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PubMedDate not supplied

Oral diseases and conditions throughout the lifespan. I. Diseases and conditions directly associated with tooth loss.

This is the first of two articles providing an overall view of oral diseases and conditions, taking the oral cavity and its organs and tissues as integrated parts of the human body. This article provides an overview of three oral diseases and conditions that are associated directly with loss of tooth structure or loss of teeth and reviews their risk factors and preventive and treatment interventions. Two of these conditions, dental caries and periodontal diseases (or their sequelae), remain the main cause of tooth loss in the U.S. Prevention, treatment, and control of these diseases require many hours of training during dental education and many hours of treatment in dental practice. The profession has fragmented into specialties based on diseases; as a result, many dentists fail to see them as integral elements of the human experience. As primary care specialists, dentists must be reminded that they need to make prevention the first choice, provide the best treatment possible based on available scientific evidence, and keep informed of new advances in research while always remembering that the oral cavity is an integral part of the human body. The changes and trends observed in the epidemiology of oral diseases will demand new skills in our dental graduates. Future dental graduates may achieve a solid understanding of oral diseases at both the biological and population level by using oral tissues and saliva to diagnose systemic diseases, relying on medical facilities to order laboratory tests, and diagnosing and treating patients in close collaboration with their medical colleagues.

Dental Caries↗
PubMed2001

Tooth loss in periodontal patients.

OBJECTIVE: To compare tooth loss between patients who received surgical therapy for chronic periodontitis and those who received nonsurgical therapy alone. METHODS: A retrospective chart study was conducted at Dalhousie University. All patients who had periodontal treatment and were active cases for at least 10 years were included (n = 335). The sample consisted of 120 males (35.8%) and 215 females (64.2%). Ages ranged from 16 to 77 (mean = 46.1 +/- 12.0 years). All patients received nonsurgical therapy; 44.8% received periodontal surgery as well. Variables recorded were demographics, initial attachment loss, treatment type, recall frequency, patient compliance and history of extracted teeth. Independent t-tests or chi-squared tests were used to compare these for surgical and nonsurgical patients. ANOVA was used to test for interactions between initial attachment loss, age, gender, compliance and type of therapy a patient received as reasons for tooth loss. RESULTS: 521 teeth were lost in 69 patients (20.6% of sample). Of teeth lost, 61.8% were due to periodontal disease; 24.8% to caries; 13.2% to other reasons. Patients initially diagnosed with early attachment loss lost an average of 0.37 (+/- 1.33) teeth. Patients diagnosed with moderate attachment loss lost an average of 1.50 (+/- 2.54) teeth and those diagnosed with advanced attachment loss lost an average of 3.11 (+/- 3.01) teeth. Those who received surgical therapy lost more teeth (mean = 1.31 +/- 2.36) than those who received nonsurgical treatment (mean = 0.68 +/- 1.87; p = 0.001). However, initial attachment loss was the only factor that could predict tooth loss. The type of therapy (surgical or nonsurgical) was not statistically significant. CONCLUSIONS: Most periodontal patients (79.4%) who received treatment at this dental school clinic did not lose any teeth due to periodontal disease over at least 10 years. Although patients who had surgical therapy lost more teeth than those who had nonsurgical therapy alone, this was not an important predictor of tooth loss.

Adolescent↗
PubMed1997

Smoking, smoking cessation, and tooth loss.

