegetables and/or legumes and fruits, and higher consumption of beans, artificial fruit juices and confectionery. CONCLUSIONS Older Brazilian adults with more severe tooth loss are consuming lower core and higher non-core foods. Our findings reinforce the importance of the common risk factor approach to tackle the adverse effects of tooth loss on diet.
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Affiliation(s)
- Andreia Morales Cascaes
- Department of Public Health, Graduate Program in Public Health, Graduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Helena Mendes Constante
- Department of Public Health, Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Juliana Dos Santos Vaz
- Faculty of Nutrition, Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Ana Lúcia Schaefer Ferreira de Mello
- Department of Dentistry, Graduate Program in Dentistry, Graduate Program in Nursing, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Rafael Aiello Bomfim
- School of Dentistry, Graduate Program in Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
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14
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Matsuyama Y. Time-varying exposure analysis of the relationship between sustained natural dentition and cognitive decline. J Clin Periodontol 2023; 50:727-735. [PMID: 36734069 DOI: 10.1111/jcpe.13786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023]
Abstract
AIM Tooth loss and cognitive decline progress over time and influence each other. This study estimated the impact of sustaining natural dentition on cognitive function in U.S. adults, accounting for the fact that dental and cognitive statuses change over time. MATERIALS AND METHODS Data from adults aged ≥51 years who participated in five waves of the Health and Retirement Study from 2004 to 2016 (n = 10,953) were analysed. The impact of retaining some natural teeth from 2006 to 2012 on cognitive function score (0-27) and cognitive impairment (defined as having a cognitive function score of <12) in 2016 was evaluated using the doubly robust targeted maximum likelihood estimation method by considering both time-invariant and time-varying confounders, including cognitive function at baseline and during follow-up. RESULTS Respondents with some natural teeth between 2006 and 2012 had a 0.40 point (95% confidence interval [CI]: 0.10-0.71) higher cognitive function score and 3.27 percentage point (95% CI: 0.11-6.66) lower cognitive impairment prevalence in 2016 than those with complete tooth loss. CONCLUSIONS Considering past cognitive function assessed at multiple time points, sustained natural dentition was associated with better cognitive function.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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15
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Kusama T, Takeuchi K, Kiuchi S, Aida J, Kondo K, Osaka K. Weight Loss Mediated the Relationship between Tooth Loss and Mortality Risk. J Dent Res 2023; 102:45-52. [PMID: 36068707 DOI: 10.1177/00220345221120642] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Tooth loss is a risk factor for increased mortality; however, the underlying mechanism remains unclear. This study aimed to evaluate the mediating effect of weight change on the relationship between tooth loss and mortality risk. This was a 10-y follow-up prospective cohort study using the data from the Japan Gerontological Evaluation Study (JAGES). The participants were independent older adults aged ≥65 y at baseline and were followed up from 2010 to 2020. The incidence of death in 2013 and 2020, incidence of >5% weight loss/gain in 2010 and 2013, and the number of remaining teeth in 2010 were used as the outcome, mediator, and explanatory variables, respectively. We conducted causal mediation analysis by fitting the Cox proportional hazard model, including possible confounders. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) of the total effect (TE), natural indirect effect (NIE), and proportion mediated (PM) were estimated. Among the 34,510 participants, the mean age was 72.6 (SD = 5.4) y, and 47.6% were men. From 2013 to 2020, 14.0% of the participants (n = 4,825) died, 60.5% (n = 20,871) had 0 to 19 remaining teeth, and 17.2% (n = 5,927) and 8.4% (n = 2,907) experienced >5% weight loss and gain, respectively. The mortality rate was 0.016 per person-year among those with ≥20 remaining teeth and 0.027 per person-year among those with 0 to 19 remaining teeth. Weight loss of >5% significantly mediated the association between tooth loss and higher mortality risk (TE: HR, 1.28 [95% CI, 1.16 to 1.40]; NIE: HR, 1.03 [95% CI, 1.02 to 1.04]; PM, 13.1%); however, we observed a slight mediating effect for >5% weight gain (NIE: HR, 1.003 [95%CI, 1.0001 to 1.01]; PM, 1.3%). The present study suggests that a clinically meaningful level of weight loss mediated the association between tooth loss and increased risk of mortality among independent older adults.
