Association between tooth loss and handgrip strength in a general adult population

Determining the relationship between oral health and physical function in elderly people

BACKGROUND

Poor oral conditions in the elderly may have numerous effects on general health, including physical fitness and performance.

OBJECTIVES

This study aimed to determine the relationship between oral health and physical function in elderly people.

METHODS

Physical function and oral health parameters were compared using parametric comparison tests and Pearson correlation analyses. In addition, principal components analysis, hierarchical clustering and multidimensional scaling analysis clustered the patients' physical and oral health scores. The relationship between the groups was also determined using decision tree analysis.

RESULTS

A total of 112 elderly patients participated in the study. Grip strength (GS) was higher in patients with high chewing ability, and Timed Up and Go (TUG) scores were lower in the high oral health group (p < .05). GS was correlated with Decay, Missing, and Filled Teeth Index (DMFT) and the number of remaining and functional teeth (p < .05). According to principal component analysis, it was seen that there were three components (oral, functional and quality of life (QoL) parameters), and the features that were related to each other were gathered together. TUG and GS showed the highest relative importance among physical function criteria in the classification based on chewing ability. They were GS and physical activity for oral health-related QoL.

CONCLUSION

In the elderly, higher physical function parameters, especially GS may be an indicator of a better oral health and oral health-related QoL. Preventive physical rehabilitation practices, in addition to oral treatments, may be effective in improving oral health in the elderly.

Gingival bleeding as a predictor of handgrip strength-an observational study and a pilot randomized clinical trial

OBJECTIVE

The aim of this study was to (i) assess the association between self-reported periodontal disease and gingival bleeding as predictors of handgrip strength (HGS) in the elderly and (ii) evaluate the impact of baseline periodontal clinical parameters on the improvement of HGS in trained or non-trained treated periodontitis patients.

METHODS

For (i), cross-sectional data from the Brazilian Longitudinal Study of Aging were retrieved and association between HGS (dependent variable) and self-reported gingival bleeding, periodontal disease, and missing teeth was analyzed using multiple linear regressions. For (ii), a pilot study was conducted with 17 patients randomly allocated to two groups-physical training or non-training-and followed for 45 days after subgingival instrumentation. Clinical parameters and HGS were recorded before and after treatment.

RESULTS

The observational study showed a significant association between HGS and tooth loss, edentulism and gingival bleeding. The clinical trial showed that baseline bleeding on probing, but not other parameters, was associated with delta HGS.

CONCLUSION

Taken together, our findings suggest that gingival bleeding could act as a predictor of handgrip strength and its improvement after non-surgical periodontal therapy.

CLINICAL RELEVANCE

Gingival bleeding, either as self-perceived or clinically detected, may impact handgrip strength, an important marker of muscle frailty and mortality.

Influence of Single-Digit Exclusions on Grip Strength in Healthy Male Adults

Grip strength (GS) of the human hand is vital to deal with objects of various sizes and shapes in daily life. The strength deteriorates if one or more digits of the hand are amputated. The main aim of this study was to determine the influence of single-digit exclusions on the GS. Healthy adults (n = 102, male) with an age range of 20 to 70 years (mean ± SD, 31.92 ± 13.14 years) participated in the study. The movements of unused digits were restrained using splints to avoid digit enslaving effects. T (Thumb), (I) Index, M (Middle), R (Ring), L (Little) digits were chosen for exclusion based on the digit configurations. The digit configurations were IMRL, MRLT, IMRT IRLT and, IMLT with exclusions T, I, L, M, and, R respectively. The results of two-way ANOVA with repeated measures showed no significant interaction (p = 0.923) between hand dominance and digit configurations. But statistical significance (p = 0.000) was observed in digit configurations and hand dominance individually. The results of posthoc analysis using Bonferroni corrected pairwise comparisons showed no statistical significance (p = 0.004) between IRLT and IMLT of both hands since the corrected p-value was 0.003. The outcomes of the F-test showed no statistical significance (p > 0.05) between the digit configurations IMRLT, IMRL; IMRL, MRLT; MRLT, IMRT; IRLT, IMLT individually within dominant (D) and non-dominant (ND) hands. When the F-test was performed using the same digit configurations between both hands, statistical significance was not observed in all the configurations except IMLT (p < 0.05). The results of the Pearson correlation of GS were observed to be very strong between the same digit configurations of D and ND hands.