Smoking is associated with an increased risk of tooth loss, but it is not known if this risk decreases significantly when individuals quit smoking. The objectives of this study were to describe the rates of tooth loss by smoking status in two populations of medically healthy men and women. Among the men, rates of tooth loss and edentulism in relation to smoking cessation were also evaluated. The subjects were drawn from a group of 584 women (aged 40 to 70) recruited from the Boston, MA, area and a separate population of 1231 male veterans (aged 21 to 75) who participated in the VA Dental Longitudinal Study in Boston. In cross-sectional baseline analyses, current cigarette smokers of either sex had significantly more missing teeth than never-smokers or former smokers. Former smokers and pipe or cigar smokers tended to have an intermediate number of missing teeth. Current male smokers had more teeth with calculus, but the differences in plaque, tooth mobility, probing depth > 2 mm, filled and decayed teeth, and bleeding on probing by smoking history were not significant. Prospective observations of 248 women (mean follow-up time = 6 +/- 2 years) and 977 men (mean = 18 +/- 7 years) indicated that individuals who continued to smoke cigarettes had 2.4-fold (men) to 3.5-fold risk (women) of tooth loss compared with non-smokers. The rates of tooth loss in men were significantly reduced after they quit smoking cigarettes but remained higher than those in non-smokers. Men who smoked cigarettes had a 4.5-fold increase in risk of edentulism, and this risk also decreased upon smoking cessation. These findings indicate that the risk of tooth loss is greater among cigarette smokers than among non-smokers. Smoking cessation significantly benefits an individual's likelihood of tooth retention, but it may take decades for the individual to return to the rate of tooth loss observed in non-smokers.

Adult↗
PubMed2002

A systematic review on the use of residual probing depth, bleeding on probing and furcation status following initial periodontal therapy to predict further attachment and tooth loss.

BACKGROUND: Chronic periodontitis affects many adults. Initial cause related therapy (ICRT) is aimed at elimination of factors causing disease progression. OBJECTIVES: To use a systematic review process of peer reviewed publications to assess the predictive value of residual probing depths (PD), bleeding on probing (BOP) and furcation involvement (FI) in determining further loss of attachment and tooth loss following ICRT. MATERIAL AND METHODS: An electronic search of the Cochrane Oral Health Group specialized register, MEDLINE and EMBASE, was performed using specific search terms to identify studies assessing the predictive value of residual probing depths (PD), bleeding on probing (BOP) and furcation involvement (FI) in determining further loss of attachment and tooth loss following ICRT. RESULTS: The searches resulted in 941 uniquely identified studies. Titles and abstracts were then independently screened by two reviewers (S.R. and G.R.P.) to identify publications that met specific inclusion criteria. The agreement between the reviewers was assessed and statistical analysis failed to demonstrate a difference between the two reviewers (kappa-value: 0.94, P = 0.003). Detailed review of 47 included publications resulted in acceptance of one publication which utilized data based on patient as unit of observation. This study included 16 subjects over 42 months demonstrating that residual probing depths are predictive of further disease progression whereas persisting bleeding on probing are not. CONCLUSIONS: Data based on one study suggest that residual probing depths are predictive of further disease progression. The implications for carefully designed multicentre randomized clinical control trials are many.

Adult↗
PubMed1999

Tooth-specific and person-level predictors of 24-month tooth loss among older adults.

OBJECTIVES: To describe: (1) the 24-month incidence of tooth loss in a diverse sample of dentate adults; and (2) the clinical, attitudinal, behavioral, and sociodemographic correlates of tooth loss incidence. METHODS: The Florida Dental Care Study is a prospective longitudinal cohort study of persons who at baseline had at least one tooth, were 45 years or older, and who resided in north Florida. An in-person interview and clinical examination were conducted at baseline and 24-months after baseline, with 6-monthly telephone interviews between those times. A two-level hierarchical generalized linear regression (logit model) was used to quantify tooth-specific and person-level factors simultaneously. RESULTS: Of the 739 persons who attended for a 24-month examination, 24% lost one or more teeth during follow-up. Tooth loss was more common in persons with dental disease at baseline, incident dental signs or symptoms, those with negative attitudes toward dental care and dental health, those with limited financial resources, older adults, blacks, females, and problem-oriented users of dental care (as distinct from regular attenders). Although disease presence at baseline was a major factor associated with incident tooth loss, most diseased teeth were in fact still present 24 months after baseline. CONCLUSIONS: Other than periodontal attachment loss, severe tooth mobility, and dental caries, no single factor was a dominant predictor of tooth loss; instead, numerous factors made statistically significant but small contributions to variation in tooth loss. Tooth loss apparently is the result of complex interactions among dental disease, incident dental signs and symptoms, tendency to use dental care in response to specific dental problems, dental attitudes, and ability to afford non-extraction treatment alternatives.