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Affiliation(s)
- T Kusama
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - K Takeuchi
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - S Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - J Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - K Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - K Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
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16
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Matsuyama Y, Fujiwara T, Murayama H, Machida M, Inoue S, Shobugawa Y. Differences in Brain Volume by Tooth Loss and Cognitive Function in Older Japanese Adults. Am J Geriatr Psychiatry 2022; 30:1271-1279. [PMID: 35831211 DOI: 10.1016/j.jagp.2022.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated the association between tooth loss and structural brain volume and its mediating effect on the association between tooth loss and cognitive function in older Japanese. METHODS A cross-sectional study was conducted by using the data of 494 randomly sampled community-dwelling individuals aged 65-84 years living in Tokamachi City, Japan. Total brain volume (TBV), gray matter volume (GMV), white matter volume (WMV), and hippocampal volume (HV) were measured with magnetic resonance imaging. The association of self-reported number of teeth (≥20, 1-19, and 0) with cognitive function assessed with the Japanese version of the Quick Mild Cognitive Impairment screen and structural brain volume was examined. Causal mediation analysis was performed to evaluate the mediating effect of structural brain volume. Age, sex, socioeconomic status, health behavior, comorbid conditions, and total intracranial volume were adjusted. RESULTS Respondents with no teeth showed lower cognitive function (coefficient = -4.01; 95% confidence interval [CI]: -7.19, -0.82), lower TBV (coefficient = -10.34; 95% CI: -22.84, 2.17), and lower GMV (coefficient = -6.92; 95% CI: -14.84, 0.99) than those with ≥20 teeth (P for trends were 0.003, 0.035, and 0.047, respectively). The number of teeth was not significantly associated with WMV or HV. GMV showed a significant mediating effect on the association between the number of teeth and cognitive function (coefficient = -0.38; 95% CI: -1.14, -0.002, corresponding to 9.0% of the total effect), whereas TBV did not. CONCLUSIONS GMV was suggested to mediate the relationship between tooth loss and lower cognitive function.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (YM, TF), Tokyo, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (YM, TF), Tokyo, Japan
| | - Hiroshi Murayama
- Research Team for Social participation and Community Health, Tokyo Metropolitan Institute of Gerontology (HM), Tokyo, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University (MM, SI), Tokyo, Japan; Department of Infection Prevention and Control, Tokyo Medical University Hospital (MM), Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University (MM, SI), Tokyo, Japan
| | - Yugo Shobugawa
- Department of Active Ageing (donated by Tokamachi city, Niigata Japan), Niigata University Graduate School of Medical and Dental Sciences (YS), Niigata, Japan
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17
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Høvik H, Kolberg M, Gjøra L, Nymoen LC, Skudutyte-Rysstad R, Hove LH, Sun YQ, Fagerhaug TN. The validity of self-reported number of teeth and edentulousness among Norwegian older adults, the HUNT Study. BMC Oral Health 2022; 22:82. [PMID: 35313882 PMCID: PMC8935783 DOI: 10.1186/s12903-022-02116-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/09/2022] [Indexed: 12/22/2022] Open
Abstract
Background Number of teeth is an established indicator of oral health and is commonly self-reported in epidemiological studies due to the costly and labor-intensive nature of clinical examinations. Although previous studies have found self-reported number of teeth to be a reasonably accurate measure, its accuracy among older adults ≥ 70 years is less explored. The aim of this study was to assess the validity of self-reported number of teeth and edentulousness in older adults and to investigate factors that may affect the accuracy of self-reports. Methods This study included two different samples of older adults ≥ 70 years drawn from the fourth wave of the Trøndelag Health Study (the HUNT Study), Norway. Sample 1 (n = 586) was used to evaluate the validity of self-reported number of teeth and sample 2 (n = 518) was used to evaluate self-reported edentulousness. Information on number of teeth and background