Relationship between tooth loss and peripheral arterial disease among women

Objectives Many older people lose their teeth. However, few studies have examined whether the number of remaining teeth or the amount of occlusal support is more important for tooth loss that occurs in older age after adjusting for systemic factors. The purpose of this study was to investigate comprehensively the factors related to tooth loss over a period of 6 years, including occlusal support in 70‐ and 80‐year‐old community‐dwelling Japanese people. Methods This cohort study included 296 participants in the 70‐year‐old group and 232 in the 80‐year‐old group. The number of teeth of all participants was recorded at baseline and after 6 years, and the participants were divided into two groups according to the number of teeth lost (0 or 4 or more). Occlusal support was classified into three groups based on posterior occlusal support. Mean probing pocket depth, tooth brushing habits, frequency of dental check‐ups, education level, economic status and systemic factors (carotid atherosclerosis, hypertension, diabetes mellitus, dyslipidemia, cognitive function and smoking habits) were evaluated. Multiple logistic regression analysis was performed to investigate the relationship of tooth loss with occlusal support and systemic factors. Results Logistic regression analysis revealed that mean probing pocket depth (odds ratio [OR] = 5.70, 95% confidence interval [CI] = 2.70‐12.04, P < .01) and posterior occlusal support (reference = Eichner class A; Eichner B1‐3, OR = 4.33, 95% CI = 1.54‐12.17, P < .01; Eichner B4 or C, OR = 6.16, 95% CI = 1.17‐32.44, P = .03) were associated significantly with the loss of four or more teeth. Conclusions This study revealed that age itself is not a predictor of multiple tooth loss in community‐dwelling older Japanese people. Deep mean probing pocket depth and a lack of posterior occlusal support were significantly associated with the loss of four or more teeth.

Section: Discussionmentioning

confidence: 99%

Occlusal support predicts tooth loss in older Japanese people

Mihara

Matsuda

Takahashi

et al. 2019

“…Tooth loss can also impact facial appearance and therefore affect self‐esteem and socialization . Other systemic conditions, such as cognitive decline and peripheral arterial disease, as well as overall mortality, have been linked to tooth loss. Financial limitations have also been linked to reduced oral healthcare utilization among older adults in multiple countries, and increased oral health insurance coverage is associated with higher use of oral healthcare services …”

Section: Introductionmentioning

confidence: 99%

Predictors of having a dentist among older adults in Iowa

Marchini

Reynolds

Caplan

et al. 2020

Objectives:Oral health plays an important role in the general well-being of older adults, yet older adults experience unique barriers to dental care. In the United States, almost two-thirds of older adults are dentally uninsured -a reflection of the exclusion of dental benefits from Medicare. The aim of this study was to investigate potential predictors of having a dentist among older adults receiving services funded through the Iowa Department on Aging (IDA).Methods: This was a cross-sectional analysis on a convenience sample (n = 2692) of adults age 65+ who completed a required survey to determine eligibility to receive services from the IDA. Data from questionnaires completed between March and December 2017 were used to generate multivariable logistic regression models that identified predictors of having a dentist. The dependent variable, having a dentist, was gathered by self-report in the survey. Explanatory variables eligible for inclusion in the models included demographic and geographic factors, indicators of access to dental care, and factors related to activities of daily living. Results:Fewer than half (46.2%) of the respondents reported having a dentist. In the final regression model, individuals with dental insurance were more than twice as likely to have a dentist than those without insurance. Conversely, individuals with a tooth/mouth problem and who need help with housekeeping and with transportation were significantly less likely to have a dentist than their counterparts. Conclusions:These results align with known insurance-related barriers and identify certain activities of daily living that might influence older adults' ability to access care. The finding that individuals with oral health problems were less likely to have a dentist underscores the need to reduce barriers to care for this population. K E Y W O R D Saccess, dental services research, geriatrics

“…To clarify the meaning of tooth loss in the epidemiologic context, it would be helpful to use longitudinal data. A few studies report on tooth survival over time or trends in repeated cross-sectional samples [14][15][16][17][18][19] but most rely on self-reported tooth loss with limitations in validity, 14,16,17 or are performed in selected patient groups with limitations in generalizability into the general population. 19,20 To date, the largest published longitudinal analysis of changes in dental status comes from the Dunedin study, a prospective cohort study of approximately 1000 participants born in 1972/1973.…”

Section: Introductionmentioning

confidence: 99%

Tooth loss is a complex measure of oral disease: Determinants and methodological considerations

Haworth

Shungin

Kwak

et al. 2018

ObjectivesCounts of missing teeth or measures of incident tooth loss are gaining attention as a simple way to measure dental status in large population studies. We explore the meaning of these metrics and how missing teeth might influence other measures of dental status.MethodsAn observational study was performed in 2 contrasting adult populations. In total, 62 522 adult participants were available with clinically assessed caries and periodontal indices from the Swedish arm of the Gene‐Lifestyle Interactions and Dental Endpoints Study (GLIDE) and the Korea National Health and Nutrition Examination Survey (KNHANES) in the Republic of Korea. Longitudinal measures of tooth loss were available for 28 244 participants in GLIDE with median follow‐up of 10.6 years.ResultsIn longitudinal analysis, hazard for tooth loss was associated with baseline dental status (previous tooth loss, periodontal status and caries status) and socio‐demographic variables (age, smoking status and highest educational level). Analysis of cross‐sectional data suggested that indices of caries exposure were not independent of periodontal status. The strength and direction of association varied between groups, even for measures specifically intended to avoid measuring tooth loss. Individuals with impaired periodontal health (community periodontal index [CPI] 3 or higher in any sextant) had higher standardized decayed and filled surfaces (DFS; number of DFS divided by total number of tooth surfaces) in GLIDE (incidence risk ratio [IRR] 1.05 [95% CI: 1.04, 1.07], but lower standardized DFS in KNHANES (IRR: 0.95 [0.92, 0.98]) than individuals with better periodontal health (CPI <3 in all sextants).ConclusionsIncident tooth loss is a complex measure of dental disease, with multiple determinants. The relative importance of dental caries and periodontal disease as drivers of tooth loss differs between age groups. Measures of dental caries exposure are associated with periodontal status in the studied populations, and these associations can be population‐specific. Consideration of the study‐specific properties of these metrics may be required for valid inference in large population studies.