Aged↗
PubMed1994

[Variations of pathological tooth loss with special reference to tooth erosion--apropos of a case].

Importance of tooth surface loss has increased in dental practice. It is difficult to determine aetiological factors and the exact diagnosis, because the symptoms are often combined. The aim of the present study was to summarise the most important factors of tooth surface loss, mainly of erosion which is a frequent form. Reviewing the literature aetiological factors, symptoms, differential diagnostic problems and therapeutic advice are discussed. Prevention, early diagnosis and treatment are very important in these patients.

Adult↗
PubMed2000

Tooth loss and need for extractions in American Indian and Alaska Native dental patients.

OBJECTIVE: This article reports results of the 1991 Indian Health Service Patient Oral Health Survey in the areas of tooth loss and need for tooth extraction. METHODS: The survey examined a sample of American Indian and Alaska Native dental patients. Tooth loss and need for tooth extraction are explored for a total of 12,349 individuals aged 18 years and older. RESULTS: Complete tooth loss in patients aged 35 years and older was 11 percent; in patients aged 65 years and older, it was 42 percent. The mean number of remaining teeth in dentate patients aged 35 years and older was 20.7; the mean number of remaining teeth decreased in each older age group. Partial and complete tooth loss were more severe in diabetic patients. In 35- to 44-year-old patients, only 20 percent had not lost at least one permanent tooth. The prevalence of tooth loss differs by geographic region. The percentage of dental patients with 20 or more teeth increased between 1984 and 1991. CONCLUSION: Tooth loss remains a substantial problem in American Indian and Alaska Native adult dental patients. This article presents results of an Indian Health Service (IHS) oral health survey conducted in 1991 of the American Indian and Alaska Native (Native American) population with respect to tooth loss. Limited comparisons of tooth loss observed in the 1991 patient survey are made to the 1984 patient survey.

Adolescent↗
PubMed2006

Outcome of implant therapy in patients with previous tooth loss due to periodontitis.

BACKGROUND: It is frequently debated whether implant treatment in individuals with previous tooth loss due to periodontitis is characterized by an increased incidence of implant loss and peri-implantitis. OBJECTIVE: The objective of the present systematic review was to assess whether individuals with previous tooth loss due to periodontitis have an increased risk of loss of suprastructures, loss of implants, peri-implantitis, and peri-implant marginal bone loss as compared with individuals with previous tooth loss due to reasons other than periodontitis. SEARCH STRATEGY: Studies considered for inclusion were searched in MEDLINE (PubMed) and relevant journals were hand searched. Moreover, reference lists of articles selected for full-text screening as well as previously published reviews relevant for the present systematic review were searched. The search was performed by one reviewer and was restricted to human studies published from January 1, 1980 to January 1, 2006. No language restrictions were applied. SELECTION CRITERIA: Prospective and retrospective cohort studies with at least a 5-year follow-up comparing the outcome of implant treatment in individuals with periodontitis-associated and non-periodontitis-associated tooth loss, respectively, were included. The outcome measures were survival of suprastructures, survival of implants, occurrence of peri-implantitis, and peri-implant marginal bone loss. The 5- and 10-year time points were evaluated. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, methodological quality assessment, and data extraction were conducted in duplicate and independently by two of the authors. The authors were contacted for missing information. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence intervals (CIs). MAIN RESULTS: Two studies with a 5- and 10-year follow-up, respectively, were identified including a total of 33 patients with tooth loss due to periodontitis and 70 patients with non-periodontitis-associated tooth loss. There was no significant difference in the survival of the suprastructures after 5 years. Furthermore, there were no significant differences in the survival of the implants after 5 and 10 years. However, there were significantly more patients affected by peri-implantitis in the group with periodontitis-associated tooth loss during the 10-year follow-up period, risk ratio (RR) 9 (95% CI 3.94-20.57). Moreover, significantly increased peri-implant marginal bone loss was observed in patients with periodontitis-associated tooth loss after 5 years, mean difference 0.5 mm (95% CI 0.06-0.94). CONCLUSIONS: The survival of the suprastructures and the implants was not significantly different in individuals with periodontitis-associated and non-periodontitis-associated tooth loss. However, significantly increased incidence of peri-implantitis and significantly increased peri-implant marginal bone loss were revealed in individuals with periodontitis-associated tooth loss. The small sample size and the methodological quality assessment of the two studies suggest that the results should be interpreted with caution. Consequently, further long-term studies focusing particularly on the outcome of implant treatment in young adults with aggressive periodontitis are needed before final conclusions can be drawn about the outcome of implant treatment in patients with a history of periodontitis.