variables (education, smoking, cognitive function, and self-perceived general and oral health) were self-reported in questionnaires, while clinical oral health examinations assessed number of teeth, number of teeth restored or replaced by fixed prosthodontics and edentulousness. Spearman and Pearson correlation coefficients, Bland–Altman plot, chi-square test and kappa statistics were used to assess the agreement between self-reported and clinically recorded number of teeth. Results The mean difference between self-reported and clinically recorded number of teeth was low (− 0.22 teeth), and more than 70% of the participants reported their number of teeth within an error of two teeth. Correlations between self-reports and clinical examinations were high for the total sample (0.86 (Spearman) and 0.91 (Pearson)). However, a lower correlation was found among participants with dementia (0.74 (Spearman) and 0.85 (Pearson)), participants having ≥ 20 teeth (0.76 (Spearman) and 0.67 (Pearson)), and participants with ≥ 5 teeth restored or replaced by fixed prosthodontics (0.75 (Spearman) and 0.77 (Pearson)). Self-reports of having teeth or being edentulous were correct in 96.3% of the cases (kappa value 0.93, p value < 0.001). Conclusions Among older Norwegian adults, self-reported number of teeth agreed closely with clinical tooth counts and nearly all the edentulous participants correctly reported having no teeth.
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Affiliation(s)
- Hedda Høvik
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
| | - Marit Kolberg
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Linda Gjøra
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Line Cathrine Nymoen
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | | | - Lene Hystad Hove
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Yi-Qian Sun
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tone Natland Fagerhaug
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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18
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Kinugawa A, Kusama T, Yamamoto T, Kiuchi S, Nakazawa N, Kondo K, Osaka K, Aida J. Association of poor dental status with eating alone: A cross-sectional Japan gerontological evaluation study among independent older adults. Appetite 2022; 168:105732. [PMID: 34619246 DOI: 10.1016/j.appet.2021.105732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/19/2021] [Accepted: 10/01/2021] [Indexed: 11/02/2022]
Abstract
Eating alone is reported to deteriorate health; however, the relationship between eating alone and poor dental health remains unclear. This cross-sectional study aimed to investigate the association between poor dental health and eating alone. Data of participants (n = 156,287) aged ≥65 years from the Japan Gerontological Evaluation Study were evaluated using logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between dental status, including prosthesis use, and eating status. Differences in these associations according to living status were also examined. The mean age of participants was 73.7 (SD = 6.0) years. The percentages of participants eating alone with 20 or more teeth, 10-19 teeth with dental prostheses, 0-9 teeth with dental prostheses, 10-19 teeth without dental prostheses, and 0-9 teeth without dental prostheses were 13.8%, 16.0%, 18.6%, 18.9%, and 27.0%, respectively. After adjusting for covariates, participants with 0-9 teeth without any dental prosthesis showed a significantly higher odds ratio for eating alone (OR = 1.81, 95% CI = 1.58-2.07) than those with 20 or more teeth. Among participants with poorer dental status, the probability of eating alone was higher in those living alone than in those living with others. Among older adults, poor dental status was significantly associated with eating alone, and this association was stronger among those living alone. Maintaining better dental status by using a dental prosthesis might reduce the risk of eating alone, especially for those living alone.
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Affiliation(s)
- Anna Kinugawa
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan; Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Takafumi Yamamoto
- Department of Health Promotion, National Institute of Public Health, 2-choume-3-6 Minami, Wako, Saitama, 351-0104, Japan.
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Noriko Nakazawa
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inage Ward, Chiba, 263-8522, Japan; National Center for Geriatrics and Gerontology, 7-430, Moriokacho, Obu, Aichi, 474-8511, Japan.
