Association between parity and dentition status among Japanese women: Japan public health center-based oral health study

MMP-8 in Periodontal Sites of Postpartum and without-Any-Pregnancy Women

The hypothesis that physiological changes in women can affect periodontal tissues is the subject of this study, and inflammatory markers such as matrix metalloproteinase-8 can measure susceptibility to inflammation. The study aimed to analyze MMP-8 levels in periodontal sites of postpartum women and women without a history of pregnancy, comparing health parameters and periodontal disease. This is a case-control study with 40 participants, 20 cases (women in the postpartum period) and 20 controls (women without any pregnancy), who underwent clinical periodontal examination and the collection of crevicular gingival fluid. The ELISA test was used to detect MMP-8 levels. Postpartum women had worse periodontal parameters, such as bleeding index on probing, number of sites with CAL ≥ 3, and fewer teeth present. In the group of women without a history of pregnancy, a significantly lower MMP-8 level was observed in healthy sites and a higher one was observed in periodontal pockets (p < 0.01). In contrast, in postpartum women, MMP-8 levels were elevated in both healthy sites and periodontal pockets (p > 0.01). The MMP-8 levels in gingival fluid appear to be related to periodontal clinical parameters and may be a possible marker of enzymatic changes involved in periodontal tissue destruction in postpartum women.

Association Between Oral Malodor and Dementia: An 11-Year Follow-Up Study in Japan

Background

As infrequent social interaction is a potential risk of dementia, oral malodor may increase the risk of dementia, including Alzheimer's disease.

Objective

This study investigated the association between malodor and dementia.

Methods

We used the Japan Public Health Center-based Prospective Study data obtained at Yokote City. A total of 1,493 individuals aged 56 to 75 years underwent a dental examination and self-reported survey from May 2005 to January 2006. Follow-up for the onset of dementia was conducted using long-term care insurance data from 2006 to 2016. Hazard ratios of oral malodor on dementia were estimated by the Cox proportional hazards model. The inverse probability-weighted Cox model was used as a sensitivity analysis.

Results

The study comprised 1493 participants (53.6% women) with a mean age of 65.6 (SD = 5.8) years old; at the end of the follow-up, 6.4% (n = 96) developed dementia, and the percentage was 20.7 in severe malodor group. Throughout 15274.133 person-years of follow-up, the average incidence rate for the onset of dementia per 1000 person-years was 6.29. The highest incidence rate was seen in participants with severe malodor (22.4 per 1000 person-years). After adjusting for confounders, compared to those with no malodor, there was a 3.8 (95% confidence interval: 1.5 to 9.4) times greater hazard of developing dementia in participants with severe malodor. The inverse probability weighted Cox model confirmed the same trend with an adjusted marginal hazard ratio of 4.4 (1.2 to 16.4).

CONCLUSIONS

A significant association between oral malodor and the onset of dementia exists.

Oral health-related quality of life among people living with HIV and HIV-negative adults in Kigali, Rwanda: a comparative cross-sectional study

BACKGROUND

Assessing health-related quality of life has become integral to people living with HIV (PLHIV) follow-up. However, there is a lack of data regarding the impact of oral health on quality of life, known as Oral health-related quality of life (OHRQoL) among PLHIV compared to HIV-negative individuals in Rwanda.

AIM

The study aimed to assess OHRQoL among PLHIV compared to HIV-negative counterparts in Kigali, Rwanda.

METHODS

The Oral Health Impact Profile short version (OHIP-14) questionnaire was interviewer-administered to 200 PLHIV and 200 HIV-negative adults (≥ 18 years old) at an HIV clinic of Kigali Teaching Hospital (CHUK). Socio-demographic characteristics, including age, sex, occupation, and socioeconomic status (SES) of participants, were collected using a survey questionnaire. A 4-point Likert scale was used to assess the frequency of oral impacts for all 14 items within 7 domains of the OHIP tool. The descriptive statistics were used to see frequencies and percentages of OHRQoL among PLHIV and HIV-negative persons, respectively. The Chi-square test was used to determine the association of OHRQoL with caries (DMFT) and periodontal disease (CPITN) among PLHIV compared to HIV-negative individuals.

