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PubMed2003

Dental caries and antemortem tooth loss in the Northern Peten area, Mexico: a biocultural perspective on social status differences among the Classic Maya.

Dental caries and antemortem tooth loss (AMTL) are investigated in a Classic Maya sample obtained from the sites of Calakmul, Dzibanché, and Kohunlich (Mexico). This study aims at assessing the effect that sex and social status had on the prevalence of oral pathologies. The lack of a direct relationship between caries, AMTL, and age-at-death led us to interpret the results in terms of the biological, socioeconomic, and behavioral conditions prevailing in these ancient Maya settlements. Benefits related to sex and social status are evident in the frequency of carious lesions, which appear less frequently in elite males than in low-status individuals of both sexes and in elite females. Individuals from problematic mortuary contexts and isolated bone assemblages, who could not be ascribed to any status group, showed the highest rates of caries. Sex discrimination in dietary preferences appears in the elite sample, while the homogeneity encountered between sexes in the low-status segment suggests a more uniform access to resources. Tooth loss clearly distinguishes elite individuals from commoners, regardless of sex, with the former bearing a much higher rate of loss. In individuals from the undefined mortuary assemblages and sacrificial contexts, it was even more pronounced than in the other groups, although its interpretation is problematic due to a lack of associated funerary data. The overall evidence from oral pathologies is interpreted to be the result of deficient oral hygiene coupled with a softer and more refined diet in the high-status population, particularly males. Whereas elite males' subsistence was apparently based more on animal proteins and relatively soft and refined foods, a diet relying on carbohydrates may account for the observed rate of oral pathologies in elite females and commoners.

Adolescent↗
PubMed1996

Tooth loss and chewing capacity among older adults in Adelaide.

This study aimed to identify sociodemographic factors associated with edentulism (loss of all teeth) and the average number of teeth lost, and to investigate relationships between tooth loss and chewing capacity. Data were obtained in 1991-92 from a cross-sectional oral epidemiological survey of Adelaide residents aged 60+ years. Interviews with 1160 participants provided information on edentulism while oral examinations among 560 dentate participants and 313 edentulous participants provided information on the number of missing teeth. People were asked if they could chew or bite six common foods. Some 41.1 per cent of persons were edentulous, and nearly half the natural teeth (mean 15.2) were missing among dentate people. Multivariate analyses revealed higher rates of edentulism (P < or = 0.05) for people who were older, female, Australian-born, or holders of pensioner health benefit cards, and for people who left school at an early age, or who did not own their residence. Among dentate people there were more (P < or = 0.05) missing teeth among those who were older, Australian-born, health benefit card holders, and who left school at an early age. Some 37.9 per cent of people reported difficulty chewing at least one food, although 57 per cent of dentate people and virtually all edentulous people wore dentures. Difficulty chewing was associated with tooth loss: 6.1 per cent of people with fewer than nine missing teeth reported difficulty compared with S8.6 per cent of edentulous people (P < 0.01). The findings show substantially compromised oral health among older adults, particularly the oldest-old and disadvantaged groups.

Aged↗
PubMed1990

The prevalence of total tooth loss, dental caries, and periodontal disease among Mexican Americans, Cuban Americans, and Puerto Ricans: findings from HHANES 1982-1984.

This paper describes the prevalence of total tooth loss, dental caries, and periodontal disease in 2,226 Puerto Ricans, 1,192 Cuban Americans, and 5,983 Mexican Americans, ages five to 74 years, who were examined during the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). The prevalence of total tooth loss was 2.60, 6.10, and 2.80 percent among Mexican Americans, Cuban Americans, and Puerto Ricans, respectively. After adjusting for the confounding effects of age, sex, income, and education status, no statistically significant differences were found in the mean number of decayed teeth among the three groups of Hispanics. Puerto Rican children had an average of 2.09 filled teeth compared with an average of 1.39 and 1.43 filled teeth for Mexican Americans and Cuban Americans, respectively. In adults, Puerto Ricans and Cuban Americans had at least 40 percent higher mean number of filled teeth than Mexican Americans. Cuban American and Puerto Rican adults had about twice as many missing teeth as Mexican Americans. The pit-and-fissure tooth surfaces in children accounted for the majority of sites affected by caries. All Hispanics had a higher prevalence of gingivitis than American adults as estimated during the 1985-86 National Institute of Dental Research (NIDR) survey of American adults. Puerto Ricans had the highest level of periodontal disease and the highest Debris Index scores among the Hispanic groups.

Adolescent↗
PubMed2003

The relation between tooth loss and bone mass in postmenopausal osteoporotic women in Turkey: a multicenter study.