Alveolar Bone Loss↗
PubMed2005

Forty-eight-month periodontal attachment loss incidence in a population-based cohort study: role of baseline status, incident tooth loss, and specific behavioral factors.

BACKGROUND: The objectives of this study were to: 1) test hypotheses that behavioral factors, baseline clinical status, and incident tooth loss are significantly associated with attachment loss incidence (ALI) and 2) quantify the effect of incident tooth loss on conclusions made about ALI. METHODS: The Florida Dental Care Study was a prospective study of persons > or =45 years old. In-person interviews and examinations were conducted at baseline and 48 months, with telephone interviews in between. RESULTS: Of 560 persons with baseline and 48-month examinations, 22% of persons and 1.8% of teeth had ALI. This was highest among persons with no dental visit during follow-up (person-level incidence of 46%; 5.0% tooth-level incidence). Statistically significant covariates in a multivariable regression of ALI were: losing a tooth due to periodontal reasons after baseline, but before the 48-month examination; not receiving a dental cleaning; and baseline factors (worst attachment level of > or =7 mm, not flossing, a molar tooth, current smoker). CONCLUSIONS: A substantial percentage of persons experienced ALI. Baseline attachment level and behavioral factors were significantly associated with ALI. Persons with incident tooth loss were also at increased risk for ALI, and teeth lost during follow-up had worse baseline attachment level. Had these teeth not been lost before the final examination, the ALI estimate could only have been higher. These findings demonstrate that those at greatest risk for ALI are least likely to enter the dental care system, and among those who do, one health outcome (tooth loss) can affect conclusions made about the incidence of another (ALI).

Cohort Studies↗
PubMed2002

Tooth loss in the very old: 13-15-year incidence among elderly Iowans.

OBJECTIVES: Very few studies have reported tooth loss incidence over a period of 10 years or more, and fewer have reported tooth loss occurrence in subjects aged 80 and older, so that the long-term pattern of tooth loss in the very old is largely unknown. This study assessed 13-15-year tooth loss incidence among a cohort of Iowans, aged 65 and older at baseline. METHODS: Oral examinations were conducted on 520 subjects beginning in 1983, and periodically until 1988, with another round of examinations conducted on surviving members of the initial cohort during 1996-98. RESULTS: Of the 73 remaining subjects, 45 subjects lost a total of 153 teeth during the period (mean=2.1 teeth lost), with a maximum of 17 teeth lost. Molars were the most commonly lost teeth, while canines and maxillary incisors were the least commonly lost. Bivariate analyses found that tooth loss was associated with untreated decay at baseline and level of periodontal attachment loss at earlier examinations. Logistic regression identified only greater severity of attachment loss as a significant risk factor for tooth loss (Adjusted odds ratio=2.4, P=0.006). The impact of tooth loss on subjects' lives was assessed using OHIP and other questions. The occurrence of tooth loss over the study period had little impact, but the number of remaining teeth significantly impacted subjects' ability to eat or chew food, swallow, or their willingness to smile. CONCLUSIONS: These results suggest that tooth loss continues in the very old, that periodontal attachment loss is associated with tooth loss in this age group, and that loss of teeth over one's lifetime does affect certain quality-of-life measures.

Aged↗
PubMed2002

Comparison of two methods of estimating 48-month tooth loss incidence.