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Jun Aida
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan; Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1Choume-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
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19
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Kiuchi S, Cooray U, Kusama T, Yamamoto T, Abbas H, Nakazawa N, Kondo K, Osaka K, Aida J. Oral Status and Dementia Onset: Mediation of Nutritional and Social Factors. J Dent Res 2021; 101:420-427. [PMID: 34796750 DOI: 10.1177/00220345211049399] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Some modifiable risk factors for dementia are closely related to oral health. Although eating and speaking abilities are fundamental oral functions, limited studies have focused on the effect of malnutrition and lack of social interaction between oral health and dementia. We investigated the mediating effects of nutritional and social factors on the association between the number of teeth and the incidence of dementia. This 6-y cohort study used data from the Japan Gerontological Evaluation Study targeting older adults aged 65 y and above. The number of teeth (exposure) and covariates in 2010 (baseline survey), mediators (weight loss, vegetable and fruit intake, homeboundness, social network) in 2013, and the onset of dementia (outcome) between 2013 and 2016 were obtained. The Karlson-Holm-Breen mediation method was applied. A total of 35,744 participants were included (54.0% women). The mean age at baseline was 73.1 ± 5.5 y for men and 73.2 ± 5.5 y for women. A total of 1,776 participants (5.0%) had dementia during the follow-up period. There was a significant total effect of the number of teeth on the onset of dementia (hazard ratio, 1.14; 95% CI, 1.01-1.28). Controlling for nutritional and social mediators, the effect of the number of teeth was reduced to 1.10 (95% CI, 0.98-1.25), leaving an indirect effect of 1.03 (95% CI, 1.02-1.04). In the sex-stratified analysis, the proportion mediated by weight loss was 6.35% for men and 4.07% for women. The proportions mediated by vegetable and fruit intake and homeboundness were 4.44% and 4.83% for men and 8.45% and 0.93% for women, respectively. Furthermore, the proportion mediated by social networks was 13.79% for men and 4.00% for women. Tooth loss was associated with the onset of dementia. Nutritional and social factors partially mediated this association.
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Affiliation(s)
- S Kiuchi
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - U Cooray
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - T Kusama
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - T Yamamoto
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - H Abbas
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - N Nakazawa
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - K Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - K Osaka
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - J Aida
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan.,Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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20
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Wu Z, O'Brien KM, Lawrence KG, Han Y, Weinberg CR, Sandler DP, Vogtmann E. Associations of periodontal disease and tooth loss with all-cause and cause-specific mortality in the Sister Study. J Clin Periodontol 2021; 48:1597-1604. [PMID: 34605056 DOI: 10.1111/jcpe.13557] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/07/2021] [Accepted: 09/19/2021] [Indexed: 11/26/2022]
Abstract
AIM Studies have found that periodontal disease and tooth loss are associated with increased mortality; however, associations with cause-specific mortality and all-cause mortality within specific subgroups have not been thoroughly investigated. MATERIALS AND METHODS We examined the association of self-reported periodontal disease and disease/decay-related tooth loss with subsequent all-cause and cause-specific mortality in the Sister Study, a prospective cohort study of 50,884 women aged 35-74 years at baseline, whose sister was diagnosed with breast cancer. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the associations were calculated with adjustment for relevant confounders. RESULTS With a mean follow-up of 10.9 years (range 0.1-14.3), 2058 women died. Participants with periodontal disease had a slightly higher rate of all-cause mortality (HR = 1.08, 95% CI 0.98-1.19), while participants with tooth loss had an increased rate of all-cause mortality (HR = 1.15, 95% CI 1.05-1.26). For cause-specific mortality, women with tooth loss had increased rates of death from circulatory system diseases, respiratory system diseases, and endocrine/metabolic diseases. Results varied in stratified models, but no heterogeneity across strata was found. CONCLUSIONS In this large prospective study, periodontal disease and tooth loss were associated with all-cause and certain specific cause-specific mortality outcomes.