Number of Teeth According to Hand Strength in Adults: A Cross-Sectional Study of 11,499 South Korean Adults

Background and Objectives: Grip strength is a measure of general health and is associated with oral health. This study aimed to investigate the relationship between the number of teeth and grip strength in Korean adults. Methods and Materials: We recruited adult participants who underwent oral examinations in the Korean National Health and Nutrition Examination Survey (KNHANES) between 2016-2018. When performing the KNHANES oral examination, an experienced dentist performed it according to the oral examination guidelines and recorded the results. A total of 24,269 participants from the 2016-2018 KNHANES were included in this study. Of these, only 16,489 participants underwent oral screening. A total of 3209 were non-adult children and adolescents, and 1781 did not respond to the grip strength test; those who did not respond to the main independent confounder were excluded. The relationships between grip strength, general characteristics, general health, oral health, and the number of remaining teeth were analyzed. There were 11,499 subjects in total in this study, with 4839 males and 6660 females. The age groups were 19-65 years of age, with 8387 subjects, and 65 years and older, with 3112 subjects, and the number of remaining teeth was 0-9 for 936 subjects, 10-19 for 1015 subjects, and 20-28 for 9548 subjects. Results: The probability that the higher the grip strength, the higher the residual number of gingiva was estimated by multinomial logistic regression analysis using complex sampling. The higher the grip strength, the higher the probability of having 20-28 teeth remaining (adjusted odds ratio, 1.59; 95% confidence interval, 1.19-2.13). Conclusions: Maintaining general health is related to maintaining teeth; the higher the grip strength, the higher the number of remaining teeth.

Influence of Joint Flexibility, Hand Grip Strength and Pain on Oral Hygiene in Musculoskeletal Disorders—A Non-Interventional Clinical Study

Diseases of the oral cavity and musculoskeletal disorders (MSDs) are common occurrences. They are commonly linked with partial mobility, resulting in limited visits to dentists for routine oral care, causing poor periodontal condition, bleeding, gingival inflammation, and increased depth of periodontal pockets. The present study was conducted to measure joint movements, hand grip strength, and pain in joints and their association with oral health. Materials and methods: The study included 200 subjects, half suffering from back, neck, shoulder, elbow, and wrist problems, belonging to different age groups and professions; 100 had joint pain, and 100 were without joint pain. The study assessed individuals exposed to oral health issues by measuring the strength of hand grip, flexibility, and pain score of the back, neck, shoulder, elbow, and wrist. The strength of the hand grip and the angle of the elbow and shoulder were measured in addition to a questionnaire to assess the relationship between back pain and oral health. To evaluate dental health status and oral hygiene, the total number of decayed, missing, and filled teeth (DMF/T) and Oral Hygiene Index—Simplified (OHI-S) indices were used. Results: The difference between all demographic parameters was statistically significant (p < 0.05). It was observed that there was a significant difference in calculus, debris, and dental caries scores in both groups, with significantly lower scores and better oral hygiene in patients without joint pain. Concerning pain score and joint movements, the group without joint pain showed a significantly better range of movements and less pain than patients suffering from joint pain, and statistically a significant difference (p < 0.05) was observed between both groups. Conclusion: The present study revealed that musculoskeletal disorders, pain in the neck and hand, and restricted movements were common among professionals. We observed that pain in joints, neck, and hands, with restricted movements, caused a serious impact on the maintenance of oral hygiene practices among subjects of different professions.

Association of Dental Caries with Muscle Mass, Muscle Strength, and Sarcopenia: A Community-Based Study

OBJECTIVES

Changes in the oral cavity can reflect other changes throughout the body. This study aimed to investigate the association of dental caries with muscle mass, muscle strength, and sarcopenia, and also to describe the microbial diversity, composition, and community structure of severe dental caries and sarcopenia.

DESIGN

Cross-sectional study based on a Chinese population aged from 50 to 85 years.

SETTING

Communities from Lanxi City, Zhejiang Province, China.

PARTICIPANTS

A total of 1,442 participants aged from 50 to 85 years from a general community (62.8% women; median age 61.0 [interquartile range: 55.0, 68.0]).