The purpose of this study was to investigate the associations of tooth loss with skeletal bone mass, years since menopause, educational level, current smoking status, dietary calcium intake, and number of pregnancies in postmenopausal osteoporotic women in Turkey. The study population consisted of 1171 postmenopausal women aged 40-86 years (mean age, 61.19 +/- 7.28 years). A detailed history was obtained from all women, including relevant lifestyle parameters, risk factors, and measurements of weight and height. Women were separated into three groups according to the number of teeth remaining as group 1 (edentulous, 457 women), group 2 (10 or fewer teeth, 232 women), and group 3 (more than 10 teeth remaining, 482 women). There was no significant difference among the three groups in mean age and menopausal age ( P < 0.05). Body mass index of group 1 was significantly higher than that of group 2 ( P< 0.01). Educational level was significantly different between three groups: groups 1 and 2 ( P< 0.001), groups 1 and 3 ( P< 0.0001), and groups 2 and 3 ( P< 0.001). Educational level was lowest in group 1 and highest in group 3. Despite a low ratio of cigarette smoking in general, a smoking habit was most prevalent in group 3 and least in group 2. The ratio of women receiving adequate calcium was significantly lower in group 1 than in other groups ( P< 0.001); mean calcium intake was similar in all groups. The number of pregnancies was significantly higher in group 1 than in other groups ( P< 0.001). Lumbar bone mineral density (BMD) of group 1 was significantly lower than that of groups 2 and 3 ( P< 0.001). Although no significant difference was found between groups 1 and 3, femoral neck BMD of group 2 was less than in others, and differences between groups 1 and 2 and between groups 2 and 3 ( P< 0.001) were significant. Lumbar bone mineral content (BMC) of group 1 was significantly lower than that of groups 2 and 3 ( P< 0.001), and lumbar BMC in group 2 was significantly higher than in group 3 ( P< 0.05). Femoral neck BMC in group 1 was significantly higher than in groups 2 and 3 ( P< 0.001). In conclusion, lumbar BMD and BMC in the edentulous group were significantly lower, whereas femoral neck BMD and BMC were significantly higher in edentulous group compared with the others. Our findings indicated that improvement in lifestyle factors and nutritional strategies for the treatment and prevention of osteoporosis may have additional benefit in reducing tooth loss.

Adult↗
PubMed2001

Dental caries experience, tooth loss, and factors associated with unmet needs of Haitian immigrants in New York City.

OBJECTIVE: The aim of this study was to characterize the dental caries experience, tooth loss, and unmet need of a group of Haitian immigrant residents of New York City. METHODS: A purposive sample of 523 adults was obtained through community outreach activities during 1997-98. Clinical examinations were performed by calibrated examiners, according to NIDCR criteria. A comprehensive survey also was administered to all the participants. RESULTS: For the whole group, the mean number of missing teeth was 2.64 (SD = 4.12), the mean DMFT = 6.05 (SD = 5.26), the mean DMFS = 18.80 (SD = 21.04), and the mean DFS = 5.58 (SD = 6.17). Seventeen percent of the subjects had all their teeth sound, 59 percent had at least one tooth missing, 60 percent had at least one decayed tooth, and only 38 percent had restorations. Multivariate analyses showed that age, sex, education, dental insurance, frequency of dental visits, and dental floss use were predictors of unmet need. CONCLUSIONS: Although results showed a relatively low caries experience among this group of Haitian immigrants, the unmet need was very high. Furthermore, the tooth loss experience was relatively high for all age groups, further denoting a lack of access to preventive and restorative services.

Adolescent↗
PubMed2000

A 12-year retrospective audit study of tooth loss in a general dental practice.

OBJECTIVES: To determine the incidence of periodontal disease in a general dental practice, and to evaluate the effectiveness of treatment in preventing tooth loss over a period of 12 years. DESIGN: This was a single centre retrospective analysis. SETTING: A general dental practice in Bournemouth. SUBJECTS AND METHODS: Over a 6-month period from February 1997 to August 1997 records were made of all patients attending at the practice who had presented for dental examination between September 1985 and September 1986. A database was constructed to record the number of teeth present at the beginning of the study, those which at their initial exam had probing depths of between 5 and 6 mm, and those with 7 mm and greater. If teeth were lost, the date of the extraction was recorded. INTERVENTIONS: All patients were treated by conventional dental therapy. MAIN OUTCOME MEASURES: Tooth loss was chosen as the end-point. RESULTS: 13% of the patients presenting initially had periodontal problems, and conventional treatment resulted in very few teeth being lost over the study period. CONCLUSIONS: Periodontal disease affected only a small number of the patients in the general dental practice. Those patients affected responded well to conventional therapy, resulting in very few teeth being lost during the period of study.