RESULTS

The results revealed a higher prevalence of PLHIV with poor OHRQoL than HIV-negative individuals in 5 domains and almost all items of OHIP-14 except for the OHIP 3 (found it uncomfortable to eat any foods because of problems with teeth or mouth) and OHIP-14 (being totally unable to function because of problems with teeth or mouth). The findings showed statistically significant results (p ≤ 0.05) for the OHIP1 item "trouble pronouncing any word," with a prevalence of 2.5% (n = 11) and 2.25% (n = 9) in PLHIV and HIV-negative, respectively. Also, PLHIV had a significantly higher prevalence, 2.75% (n = 11) for the OHIP 13 item "life not satisfying due to teeth and mouth problems compared to HIV-negative individuals 2% (8) p ≤ 0.05. Moreover, dental caries was significantly associated with poor OHRQoL among PLHIV and HIV-negative adults and for all 14 items of the OHIP tool. Periodontal disease was not significantly associated with OHRQoL among PLHIV and HIV-negative adults.

CONCLUSION

This study revealed poor OHRQoL among PLHIV compared to HIV-negative adults. There is a need for further longitudinal studies to investigate the OHRQoL in Rwanda, especially among PLHIV. It is essential to include oral health care as one of the components of the medical health care programs for PLHIV in Rwanda.

Prevalence of dental caries in pregnant Colombian women and its associated factors

OBJECTIVE

To identify the prevalence of dental caries in pregnant women in the Colombian population and its association with the medical history and social determinants, based on data from the fourth National Oral Health Survey (ENSAB IV).

MATERIALS AND METHODS

A total of 1,047 pregnant women from different areas of Colombia were evaluated. A dental evaluation was performed using a flat oral mirror and blunt-tipped probe (World Health Organization, 2007). For diagnosis of the dental condition, the DMFT index was used. A negative binomial regression analysis was performed to evaluate the association between social determinants and the DMFT index.

RESULTS

The results of this national study show a 59% prevalence of caries in this population. Regarding the experience of caries, 89.9% of pregnant women showed having had caries.

CONCLUSIONS

The results of this national study on pregnant women show a high prevalence of dental caries. The women's level of education is an important factor associated with dental caries and filled teeth, so the role of oral health education and dental check-ups are important.

CLINICAL RELEVANCE

The findings of this study show the oral health situation of pregnant women, with a high prevalence of dental caries. This leads to the development and strengthening of oral health education strategies that empower pregnant women in their care. In addition, dental checkups during pregnancy should be implemented and reinforced to prevent and treat oral pathologies and thus prevent complications during this stage.

Unfavourable beliefs about oral health and safety of dental care during pregnancy: a systematic review

BACKGROUND

Oral conditions such as gingivitis and periodontitis are correlated with adverse pregnancy outcomes such as preeclampsia, preterm birth and low birth weight. Oral health-related unfavourable beliefs can have negative influences on oral health behaviours including hesitation in accessing preventative dental treatments and dental service utilization. The objective of this systematic review was to examine unfavourable beliefs that expectant or new mothers frequently hold about oral health and the safety of dental care during pregnancy.

METHODS

An electronic database search on PubMed, Scopus, CINAHL, and MEDLINE (Ovid) followed by forward and backward citation tracing of the included studies was conducted. All English primary studies regardless of the year of publication were independently screened by two reviewers to identify studies addressing unfavourable beliefs about oral health and dental care during pregnancy. The CLARITY tool was applied to assess the risk of bias in the included studies.