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Affiliation(s)
- Zeni Wu
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Yongli Han
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Emily Vogtmann
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
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21
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Bots-VantSpijker PC, van der Maarel-Wierink CD, Schols JMGA, Bruers JJM. Assessed and perceived oral health of older people who visit the dental practice, an exploratory cross-sectional study. PLoS One 2021; 16:e0257561. [PMID: 34559825 PMCID: PMC8462729 DOI: 10.1371/journal.pone.0257561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/05/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To assess the oral health of older people who visit the community dental practice from both the dentists' and the patients' perspective. MATERIALS AND METHODS In this exploratory cross-sectional study the oral health of Dutch community dwelling older people was assessed. A representative sample of general dental practitioners was asked to randomly and prospectively select one older patient and describe this patient using a specially-developed registration form; in addition the patient was requested to complete a questionnaire. The oral health of older people was described from the perspective of the dentists and the perspective of the older people themselves based on the definition of oral health from the World Dental Federation (FDI]. Relations between oral health of older people and dentist and older patient characteristics were analysed using Spearman's rank correlation coefficient (rho) and an ordinal regression model. RESULTS In total, 923 dentists were asked to participate in the study; data was available for 39.4% dentist-patient pairs. Dentists assessed the oral health of older patients as good or acceptable in 51.4% of the cases while this was the case in 76.2% of older patients themselves. The assessment of the dentist gets more negative with high treatment intensity and with older patients having certain diseases and more medication, while the assessment is more positive for older patients who visit the dentist on a regular basis. Older people's assessment of their oral health gets more negative by being female and with high treatment intensity, having certain diseases and higher use of medication. CONCLUSIONS AND CLINICAL RELEVANCE Chronically illness as expressed by the number of diseases and the use of medication, seems to be a risk factor for poor oral health. Older patients themselves assess their oral health differently, mostly more positive, than their dentist.
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Affiliation(s)
- Pieternella C. Bots-VantSpijker
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Claar D. van der Maarel-Wierink
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Jos M. G. A. Schols
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Caphri/Department of Family Medicine and Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Josef J. M. Bruers
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
- Royal Dutch Dental Association (KNMT), Utrecht, The Netherlands
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22
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Bhat M, Bhat S, Roberts-Thomson KF, Do LG. Self-Rated Oral Health and Associated Factors among an Adult Population in Rural India-An Epidemiological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6414. [PMID: 34199275 PMCID: PMC8296255 DOI: 10.3390/ijerph18126414] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND To determine the perception of oral health status and its associated factors among adults living in rural areas in Karnataka state, India. METHODS A cross-sectional study was conducted among adults in the age group of 35-54 years old residing in villages in a southern state in India. The main outcome measure was poor self-rated oral health (SROH) among adults in rural India. RESULTS About 873 adults participated in the study. The prevalence of poor SROH was 15.2%. Adults of age 40-44 years, females, those in lower socioeconomic conditions, and those with high caries experience (DMFT ≥ 4) and periodontal disease were associated with poor SROH. Those who had visited a dentist in the previous one year were 1.9 times more likely to report poor oral health. CONCLUSIONS Nearly 15% of rural people reported poor oral health. Socioeconomic conditions, sex, age, smoking, and dental visiting were associated with poor SROH. People's perception of poor oral health was associated with severe periodontitis and DMFT ≥ 4. A dose-response relationship was observed between experience with dental caries and poor SROH.