Adult↗
PubMed2003

Periodontal disease, tooth loss, and incidence of ischemic stroke.

BACKGROUND AND PURPOSE: Periodontal and other infections have been suggested as potential risk factors for stroke. This study evaluates periodontal disease and tooth loss as risk factors for ischemic stroke. METHODS: The study population consisted of 41 380 men who were free of cardiovascular disease and diabetes at baseline. Periodontal disease history was assessed by mailed validated questionnaires. During 12 years of follow-up, stroke incidence was assessed and subclassified by use of medical history, medical records, and imaging reports. Hazard ratios (HRs) were adjusted for age, amount smoked, obesity, alcohol, exercise, family history of cardiovascular disease, multivitamin use, vitamin E use, profession, baseline reported hypertension, and hypercholesterolemia. Sex and socioeconomic status were inherently controlled for by restriction. Confounding variables were updated in the analyses for each 2-year follow-up interval. RESULTS: We documented 349 ischemic stroke cases during the follow-up period. Men who had < or =24 teeth at baseline were at a higher risk of stroke compared to men with > or =25 teeth (HR=1.57; 95% CI, 1.24 to 1.98). There was little evidence of an increased risk with recent tooth loss during follow-up. A modest association was seen between baseline periodontal disease history and ischemic stroke (HR=1.33; 95% CI, 1.03 to 1.70). Addition of dietary factors to the model changed the HR only slightly. CONCLUSIONS: Our results suggest that periodontal disease and fewer teeth may be associated with increased risk of ischemic stroke.

Adult↗
PubMed1989

Women's teeth. A cross-sectional and longitudinal study of women in Gothenburg, Sweden, with special reference to tooth loss and restorations.

A population study comprising a representative sample of women in five age strata between 38 and 60 was carried out in Gothenburg, Sweden, in 1968-69. Altogether 1418 women participated in the dental part of the study (87.4% of those sampled). The women were re-examined in 1980-81. A new group of 38-year-old women was invited in 1980-81. In this way cross-sectional comparisons could be made between women who were 38 and 50 years of age at the time of the two studies in 1968-69 and 1980-81 respectively. In addition, those who participated in both investigations could be studied longitudinally. Panoramic radiography was used to evaluate different dental health variables, for which the technique was found as valid as the more extensive intraoral full mouth radiographic examination. An improvement in dental health in terms of a decrease in tooth loss occurred over the twelve-year period. There was, among middle-aged and older women, no sign of a decrease in the proportion of restored teeth during the same period. A decrease in the differences between social groups had occurred, although differences in number of remaining teeth between women of various educational and socio-economic background to some extent still existed. Social factors seemed, however, to be of minor importance as discriminating factor for tooth loss during the follow-up period. The effect of smoking was also studied. Smoking seemed to be an important actor influencing tooth loss. An association between a low number of remaining teeth and impaired well-being was noted. Presence of amalgam fillings did not, on the population level, play any demonstrable role for impaired well-being among the women.

Adult↗
PubMed2001

Relationship between tooth loss and electrocardiographic abnormalities in octogenarians.

Recent reports have suggested that periodontal disease is a risk factor for coronary heart disease (CHD). However, little is known about the relationship between periodontal disease and CHD in the very elderly. Therefore, we evaluated the association between tooth loss and abnormal ECG findings in octogenarians. Of the 1,282 octogenarians in Fukuoka Prefecture, Japan, 697 participated. Oral examinations--including a tooth count and an assessment of the Community Periodontal Index--and a 12-lead ECG were performed. Logistic regression analysis revealed that individuals with < 20 teeth had increased prevalence of ST segment depression, and T-wave abnormalities, after we adjusted for gender, smoking, serum cholesterol and glucose, blood pressure, and body mass index. Compared with individuals with > or = 20 teeth, edentulous individuals had an increased prevalence of T-wave abnormalities and arrhythmias after adjustment for coronary risk factors. We conclude that tooth loss may be an independent predictor of abnormal ECG findings in octogenarians.

Aged↗
PubMed1989

Trends in tooth loss due to caries and periodontal disease by tooth type.