RESULTS

Out of a total of 5766 records, 39 quantitative and six qualitative studies met the inclusion criteria. The commonly held unfavourable beliefs were regarding the safety of dental services utilization and dental treatment procedures, the adverse impacts of pregnancy on oral health, and oral hygiene necessity during pregnancy. The most discussed unfavourable beliefs included "pregnant women lose their teeth because of pregnancy" (n = 18), "dental treatments are not safe and harm the fetus" (n = 17), and "the developing baby absorbs calcium from the mother's teeth" (n = 14).

CONCLUSIONS

Unfavourable beliefs about oral health and dental care utilization are common among pregnant women and new mothers. The literature suggests that a low level of oral health knowledge and seeking information from social networks can contribute to such beliefs. This has implications for health promotion.

Parity, dental caries and implications for maternal depletion syndrome in northern Nigerian Hausa women

BACKGROUND

Female reproductive history, especially high parity, affects general health and may impact negatively on oral health. While parity has been positively linked to tooth loss, the specific association between parity and caries has not been adequately investigated.

AIM

To determine the association between parity and caries in a population of higher parity women. Influences of likely confounders (age, socio-economic status, reproductive parameters, oral health practices and sugar consumption between meals) were considered.

METHODS

This was a cross-sectional study involving 635 Hausa women of varying parity aged 13-80 years. Socio-demographic status, oral health practices and sugar consumption were obtained using a structured interviewer-administered questionnaire. All decayed, missing and filled teeth due to caries (excluding third molars) were noted, and tooth loss etiology was queried. Associations with caries were evaluated through correlation, ANOVA, post hoc analyses and Student's t tests. Effect sizes were considered for magnitude of differences. Multiple regression (binomial model) was used to investigate predictors of caries.

RESULTS

Hausa women had a high prevalence of caries (41.4%) despite low sugar consumption; nonetheless the overall mean DMFT score was very low (1.23 ± 2.42). Older, higher parity women experienced more caries, as did those with longer reproductive spans. Additionally, poor oral hygiene, use of fluoride toothpaste and frequency of sugar consumption were significantly associated with caries.

CONCLUSION

Higher parity (>6 children) was associated with higher DMFT scores. These results suggest that a form of maternal depletion, expressed as heightened caries susceptibility and subsequent tooth loss, occurs with higher parity.

Assessing the Relationship Between Motherhood and Cervical Cancer Screening and Prevention Behaviors

Background: National guidelines recommend Papanicolaou (Pap) testing and human papillomavirus (HPV) vaccination for cervical cancer prevention; however, certain subgroups may be at risk for underutilization. Prior studies have identified motherhood as a predictor of health outcomes, but this research has not been extended to cervical cancer prevention. Informed by the Health Belief Model, we explored the relationship between motherhood, health beliefs, and Pap testing and HPV vaccination. Methods: This study used an observational, cross-sectional design. Participants assigned female at birth (N = 417) completed an online survey assessing motherhood, health beliefs (perceived risk, perceived benefits, perceived barriers, and self-efficacy), and prior Pap testing and HPV vaccination. Bootstrapped mediation analyses determined whether motherhood was associated with prior Pap testing and HPV vaccination and whether health beliefs mediated these relationships. Results: Of mothers (25%), 75% were up-to-date with Pap testing and 36% had previously received ≥1 dose of the HPV vaccine. There was no direct effect of motherhood on Pap testing (p = 0.873) or HPV vaccination (p = 0.921) and no significant indirect effects via health beliefs (ps ≥ 0.096). However, perceived benefits and self-efficacy were significantly related to both Pap testing (ps ≤ 0.003) and HPV vaccination (ps ≤ 0.010). Mothers reported lower self-efficacy for HPV vaccination than nonmothers (p = 0.035). Discussion: Consistent with nationwide statistics, most eligible participants were up-to-date with Pap testing and HPV vaccination. Although motherhood was not significantly associated with either behavior, mothers reported lower self-efficacy for HPV vaccination. Perceived benefits and self-efficacy may be important targets for future interventions aiming to increase cervical cancer prevention and screening behaviors.