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Affiliation(s)
- Meghashyam Bhat
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide 5005, Australia;
| | - Sreevidya Bhat
- Srinivas Institute of Dental Sciences, Mangalore and Affiliated to Rajiv Gandhi University of Health Sciences, Bengaluru 560041, Karnataka, India;
| | | | - Loc Giang Do
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia;
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23
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Matsuyama Y, Jürges H, Dewey M, Listl S. Causal effect of tooth loss on depression: evidence from a population-wide natural experiment in the USA. Epidemiol Psychiatr Sci 2021; 30:e38. [PMID: 34030762 PMCID: PMC8157508 DOI: 10.1017/s2045796021000287] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/22/2021] [Accepted: 04/17/2021] [Indexed: 01/21/2023] Open
Abstract
AIMS Depression severely affects people's health and well-being. Oral diseases have been suggested to be associated with depression, but so far, there is no causal evidence. This study aimed to identify the causal effect of tooth loss on depression among US adults in a natural experiment study. METHODS Instrumental variable analysis was conducted using data from 169 061 respondents born in 1940-1978 who participated in the 2006, 2008 or 2010 waves of the Behavioral Risk Factor Surveillance System (BRFSS). Random variation in tooth loss due to differential childhood exposure to drinking water fluoride was exploited as an instrument. RESULTS US adults who were exposed to drinking water fluoride in childhood had more remaining teeth, therefore providing a robust instrument (F = 73.4). For each additional tooth loss, depressive symptoms according to the eight-item Patient Health Questionnaire depression (PHQ-8) score increased by 0.146 (95% CI 0.008-0.284), and the probability of having clinical depression (PHQ ⩾10) increased by 0.81 percentage points (95% CI -0.12 to 1.73). CONCLUSIONS Tooth loss causally increased depression among US adults. Losing ten or more teeth had an impact comparable to adults with major depressive disorder not receiving antidepressant drugs.
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Affiliation(s)
- Y Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - H Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - M Dewey
- Department of Health Service & Population Research, King's College London, London, UK
| | - S Listl
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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24
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Matsuyama Y, Listl S, Jürges H, Watt RG, Aida J, Tsakos G. Causal Effect of Tooth Loss on Functional Capacity in Older Adults in England: A Natural Experiment. J Am Geriatr Soc 2021; 69:1319-1327. [PMID: 33496349 DOI: 10.1111/jgs.17021] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/22/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVES Tooth loss is associated with reduced functional capacity, but so far, there is no relevant causal evidence reported. We investigated the causal effect of tooth loss on the instrumental activities of daily living (IADL) among older adults in England. DESIGN Natural experiment study with instrumental variable analysis. SETTING The English Longitudinal Study of Aging (ELSA) combined with the participants' childhood exposure to water fluoride due to the community water fluoridation. PARTICIPANTS Five thousand six hundred and thirty one adults in England born in 1945-1965 participated in the ELSA wave seven survey (conducted in 2014-2015; average age: 61.0 years, 44.6% men). MEASUREMENTS The number of natural teeth predicted by the exogenous geographical and historical variation in exposure to water fluoride from age 5 to 20 years old (instrumental variable) was used as an exposure variable. The outcome, having any limitations in IADL (preparing a hot meal, shopping for groceries, making telephone calls, taking medications, doing work around the house or garden, or managing money), was assessed by self-reported questionnaires. RESULTS Linear probability model with Two-Stage Least Squares estimation was fitted. Being exposed to fluoridated water was associated with having more natural teeth in later life (coefficient: 0.726; 95% confidence interval (CI) = 0.311, 1.142; F = 11.749). Retaining one more natural tooth reduced the probability of having a limitation in IADL by 3.1 percentage points (coefficient: -0.031; 95% CI = -0.060, -0.002). CONCLUSION Preventing tooth loss maintains functional capacity among older adults in England. Given the high prevalence of tooth loss, this effect is considerable. Further research on the mechanism of the observed causal relationship is needed.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan.,Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Stefan Listl
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Conservative Dentistry, Translational Health Economics Group, Heidelberg University, Heidelberg, Germany
| | - Hendrik Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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25
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Bof de Andrade F, Watt RG, Lima-Costa MF, de Oliveira C. Poor sleep quality and oral health among older Brazilian adults. Oral Dis 2020; 28:227-232. [PMID: 33244826 DOI: 10.1111/odi.13734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study evaluates the association between normative and subjective oral health measures and poor self-reported sleep quality among community-dwelling older adults in Brazil. METHODS This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging. The dependent variable was the poor sleep quality. Independent variables of interest included number of teeth and self-reported impact of oral health on eating/chewing and on maintaining emotional stability. RESULTS Poor sleep quality was reported by 17.8 (95% CI 16.6; 19.2) of the participants, 29% of the participants were edentulous, and 30% had 20 or more teeth. Impacts of oral health on eating and maintaining emotional stability was found among 33.3% and 20% of the older adults, respectively. After adjusting for all oral health measures and covariates, the magnitude of the associations between the number of teeth and sleep quality was attenuated. Sleep quality was related to oral health impacts on eating (OR 1.19 [95% CI 1.00; 1.41]) and on emotional stability (OR 1.51 [95% CI 1.21; 1.87]). CONCLUSIONS This study found an association between oral health and sleep quality emphasizing the importance of oral health to general health.