Although the patterns of dental disease is gradually changing, caries and periodontal disease still account for the most important reason for extractions in most countries. However their relative contributions towards overall tooth mortality figures varies. The aim of this study is to investigate the types of teeth usually associated with extractions due to caries or periodontal disease and its relation to the age at which the tooth was lost. The highest proportion of extractions due to caries occurred between 21 to 30 years of age while that for periodontal disease occurred between 41 to 50 years. For caries, the greatest proportion of extractions involved the posterior teeth. The most frequently extracted teeth due to caries are the molars, in particular the first permanent molar. However, for periodontal disease a slightly greater proportion of anterior teeth were lost than the posteriors. This trend is more marked in the lower jaw than the upper. Overall, extractions related to caries tend to increase posteriorly, while that for periodontal disease tend to increase anteriorly.

Adolescent↗
PubMed2005

Efficacy of periodontal disease and tooth loss to screen for low bone mineral density in Japanese women.

The relationship between oral indicators and bone mineral density (BMD) has been studied by many investigators, with mixed and complex results. The purpose of the present cross-sectional study was to evaluate the associations of periodontal conditions and tooth loss with metacarpal BMD (m-BMD) in a community-based cohort and the usefulness of tooth count as a potential screening tool to detect low BMD. Subjects were 356 Japanese women (171 premenopausal, mean age 37.9+/-8.0 years; 185 postmenopausal, mean age 63.3+/-7.7 years). Periodontal status was evaluated by the Community Periodontal Index of Treatment Needs (CPITN). m-BMD was measured by computerized X-ray densitometry. The proportion of subjects with periodontitis (CPITN 3 or 4) increased as m-BMD decreased. The odds ratio (OR) of osteopenia or osteoporosis in relation to periodontitis was 3.2 (95% confidence interval [CI], 2.0--5.3). After adjustment for age and menopausal status, the OR was 2.0 (95% CI, 1.1--3.7). Among postmenopausal women, those having fewer than 20 teeth were 1.6 times more likely to have low m-BMD than those having more than 20 teeth (chi-square for trend in postmenopausal group, 4.27; P<0.05). Receiver-operating curve (ROC) analysis indicated that number of teeth remaining or CPITN score had a greater than 50/50 chance to correctly identify women with osteoporosis or osteopenia, but the areas under the curve (0.72 and 0.67, respectively) are considered less than highly accurate screening tools. These results indicate that periodontitis and tooth loss after menopause may be useful indicators of m-BMD loss in Japanese women.

Absorptiometry, Photon↗
PubMed2005

Ultrasound measurement of mandibular arterial blood supply: techniques for defining ischemia in the pathogenesis of alveolar ridge atrophy and tooth loss in the elderly?

PURPOSE: To adapt ultrasound methods used to measure blood flow in the extremities to quantify mandible blood flow in order to determine the role of ischemia in the pathogenesis of mandible atrophy and tooth loss in the elderly. PATIENTS AND METHODS: Doppler and duplex ultrasound techniques as used in measurement of arterial pulse in the extremities were adapted for recording the intraoral pulse profile at 7 sites in 57 patients of varying ages. RESULTS: After omitting the large number (26 patients) with signals of indeterminate strength, the mental artery pulse was strong in 11 of 12 (92%) in those younger than 65 versus 9 of 19 (47% in those older than 65 years; P = .02). The equivalent figures for the sublingual artery were 15 of 15 strong for those younger than 65 and 11 of 17 (65%) for those older than 65 years ( P = .02). The varying depth of soft tissue overlying the inferior alveolar artery made its signal difficult to evaluate, but there was no statistically significant age-related difference in the inferior alveolar artery signals. In 4 elderly patients (2 with established carotid artery disease), Doppler and duplex scanning showed reversal of mental artery flow, indicating collateral flow to the mandible. CONCLUSIONS: Ultrasound Doppler techniques used for measuring peripheral arterial flow can be adapted to quantify mandible alveolar ridge perfusion. This provides means to evaluate the role of arterial obstruction in mandible alveolar ridge atrophy and tooth loss in the elderly. The mental artery is the best site for this purpose. Preliminary data suggest an age-related reduction in mental artery flow.

Age Factors↗
PubMed1983

Study of tooth loss in an adolescent Brazilian population.

Data concerning tooth loss in developing countries may indicate the dental health status in young people and serve as baseline data for evaluation of future dental health programs. The study population consisted of 304 schoolchildren (145 males, 159 females) from Belo Horizonte, M.G. Brazil. The mean age was 14.5, ranging from 13 to 16 yr. The number of teeth already lost and teeth indicated for extraction were assessed from two posterior bitewing radiographs and one frontal color photo which were obtained from all participants. The results showed that 2/3 of the studied population had lost one or more permanent teeth. The average number of missing teeth was 1.8 in both males and females. Of the various teeth, the mandibular first molars had most frequently been lost. Differences between the sexes concerning amount and pattern of lost teeth were small.

