Association between number of teeth and Alzheimer’s disease using the National Database of Health Insurance Claims and Specific Health Checkups of Japan

Abstract

Associations of numbers of teeth present and of missing teeth with Alzheimer’s disease were cross-sectionally analyzed using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Dental care claims data of patients aged 60 years or older diagnosed with periodontitis (n = 4,009,345) or missing teeth (n = 662,182) were used to obtain information about the numbers of teeth present and of missing teeth, respectively, and they were combined with medical care claims data including the diagnosis of Alzheimer’s disease. Numbers of teeth present and of missing teeth excluding third molars were calculated using the dental formula in the claims for periodontitis and missing teeth, respectively, and categorized into three groups each. Percentages of subjects treated for Alzheimer’s disease with 20–28, 10–19, and 1–9 teeth present were 1.95%, 3.87%, and 6.86%, respectively, in patients diagnosed as having periodontitis, and those treated for Alzheimer’s disease with 1–13, 14–27, and 28 missing teeth were 2.67%, 5.51%, and 8.70%, respectively, in patients diagnosed as having missing teeth. Logistic regression models using treatment for Alzheimer’s disease as an outcome variable and adjusting for age and sex showed that odds ratios (95% confidence intervals) for patients with 10–19 and 1–9 teeth (reference: 20–28 teeth) were 1.11 (1.10–1.13) and 1.34 (1.32–1.37), respectively, (p<0.001), in patients diagnosed as having periodontitis, and odds ratios (95% confidence intervals) for patients with 14–27 missing teeth and 28 missing teeth (reference: 1–13 missing teeth) were 1.40 (1.36–1.44) and 1.81 (1.74–1.89), respectively, (p<0.001), in patients diagnosed as having missing teeth. In conclusion, the results of the present study using Japanese dental claims data showed that older people visiting dental offices with fewer teeth present and a greater number of missing teeth are more likely to have Alzheimer’s disease.

Severity of Dementia Is Associated with Increased Periodontal Inflamed Surface Area: Home Visit Survey of People with Cognitive Decline Living in the Community

“…Participants in this study also had more teeth than other reports of older people with dementia in Japan [40]. Older people with more remaining teeth, subjective chewing and no oral pain are therefore less likely to see a dentist [41]. Periodontal disease is generally painless, and thus people with dementia who have periodontal disease tend not to go to the dentist, and may therefore have unmet oral care needs.…”

Longitudinal association of oral functions and dementia in Japanese older adults

“…There was no association between number of present teeth and dementia in our study. Past studies were reported that missing tooth is associated with development of Alzheimer's dementia 36 . This may be related to number of participants with missing tooth.…”

The Impact of Masticatory Function on Cognitive Impairment in Older Patients: A Population-Based Matched Case-Control Study

“… 22 Another recent study of national database from Japan reported that older people with fewer teeth were more likely to develop Alzheimer’s disease. 23 …”