Functional tooth number and 15‐year mortality in a cohort of community‐residing older people

Abstract

Background:To study how dental status can become a predictor of overall mortality risk.Methods: Community residents (n = 5730) over 40 years old in the Miyako Islands, Okinawa Prefecture, Japan were followed up for 15 years, 1987-2002. Functional tooth numbers were examined by dentists and overall mortalities of subjects with functional tooth numbers of <10 and 310 were compared in the age groups 40-49, 50-59, 60-69, 70-79 and 80 years or more in both males and females.Results: Groups of 80 years or more showed a significantly higher rate of overall mortality in subjects with functional tooth numbers of less than 10 than 10 or more, and there was no significant difference in the other age groups. Conclusion:The present study suggests that systemic attention to dental status should be recommended in older males.

The association of tooth loss with all-cause and circulatory mortality. Is there a benefit of replaced teeth? A systematic review and meta-analysis

“…Smoking has considerable influence on the development of clinically detectable periodontitis [79], which eventually over a period of time leads to tooth loss. As smoking is also an important risk factor for allcause and circulatory mortality [80], its non-consideration or rough classification [81,82] may have given rise to an overestimation of tooth number-related effects on mortality in some studies [39,41,43,44,50]. Residual confounding because of smoking has not always been discussed [41,43,44,49,50], although it was known that the relationship between periodontal and cardiovascular disease is prone to this major limitation [83].…”

“…Moreover, the confounder sets of the studies were quite heterogeneous. Few risk models lacked adjustment for clinically relevant confounders such as smoking [39,41] and diabetes [41,46,52] (Tables 3 and 4). Potential residual confounding by smoking was addressed in three studies by performing sensitivity analysis [36], using the number of cigarettes per day for current and former smokers [47], or stratifying by smoking status [56].…”

“…Most of the studies were conducted in Europe [37, 40, 43-46, 49, 50, 52, 55-57] or Japan [38,41,42,48,54,58], four in the United States [39,47,51,53] and one in China [36]. Study participants were recruited from the general population [36-46, 48-53, 57, 58], nursing facilities [54], registers [47,55] and a university hospital [56].…”

“…As smoking is also an important risk factor for allcause and circulatory mortality [80], its non-consideration or rough classification [81,82] may have given rise to an overestimation of tooth number-related effects on mortality in some studies [39,41,43,44,50]. Residual confounding because of smoking has not always been discussed [41,43,44,49,50], although it was known that the relationship between periodontal and cardiovascular disease is prone to this major limitation [83]. Similarly, not controlling diabetes, body mass index or obesity as surrogates limits the validity of some findings [41,43,44,46,49,50,52,55] because diabetes is an important risk factor of periodontal disease and strongly associated with increased mortality and thereby confounding the relationship between tooth loss and mortality [84].…”

Relationship between Eichner Index and Number of Present Teeth

“…Fukai et al 4) reported on the mortality of a cohort of community-residing older people. That study indicated that, above the age of 80 years, participants with fewer than 10 functional teeth showed a significantly higher rate of overall mortality than those with 10 PT or more.…”