Prevalence and correlates of periodontitis among Kenyan women planning to conceive

Background

Periodontitis has been associated with adverse pregnancy outcomes. Little is known about the burden and risk factors for periodontitis among reproductive age women in sub-Saharan Africa. This analysis aimed to determine the prevalence and correlates of periodontitis among Kenyan women planning to conceive.

Methods

HIV-seronegative, reproductive-age women who were planning to conceive were enrolled and underwent a periodontal examination. Following the US Centers for Disease Control and Prevention clinical case definitions, the presence and severity of periodontitis was determined by establishing the level of clinical periodontal attachment loss and graded in three categories: no/mild, moderate, and severe. Secondary outcomes included the scores on the Gingival Index and Decayed, Missing, and Filled Teeth (DMFT) Index. Correlates of periodontitis were examined using univariable and multivariable logistic regression.

Results

Of the 647 women in the study, 84% (n = 541) had no/mild periodontitis, 15% (n = 97) had moderate periodontitis, and 1% (n = 9) had severe periodontitis. Mild gingivitis was present in 61% (n = 396) of women, while 27% (n = 176) had moderate gingivitis, and 1% (n = 9) had severe gingivitis. The majority (75%, n = 487) of women had a DMFT index in the very low range (score < 5). Periodontitis was observed in 12% (12/101) of nulliparous women compared to 13% (36/286) of women with one prior delivery (prevalence ratio [PR] 1.03, 95% confidence interval [95% CI] 0.57–1.96), 21% (36/170) of women with two prior deliveries (PR 1.78, 95% CI 0.97–3.26), and 24% (22/90) of women with 3 or more prior deliveries (PR 2.06, 95% CI 1.08–3.92).

Conclusion

This study demonstrated a substantial prevalence of moderate-severe periodontitis among women planning to conceive in Kenya. These results highlight the need to address the oral care needs of reproductive age women, particularly those with multiple prior pregnancies.

Does having children affect women's oral health? A longitudinal study

BACKGROUND

Many believe women's oral health deteriorates as a result of having children. If so, such associations should exist among women but not among men. The aims of this study were to investigate whether number of children is associated with experience of dental disease and tooth loss among both men and women and to examine whether this association is affected by other variables of interest.

METHODS

This study used data from the Dunedin Multidisciplinary Health and Development study, a longitudinal study of 1037 individuals (48.4% female) born from April 1972 to March 1973 in Dunedin, New Zealand, who have been examined repeatedly from birth to age 45 years.

RESULTS

Data were available for 437 women and 431 men. Those with low educational attainment were more likely to have more children and began having children earlier in life. Having more children was associated with experiencing more dental caries and tooth loss by age 45, but this association was dependent on the age at which the children were had. Those entering parenthood earlier in life (by age 26) had poorer dental health than those entering parenthood later in life, or those without children. There was no association between number of children and periodontal attachment loss (PAL). Low educational attainment, poor plaque control, never routine dental attendance, and smoking (for PAL) were associated with PAL, caries experience, and tooth loss.

CONCLUSIONS

Social factors associated with both the timing of reproductive patterns and health behaviors influence the risk of dental disease and its management.

Oral health and emotional well-being in premenopausal and postmenopausal women: a cross-sectional cohort study

Background

Menopause, the absence of ovarian sex steroids, is frequently accompanied by emotional and physiological changes in a woman´s body, as well as oral health changes. The present study aimed to evaluate the association between the periodontal health status and emotional and physical well-being among postmenopausal women (PMW) in comparison with regularly menstruating premenopausal women (RMPW).

Methods

A total of 115 women (PMW, n = 56, mean age ± SD: 54 ± 5; RMPW, n = 59, mean age ± SD: 41 ± 4) received a comprehensive medical assessment and a full-mouth oral examination. All completed the Women’s Health Questionnaire (WHQ) to measure emotional and physical well-being. The corresponding bone mineral density (BMD) scores were obtained from participants´ medical records.