MEASUREMENTS

Dental caries was assessed by the decayed, missing, and filled teeth (DMFT) index. Sarcopenia was defined as the presence of both low muscle mass (assessed by dual-energy X-ray absorptiometry scanning) and low muscle strength (assessed by handgrip strength). Multivariate logistic regression models were used to analyze the association of dental caries with muscle mass, muscle strength, and sarcopenia. Fecal samples underwent 16S rRNA profiling to evaluate the diversity and composition of the gut microbiota in patients with severe dental caries and/or sarcopenia.

RESULTS

In the fully adjusted logistic models, dental caries was positively associated with low muscle strength (DMFT ≥ 7: OR, 1.61; 95% CI, 1.25-2.06), and sarcopenia (DMFT ≥ 7: OR, 1.51; 95% CI, 1.01-2.26), but not low muscle mass. Severe dental caries was positively associated with higher alpha-diversity indices (richness, chao1, and ACE, all p < 0.05) and associated with beta-diversity based on Bray-Curtis distance (p = 0.006). The severe dental caries group and the sarcopenia group overlapped with 11 depleted and 13 enriched genera.

CONCLUSION

Dental caries was positively associated with low muscle strength and sarcopenia but not muscle mass, and this association was more pronounced in male individuals. Significant differences were observed in gut microbiota composition both in severe dental caries and sarcopenia, and there was an overlap of the genera features. Future longitudinal studies are needed to clarify causal relationships.

Association between Present Teeth and Muscle Strength in Older People in Korea

Background: As the world population continues to age, interest in muscle strength loss in older people is increasing. This study aimed to confirm the association between present teeth and muscle strength in older people in Korea. Methods: Using data extracted from the 2014–2019 Korea National Health and Nutrition Examination Survey, we analyzed 5136 older people aged 65–79 years. The present teeth were based on 20 teeth, which is the criteria for comfortable mastication. The association of the risk of low muscle strength according to the present teeth was assessed using multiple logistic regression analysis, and the association was confirmed by dividing into subgroups according to sex. Results: The prevalence of low muscle strength was 17.87% among all participants. Multiple logistic regression analysis confirmed the association between low muscle strength and present teeth; a significant association was found even in the model in which all covariates were adjusted (odds ratios (OR) = 1.35; 95% confidence interval (CI): 1.13–1.61). Subgroup analysis revealed a significant association between present teeth and low muscle strength even in the model in which both covariates were adjusted for sex (Men, OR = 1.41; 95% CI: 1.02–1.95; Women, OR = 1.31; 95% CI: 1.06–1.6). Conclusion: An association between present teeth and low muscle strength was confirmed in older people in Korea. These results indicate that the importance of oral hygiene management should be emphasized to prevent muscle strength loss in older people.

Relationship between tooth loss and sarcopenia in suburban community-dwelling older adults in Shanghai and Tianjin of China

Both sarcopenia and loss of teeth are associated with aging. The purpose of this study was to investigate potential relationships between tooth loss and sarcopenia and its components in suburban community-dwelling older adults of Shanghai and Tianjin, China. The subjects were 1494 people over 60 years of age (40.7% men; aged 71.64 ± 5.97 years) from Chongming District of Shanghai and Hangu District of Tianjin. Asian Working Group for Sarcopenia(AWGS) criteria were used to define sarcopenia. Muscle mass, muscle strength, and physical performance were assessed using a bioelectrical impedance analyzer, a grip strength test, and a four-meter walk test, respectively. The subjects were divided into groups depending on self-reported loss of teeth. Our studies found no correlation between tooth loss and sarcopenia or muscle mass. However, the walking speed of female participants with at least 10 teeth lost was 0.059 m/s slower than that of participants with fewer than 10 teeth lost (p < 0.001), and grip strength was 1.577 kg lower among male participants with at least 10 teeth lost than among males with fewer than 10 teeth lost (p = 0.023). These results are consistent with the importance of good oral hygiene in preventing declines of physical performance in older adults.

