Tooth Loss and Mortality in Elderly Japanese Adults: Effect of Oral Care

Hayasaka, Kazuki; Tomata, Yasutake; Aida, Jun; Watanabe, Takashi; Kakizaki, Masako; Tsuji, Ichiro

doi:10.1111/jgs.12225

Cited by 62 publications

(77 citation statements)

References 30 publications

(68 reference statements)

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“…In a study of 21,700 elderly Japanese, tooth brushing and regular dental visits were associated with survival after controlling for age, sex, education level, smoking, drinking, and medical history. 26 Other studies have found an association between tooth loss and overall mortality in Danish, 27 Taiwanese, 28 Scottish, 29 French 30 and Chinese populations. 31 The mechanism is unclear and it has been suggested that markers of oral health such as tooth loss, visits to the dentist, and tooth brushing may serve as a proxy for life and health stressors that can affect mortality.…”

Section: Discussionmentioning

confidence: 96%

Poor oral health affects survival in head and neck cancer

et al. 2017

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Introduction Poor oral health has emerged as a risk factor for squamous cell carcinoma of the head and neck (HNSCC) but its impact on survival has not been examined. We sought to estimate the impact of oral health indicators on survival in a population-based HNSCC cohort. Materials and Methods Cases (n=1381) and age-, sex- and race-matched controls (n=1396) were participants in the Carolina Head and Neck Cancer Epidemiologic Study (CHANCE). Vital status was determined via linkage with the National Death Index. Survival was considered at 5 years post-diagnosis or study-enrollment for controls. Oral health was assessed using self-reported indicators including frequency of routine dental exams and tooth brushing. We used Kaplan-Meyer analyses and Cox regression to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI). Results Routine dental visits during the preceding 10 years were associated with decreased mortality risk (>10 visits: HR=0.6, 95% CI=0.4–0.8) after adjusting for confounders. This effect was most pronounced for oral cavity cancer—(e.g., >10 visits: HR=0.4, 95% CI=0.2–0.9). Dental visits were also positively associated with survival among controls. No other routine health screening (e.g., eye exams) was associated with survival. Conclusion We found significant associations between markers of oral health and survival among both HNSCC cases and controls. This association was most pronounced for sites closer to the dentition. Oral health may have a direct effect on tumor biology due to the associated immune or inflammatory response. It may also represent a proxy for wellness or unmeasured social determinants of health.

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Section: Discussionmentioning

confidence: 96%

Poor oral health affects survival in head and neck cancer

et al. 2017

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“…Paganini-Hill et al (9) followed 5,611 men and women for 17 years in the United States and reported that people with poor oral hygiene habits had a higher risk of mortality (9). A study on 21,730 community residents in Japan also reported that people with poor oral health care habits had a higher risk of mortality (10).…”

Section: Introductionmentioning

confidence: 96%

Association between socioeconomic status and oral health behaviors: The 2008–2010 Korea national health and nutrition examination survey

Park

Han

Park

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Socioeconomic status (SES) has been reported to be associated with oral health behavior. Therefore, the present study was conducted to assess the relationship between SES and oral health behaviors in a large sample of the Korean population. Data from the Korea National Health and Nutrition Examination Survey, which was conducted between 2008 and 2010 by the Division of Chronic Disease Surveillance under the Korea Centers for Disease Control and Prevention and the Korean Ministry of Health and Welfare, were used in the present study. Daily tooth brushing frequency and the use of secondary oral products according to demographic variables and anthropometric characteristics of the participants were assessed. Multivariate logistic regression analyses were used to analyze the associations between daily tooth brushing frequency and the use of secondary oral products, and SES, urban/rural residence, body mass index (BMI), alcohol intake and smoking. An association between SES and tooth brushing frequency and the use of secondary oral products was detected after adjustment. Following adjustment for age, gender, BMI, smoking, drinking, exercise, energy intake, fat intake, periodontal treatment needs and education or income, the adjusted odds ratios and 95% confidence intervals (CI) of tooth brushing ≥3 per day in the highest income group were 1.264 (95% CI, 1.094-1.460) and 2.686 (95% CI, 2.286-3.155) for highest education level group. The adjusted odds ratios for the use of secondary oral products in the highest income and highest education groups were 1.835 (95% CI, 1.559-2.161) and 5.736 (95% CI, 4.734-6.951), respectively, after adjustment for age, gender, smoking, BMI, exercise, calorie intake, periodontal treatment requirements or income. The present study demonstrated an association between SES and oral health behaviors in a large sample of the Korean population. Within the limits of the present study, income and education were suggested as potential risk indicators for oral health behaviors; therefore, patients with a low SES should be investigated further, in relation to oral health.

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“…Many studies of oral health status have examined factors such as number of teeth, oral hygiene, denture use status, saliva secretion, and masticatory function to clarify any relationship with mortality in the elderly [1–7]. In addition, masticatory function has been studied in terms of nutritional analysis from the diet, functional analysis by muscle activity involved in chewing, and analysis of the maximum occlusal force (MOF) [8–10].…”

Section: Introductionmentioning

confidence: 99%

Association between maximum occlusal force and 3-year all-cause mortality in community-dwelling elderly people

et al. 2016

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BackgroundAmong the very elderly, poor oral health reduces life expectancy. In this study, differences in the magnitude of the maximum occlusal force (MOF) in the very elderly were examined in terms of effects on all-cause mortality in a 3-year follow-up.MethodsWe evaluated 489 community-living elderly individuals aged 85 years or older. MOF was measured using an occlusal force measuring device, and participants were classified into three groups according to gender- and dental status-sensitive tertiles. Demographic variables, cognitive, physical function, psychological status, oral health, comorbidity, and blood chemistry factors were assessed. One-way analyses of variance, χ2 tests, and the Kruskal-Wallis test were used for statistical analyses. The relationship between MOF tertiles and 3-year all-cause mortality was examined using a multivariate Cox model analysis after adjusting for confounding factors.ResultsMOF tertiles were significantly associated with cognitive impairment, number of teeth, limitations on chewable foods, handgrip strength, timed up-and-go test, and diabetes mellitus. During the follow-up period, 74 subjects died. Subjects with the highest MOF had a significantly lower mortality rate than other groups (log rank P = 0.031). In the univariate Cox model, MOF tertiles were independently associated with a lower risk of death (HR = 0.69, 95 % CI = 0.51–0.91). Even after adjusting for various confounders in the multivariate Cox model (Model 1), MOF was independently associated with a lower risk of death (HR = 0.67, 95 % CI = 0.50–0.91). In model 2, we added handgrip strength as a confounder and found that the HR for MOF was attenuated (HR = 0.73, 95 % CI = 0.54–0.99), but still statistically significant.ConclusionsIn a cohort of the very elderly, MOF was independently associated with all-cause mortality after adjusting for various health issues. Moreover, this independent association remained after a further adjustment for handgrip strength; however, the HR was attenuated. This suggests that MOF and handgrip strength may share a common mechanism of a general decrease in muscle strength, possibly sarcopenia, which is a significant cause of mortality in the very old.

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Tooth Loss and Mortality in Elderly Japanese Adults: Effect of Oral Care

Abstract: Tooth brushing, regular dental visits, and use of dentures are inversely associated with mortality in elderly individuals with tooth loss.

Cited by 62 publications

References 30 publications

Poor oral health affects survival in head and neck cancer

Poor oral health affects survival in head and neck cancer

Association between socioeconomic status and oral health behaviors: The 2008–2010 Korea national health and nutrition examination survey

Association between maximum occlusal force and 3-year all-cause mortality in community-dwelling elderly people

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