Results

Tooth loss was significantly higher in PMW than RMPW after adjusting for age (3.88 ± 2.41 vs 2.14 ± 2.43, p < 0.05). No significant difference was found in the prevalence of periodontitis between the two groups (PMW: 39.2%, RMPW: 32.2%, p > 0.05). The prevalence of periodontitis was associated with fewer daily brushing sessions in PMW (p = 0.021). Based on the WHQ, both PMW and RMPW with periodontitis had higher ‘’depressed mood’’ scores compared to periodontally healthy women (p = 0.06 and p = 0.038, respectively). The women who reported fewer daily toothbrushing sessions found to have higher depressive mood scores (p = 0.043).

Conclusions

Presence of periodontitis is associated with the emotional and physical well-being of women and reinforcement of oral healtcare is recommended at different stages of a woman’s life including menopause to reduce the risk for early tooth loss in women.

The prevalence and socio-behavioural and clinical covariates of oral health related quality of life in Ugandan mothers with and without HIV-1

Background

There is limited evidence regarding oral health related quality of life of HIV positive populations in sub-Saharan Africa. Focusing HIV positive- and HIV negative Ugandan mothers, this study assessed the influence of HIV status on oral health related quality of life in terms of oral impacts on daily performances, whilst adjusting for clinical- and socio-behavioural factors. We also examined whether any association of clinical and socio-behavioural factors with oral impacts on daily performances vary according to mothers’ HIV status.

Methods

This cross-sectional study used data from a trial (n = 164) and a comparison group (n = 181). The trial comprised of mothers with HIV-1 participating in the ANRS 121741-PROMISE-PEP-trial (NCT00640263) conducted between 2009 and 2013 and from the ANRS 12341-PROMISE-PEP-M&S follow-up study conducted in 2017. The comparison group comprised of HIV negative mothers recruited in 2017. Interviews and clinical oral examinations were performed. The oral health related quality of life was assessed using the oral impacts on daily performances frequency scale. Caries experience and gingival bleeding were assessed using the World Health Organization’s Decayed, Missed and Filled teeth indices and community periodontal index. Logistic and negative binomial regression analyses were performed.

Results

29% of HIV-1 positive and 32% among the comparison reported any oral impact on daily performance. In adjusted logistic regression analysis, HIV status was not significantly associated with oral impacts on daily performances. Mother’s self-reported oral health, caries experience, gingival bleeding and oral health related quality of life of their children were independently associated with oral impacts on daily performances. Corresponding prevalence ratios and 95% confidence intervals were: 0.3 (0.2–0.6), 1.8 (1.0–3.2), 1.1 (1.0–1.1), and 2.1 (1.1–4.3). No significant interaction between HIV status and covariates were observed.

Conclusions

Oral health related quality of life was substantially impaired in Ugandan mothers but did not discriminate between HIV positive and negative participants. Mothers with impaired oral health related quality of life were more likely to have dental caries and children with impaired oral health related quality of life. HIV positive and negative mothers in Uganda deserve special attention regarding their oral disease and quality of life status.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01844-3.

Age at first childbirth in relation to oral health later in life

OBJECTIVE

This study aimed to examine the relationship between age at first childbirth and oral health. The mediation effect of body mass index (BMI) on this relationship was also determined.

METHODS

This study analyzed data of 2,506 parous postmenopausal women aged 50 or older from the Korea National Health and Nutrition Examination Survey 2013-2015. Chewing inconvenience was investigated by an oral interview. Periodontitis and dental caries were determined through dental examinations. Multivariable logistic regression analysis was performed to examine the relationship between age at first childbirth and oral health, and mediation analysis was performed to examine the contribution of BMI on the relationship between age at first childbirth and oral health.