Hopeless tooth and less posterior occlusion is related to a greater risk of low handgrip strength: A population-based cross-sectional study

The effect of severely compromised teeth on masticatory function has not been properly evaluated in previous studies, as they were often considered equivalent to the healthy tooth or excluded as if absent in the dentition. Hopeless teeth, which refer to non-salvageable teeth that require extraction, can interfere with masticatory function. As posterior occlusion is directly related to the masticatory function, we evaluated pairs opposing posterior teeth (POPs) that reflect the arrangement as well as the number of remaining posterior teeth. This study investigated the relationship of a hopeless tooth to handgrip strength according to POPs in the elderly. This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). Among the data of 23,466 participants from 2015 to 2018, participants aged 60 years or older (n = 4,729) were included. In males with POPs scores of 0-7, considered poor posterior occlusion, the association with low handgrip strength persisted in the multivariate logistic regression model adjusted for all confounding variables. The odds ratio (OR) in the absence of hopeless teeth (OR = 1.91, 95% CI: 1.02-3.59) increased in the presence of a hopeless tooth (OR = 2.78, 95% CI: 1.42-5.47). Even with POPs scores of 8-11, considered good posterior occlusion, the association was significantly high in the presence of a hopeless tooth (OR = 2.82, 95% CI: 1.06-7.52). In females, the association disappeared in adjusted models. The fewer pairs of natural posterior teeth with occlusion, the greater the risk of low handgrip strength. Dentition containing hopeless teeth increases the risk of low handgrip strength, even in dentition with sufficient posterior occlusion. Preserving the posterior teeth in a healthy condition through personal oral hygiene and regular dental management is essential for maintaining components of physical function such as handgrip strength.

Association between Oral Health Status and Relative Handgrip Strength in 11,337 Korean

Grip strength is a simple indicator of physical strength and is closely associated with systemic health. Conversely, oral health has also been reported to have an important association with systemic health. The present study aimed to assess the effect of oral health status on relative handgrip strength. The data pertaining to 11,337 participants were obtained by means of the seventh Korea National Health and Nutrition Survey (2016 to 2018). Oral health status was evaluated on the basis of the presence of periodontitis and number of remaining teeth (PT, present teeth). Relative handgrip strength was evaluated by means of a digital dynamometer and the value pertaining to the lower 25% of measurements was used as the quartile by gender. The association between oral health status and relative handgrip strength was evaluated by means of multiple regression analysis and multiple logistic regression analysis with covariate correction. Analysis of the crude model revealed a significant association in the group of patients with periodontal disease (odds ratio = 1.69, 95% confidence interval: 1.51-1.89). However, analysis with adjusted covariates revealed that the association was not statistically significant. Moreover, statistical analysis after adjustment for covariates revealed a consistent correlation between PT and relative handgrip strength as categorical and continuous variables. Hence, the present study observed a significant association between oral health status and relative handgrip strength among the Korean adult population.

Tooth Loss Is Associated with Disease-Related Parameters in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis-A Cross-Sectional Study

Background: The aim of this cross-sectional study was to investigate potential associations between periodontal inflamed surface area (PISA) and tooth loss with disease-related parameters in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods: Patients who attended the Department of Nephrology and Rheumatology, University Medical Centre Goettingen, Germany, were included. The oral examination comprised the detection of the number of remaining teeth and periodontal condition based on staging and grading matrix. Based on periodontal pockets with positive bleeding on probing, the periodontal inflamed surface area (PISA) was determined. Disease related parameters were extracted from the patients’ records. Results: In total, 101 (RA) and 32 participants (AS) were included. Patients with RA had 22.85 ± 4.26 and AS patients 24.34 ± 5.47 remaining teeth (p < 0.01). Periodontitis stage III and IV was present in 91% (RA) and 81.2% (AS) of patients (p = 0.04). Associations between PISA and disease-related parameters were not found in both groups (p > 0.05). In RA, a higher age (p < 0.01), C-reactive protein (p = 0.02), disease activity (p < 0.01) and prednisolone intake (p < 0.01) were associated with fewer remaining teeth. In AS, a higher age (p = 0.02) and increased Bath Ankylosing Spondylitis Metrology Index (p = 0.02) were associated with a lower number of remaining teeth. Conclusions: Tooth loss is associated with disease activity, especially in RA individuals. Dental care to prevent tooth loss might be recommendable to positively influence oral health condition and disease activity in RA and SA patients.