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Affiliation(s)
| | - Richard G Watt
- Department of Epidemiology & Public Health, University College London, London, UK
| | | | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
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26
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Tan CXW, Brand HS, Iqbal S, De Boer NKH, Forouzanfar T, de Visscher JGAM. A self-reported survey on oral health problems in patients with inflammatory bowel disease with a stoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:e80-e86. [PMID: 32601008 DOI: 10.1016/j.oooo.2020.04.816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/06/2020] [Accepted: 04/27/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Patients with inflammatory bowel disease have an increased risk of developing oral health problems. The aim of this study was to investigate whether oral diseases in these patients are related to inflammation of the intestine and if there is a correlation between inflammatory bowel disease-specific health-related quality of life (IBD-HR-QOL) and oral health problems. STUDY DESIGN The study was a cross-sectional survey and analysis of self-reported oral health of individuals with a stoma for Crohn's disease (CD), ulcerative colitis (UC), and treated colon cancer (CC). Validated international questionnaires were sent to members of the Stoma Federation of The Netherlands. Because there was an unequal distribution of male and female patients with CD and CC, data of 169 age-matched female patients with CD, UC, and CC with a stoma were analyzed. RESULTS Patients with CD had significantly more oral health problems compared with those with UC or CC. Patients with CD and UC both had significantly more gingival-related problems compared with patients with CC. There was a significant negative correlation between IBD-HR-QOL and oral health problems. CONCLUSIONS In the 3 distinguishable groups of patients with a stoma, patients with CD had an increased risk for oral health problems, independently from surgical removal of (a part of) the inflamed intestine, suggesting a general increased susceptibility of patients with CD for oral health problems.
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Affiliation(s)
- Christopher X W Tan
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | - Henk S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Sumaira Iqbal
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Nanne K H De Boer
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, VU University, AG&M Research Institute, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jan G A M de Visscher
- Departments of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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27
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Bassim CW, MacEntee MI, Nazmul S, Bedard C, Liu S, Ma J, Griffith LE, Raina P. Self‐reported oral health at baseline of the Canadian Longitudinal Study on Aging. Community Dent Oral Epidemiol 2019; 48:72-80. [DOI: 10.1111/cdoe.12506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 10/09/2019] [Accepted: 10/09/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Carol W. Bassim
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada
| | | | - Sohel Nazmul
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada
| | - Chloe Bedard
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada
| | - Siying Liu
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada
| | - Lauren E. Griffith
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada
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28
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Listl S. Value-Based Oral Health Care: Moving Forward With Dental Patient-Reported Outcomes. J Evid Based Dent Pract 2019; 19:255-259. [PMID: 31732101 DOI: 10.1016/j.jebdp.2019.101344] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Value-based oral health care is about improving people's oral health outcomes divided by the costs involved. This article addresses five questions (the "5 W's") pertaining to the measurement of oral health outcomes: why oral health outcomes should be measured, what should be measured, by whom, when, and where. Therefore, dental patient-reported outcome measures offer great potential for driving improvements in oral health care. For illustration, a tentative set of seven key relevant items is presented, which comprises the four dimensions of oral health-related quality of life and the three dental conditions with the highest burden of disease. Through promoting the ample use of oral health outcome measures, it is hoped that this article can contribute to expedite value-based oral health care.
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Affiliation(s)
- Stefan Listl
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Healthcare, Nijmegen, the Netherlands; Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg University Hospital, Heidelberg, Germany.
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