RESULTS

Women who underwent their first delivery between the age of 26 and 46 years had significantly decreased odds of chewing inconvenience (odds ratio [OR] = 0.72, 95% confidence interval [95% CI] = 0.56-0.93, P = 0.010) compared with the odds of those women whose first delivery was between at the age of 15 and 22 years. We also found a significant linear relationships between age at first childbirth and odds of chewing inconvenience (OR = 0.83, 95% CI = 0.74-0.95, P = 0.017) and dental caries (OR = 0.84, 95% CI = 0.74-0.96, P = 0.025). BMI accounted for 12.9% of the relationship between age at first childbirth and dental caries. Age at first childbirth was only indirectly associated with periodontitis through BMI (OR = 0.98, 95% CI = 0.96-0.99, P = 0.003).

CONCLUSIONS

Women whose first delivery occurred at a young age had significantly increased odds of chewing inconvenience and dental caries. BMI mediated the relationships between age at first childbirth and periodontitis and dental caries.

High Parity Is an Independent Risk Factor for Tooth Loss in Women: A Community-Based Takahata Study in Japan

Risk factors for tooth loss have been widely examined previously. However, no previous study has comprehensively investigated the risk factors, including lifestyle-related specific factors (parity, oral health habits, and socioeconomic status), for fewer than 20 teeth among women in the general population in Japan. This cross-sectional study explored the association of these risk factors, especially parity, with having fewer than 20 teeth among Japanese women. A self-reported questionnaire including items on lifestyle-related risk factors (parity, oral health, diet [e.g., alcohol and sucrose consumption]) and socioeconomic status was sent by post to female residents (age ≥ 40 years) of Takahata town, Yamagata Prefecture, in 2005. Multivariate logistic regression analysis including 3,854 eligible participants was performed to investigate the association between various factors (including parity) and having fewer than 20 teeth. The results indicated that, compared with nulliparous women, women with two, three, and four completed pregnancies had 2.485-, 2.844-, and 4.305-fold increased risk of having fewer than 20 teeth, respectively. Our study is the largest-scale study of the general female population in Japan and the first study to comprehensively investigate risk factors (parity, oral health status, and socioeconomic status) for fewer than 20 teeth. We thus found that higher parity, especially, two or more, was independent risk factors for having less than 20 teeth among Japanese women. In conclusion, the present study emphasizes the importance of good oral health habits in women, especially, during pregnancy and in the postpartum period, to maintain 20 or more teeth.

Parity and Number of Teeth in Japanese Women: Results from the Japan Nurses' Health Study

Background: Parity is thought to be associated with a decreased number of teeth present in women. However, educational level and social status, which are particularly significant risk factors for loss of teeth, have been heterogeneous in previous observations. This cross-sectional survey aimed to clarify the associations of parity with the risk of having <20 teeth in Japanese female nurses participating in the Japan Nurses' Health Study (JNHS). Methods: In the third follow-up questionnaire of the JNHS, 11,299 women aged 27-82 years participated in this study. The number of participants according to age range was 7,225 (63.9%) aged <50 years and 4,074 (36.1%) aged ≥50 years. Information on parity and risk factors for loss of teeth was collected through a baseline questionnaire and then a follow-up questionnaire. Multivariate logistic regression analysis was used to calculate the adjusted odds ratio (OR) and 95% confidence interval (CI) of having <20 teeth according to parity category. Results: Participants ≥50 years who had experienced three or more deliveries had a significantly higher risk of having <20 teeth than those who had not experienced delivery (OR = 1.59, 95% CI = 1.14-2.20), although this finding was not observed in participants <50 years. In addition to parity, age and current smoking may be independent risk factors for having <20 teeth in Japanese nurses. Conclusions: Higher-parity female nurses ≥50 years may be more likely to lose teeth than those who have not experienced delivery.

Gain a child, lose a tooth? Using natural experiments to distinguish between fact and fiction

Background

Dental diseases are among the most frequent diseases globally and tooth loss imposes a substantial burden on peoples' quality of life. Non-experimental evidence suggests that individuals with more children have more missing teeth than individuals with fewer children, but until now there is no causal evidence for or against this.