Adolescent↗
PubMed2003

Tooth loss and dietary intake.

BACKGROUND: Several studies have reported that impaired dentition status is associated with poor nutritional intake. However, most of these studies are cross-sectional and thus are unable to clarify the temporal sequence. METHODS: We assessed the longitudinal relation between tooth loss and changes in consumption of fruits and vegetables and of nutrients important for general health among 31,813 eligible male health professionals. RESULTS: Subjects who lost five or more teeth had a significantly smaller reduction in consumption of dietary cholesterol and vitamin B12, greater reduction in consumption of polyunsaturated fat and smaller increase in consumption of dietary fiber and whole fruit than did subjects who had lost no teeth. Men who had lost teeth also were more likely to stop eating apples, pears and raw carrots. CONCLUSIONS: The results support the temporal association between tooth loss and detrimental changes in dietary intakes, which could contribute to increased risk of developing chronic diseases. PRACTICE IMPLICATIONS: Dietary evaluation and recommendations can be incorporated into dental visits to provide a greater benefit to patients.

Adult↗
PubMedDate not supplied

The accuracy of tooth loss data collected by nurses.

This paper reports on the accuracy of tooth counts conducted in 22 subjects by 10 trained nurses as part of a large longitudinal study of a pharmacological agent. These nurses participated in a training course consisting of seminars, discussion, demonstrations, and practice examinations. Each of the nurses then counted the teeth of 22 subjects and recorded their findings independently. The counts of the nurses were compared with those of the dentists to assess the accuracy of the nurses' counts. We found that nurses and dentists were in perfect agreement for 86% of the patient counts conducted. Individual nurses' levels of agreement with dentists ranged from 73% to 100%, with pairwise kappa statistic values ranging from 0.70 to 1.00. In addition, both Pearson correlation and interclass correlation measures exceeded 0.98 for every comparison of dentist and nurse counts. The results of this study suggest that training nondental health care workers may be an accurate and low-cost way of obtaining tooth loss data and other oral health measures, particularly when oral health data are collected as part of larger, multi-disciplinary studies.

Aged↗
PubMed2005

The association between tooth loss and the self-reported intake of selected CVD-related nutrients and foods among US women.

OBJECTIVES: Many studies have reported associations between oral health and cardiovascular diseases; poor nutritional status due to impaired dentition status has been suggested as a mediator. Our objective is to evaluate the associations between tooth loss and the self-reported consumption of fruits and vegetables and selected CVD-related nutrients. METHODS: A total of 83,104 US women who completed a food frequency questionnaire (FFQ) in 1990 and 1994 and reported number of natural teeth in 1992, were included in a cross-sectional analysis relating dietary intake to number of natural teeth. A longitudinal analysis was also conducted to evaluate whether tooth loss in 1990-1992 was associated with change in diet between 1990 and 1994. RESULTS: After adjusting for age, total calorie intake, smoking and physical activity, edentulous women appeared to have dietary intake associated with increased risk for CVD, including significantly higher intake of saturated fat, trans fat, cholesterol and vitamin B12, and lower intake of polyunsaturated fat, fiber, carotene, vitamin C, vitamin E, vitamin B6, folate, potassium, vegetables, fruits, and fruits excluding juices compared with women with 25-32 teeth. In the longitudinal analyses, women who lost more teeth were more likely to change their diet in ways that would potentially increase risk for development of CVD. They also tended to avoid hard foods, such as raw carrot, fresh apple or pear. CONCLUSIONS: Women with fewer teeth have unhealthier diets such as decreased intake of fruits and vegetables, which could increase CVD risk. Diet may partially explain associations between oral health and cardiovascular disease.

Adult↗
PubMed2005

[Tooth loss and the incidence of ischemic stroke].

Chronic infectious diseases may increase the risk of stroke. We investigated whether periodontal disease was a risk factor for cerebral ischemia. A case-control study with 444 stroke patients, 194 hemorrhagic patients and 250 ischemic patients, and 164 hospital controls with nonvascular and noninflammatory neurological diseases, was performed. All subjects were evaluated by either a CT scan or MRI and their number of teeth was determined. The number of teeth in the patients with cerebral ischemia was found to be significantly fewer than for the cerebral hemorrhage group and a control group between 40 and 65 years of age. The degree of tooth loss was particularly remarkable in patients with atherothrombotic and cardioembolic brain infarction. As a result, tooth loss following severe periodontal disease may therefore be a risk factor for the onset of cerebral infarction in some patients.

Adult↗