Methods

Using a Two-Stage Least Squares (2SLS) instrumental variables approach and large-scale cross-sectional data from the Survey of Health, Ageing, and Retirement in Europe (study sample: 34 843 non-institutionalised individuals aged 50+ from 14 European countries and Israel; data were collected in 2013), we investigated the causal relationship between the number of biological children and their parents’ number of missing natural teeth. Thereby, we exploited random natural variation in family size resulting from (i) the birth of multiples vs singletons, and (ii) the sex composition of the two first-born children (increased likelihood of a third child if the two first-born children have the same sex).

Results

2SLS regressions detected a strong causal relationship between the number of children and teeth for women but not for men when an additional birth occurred after the first two children had the same sex. Women then had an average of 4.27 (95% CI: 1.08 to 7.46) fewer teeth than women without an additional birth whose first two children had different sexes.

Conclusions

This study provides novel evidence for causal links between the number of children and the number of missing teeth. An additional birth might be detrimental to the mother’s but not the father’s oral health.

Pregnancy, parity and periodontal disease

Many women believe that their dental condition deteriorated during pregnancy or as a result of having children. Epidemiological studies have reported an association between higher parity and tooth loss, and higher parity and periodontal attachment loss. Several possible explanations for this association exist. First, hormonal changes during pregnancy affect the immune response to bacterial plaque and drive vascular and gingival changes that may contribute to heightened gingival inflammation. These changes are transient, without irreversible loss of periodontal attachment, and post-partum resolution can be expected for most women. For women with destructive periodontal disease, the effects of pregnancy and parity are unclear. Second, it is also plausible that parity and socioeconomic position (SEP) have shared risk factors, increasing the incidence of disease or influencing its management. Education, one aspect of SEP, is an important determining factor for women's fertility rate, with a gradient of fewer children with higher educational attainment. Higher levels of education are also favourably associated with behaviours conducive to oral health, and a lower incidence of damaging health behaviours. Thus, the potential for confounding is considerable. This review examines the literature on the association between pregnancy, parity and periodontal health, and explores sociobehavioural mechanisms for the observed association.

Factors associated with having less than 20 natural teeth in rural adults: a cross-sectional study

BACKGROUND

Some systematic reviews have consistently indicated a positive link between Metabolic syndrome, impairedfasting glucose, all-cause or circulatory disease-related mortality, general health, periodontitis, and toothloss. This study was to examine the prevalence of number of remaining teeth <20 and associated risk factors among adults in a rural area of Taiwan.

METHODS

A community-based, cross-sectional study was conducted in southwestern coastal Taiwan in 2013; 6680 residents aged 20-64 years were studied. Oral hygiene, substance use, dietary habits, and metabolic syndrome were explored as potential risk factors for number of remaining teeth <20 using logistic regression analysis.

RESULTS

The mean number of remaining teeth was 24.6 (SD = 7.4), and 16.3 % (n = 1085) of the participants had number of remaining teeth <20. Men had significantly less frequent use of dental floss, unhealthy dietary habits, more substance use and metabolic syndrome than did women (p <0.001). However, women tended to have fewer teeth than men (p <0.001). After adjusting for potential confounders, older age (odds ratio [OR] = 4.56, 95 % confidence interval [CI]: 3.74-5.55), female (OR = 1.88, 95 % CI: 1.56-2.25), less education (OR = 2.40, 95 % CI: 1.90-3.02), infrequent use of dental floss (OR = 1.94, 95 % CI: 1.66-2.27), substance use (OR = 1.32, 95 % CI: 1.09-1.59), and number of metabolic syndrome components (OR = 1.10, 95 % CI: 1.04-1.16) were independently associated with a higher risk of number of remaining teeth <20.

CONCLUSIONS

Number of remaining teeth <20 was highly prevalent among rural adults. In addition to unmodifiable factors, infrequent use of dental floss, substance use, and metabolic syndrome were risk factors associated with tooth loss.