OBJECTIVES: This paper quantifies validity of self-reported tooth loss, compares incidence using two methods (semiannual self-report, biannual clinical examination), and compares conclusions about risk factors for tooth loss using these two methods. METHODS: The Florida Dental Care Study included persons who at baseline had at least one tooth. In-person interviews and clinical examinations were conducted at baseline, 24 months, and 48 months, with semiannual telephone interviews in between. RESULTS: Agreement between self-reported and clinically derived tooth loss was high, although some statistically significant differences by certain baseline characteristics were evident. On a nominal scale (some tooth loss, none), kappa was 0.88 and percent concordance was 94 percent. On a ratio scale, Spearman's correlation was 0.90. Using self-report, the incidence estimate would have been 34 percent, as compared to 36 percent based on clinical examination. In a single bivariate (loss by self-report, loss by clinical examination) multiple logistic regression, conclusions about statistical significance and magnitude of seven risk factors for tooth loss did not differ. CONCLUSIONS: Validity of self-reported incidence was excellent. The self-reported method allowed for semiannual estimates and was less resource intensive. Substantive conclusions about tooth loss using either method were similar, although validity did differ between persons with certain baseline characteristics.

Analysis of Variance↗
PubMed1998

Periodontal disease and tooth loss.

Numerous epidemiological studies have shown that caries is the main reason for tooth loss. More recent epidemiological data seem to show an increasing trend of tooth loss due to periodontal reasons rather than caries. In considering the issue of periodontal disease and tooth loss the following observations were made. The presence of initial attachment loss, bone height and the habit of smoking significantly increase the risk of tooth mortality. There is a strong correlation between smoking, the severity of periodontal disease and tooth mortality. Cross-sectional population surveys of tooth loss reported lower anterior teeth to be the most frequently extracted due to periodontal reasons, followed by upper anteriors and upper second molars. However, in long term maintenance studies, molars were lost most frequently. Periodontal reasons for tooth loss were mainly mobility followed by furcation involvement. Periodontal surgery did not significantly enhance tooth retention in high risk groups. Ethnic differences observed were not significant and would need further investigations to address variables such as cultural differences, health habits, diet and socio-economic status. In conclusion, periodontal tooth mortality was found to be associated with the loss of periodontal attachment and risk groups with advanced periodontitis contributing to major tooth loss in a minority of the population.

Alveolar Bone Loss↗
PubMed2005

Lifestyle and psychosocial factors associated with tooth loss in Mexican adolescents and young adults.

OBJECTIVE: The aim of the present study was to examine: (1) the prevalence of tooth loss in persons living in community dwellings and (2) the strength of the association identified between tooth loss experience and the psychosocial factors of lifestyle, stress, and anxiety. MATERIAL AND METHODS: A cross-sectional study was carried out in a convenience sample where data were collected by means of self-administered questionnaires of lifestyle and psychosocial factors (stress and anxiety) and a clinical examination. A total of 516 subjects aged 14-30 years of age were included in the study. Subjects had a visual dental examination. Prevalence and mean of tooth loss were calculated excluding third molars, and their related factors were adjusted in a binary logistic regression. RESULTS: Mean age of participants was 17.4+/-3.0 years; 45.5% were men. The prevalence of tooth loss (when at least one tooth was lost) was 20.5%. Among the 516 persons, a total of 201 teeth were lost with a mean tooth loss 0.39+/-0.95 overall. Mean tooth loss in subjects with at least one missing tooth was 1.90+/-1.26 teeth. Results adjusted by anxiety in the multivariate logistic regression model showed tooth loss was associated with lifestyle (OR=1.95, 95% CI=1.17 - 3.24), age (OR=2.65, 95% CI=1.64 - 4.26), and Angle's malocclusion II and III (OR=2.86; 95% CI=1.67 - 4.90). A slight association toward tooth loss was observed (p<0.10) in the sex and stress variables. CONCLUSIONS: Lifestyle and tooth loss have a substantial association. According to age group, these results suggest tooth loss is an oral health problem in the study population.

Adolescent↗
PubMed2004

Relationship of periodontal disease and tooth loss to prevalence of coronary heart disease.

BACKGROUND: Studies relating periodontal disease to coronary heart disease (CHD) have provided equivocal results using tooth loss and/or clinical signs of periodontal disease as measures of periodontal exposure. METHODS: The purpose of this cross-sectional study was to evaluate the relationship of tooth loss and periodontitis to prevalent CHD at the Atherosclerosis Risk in Communities (ARIC) visit 4 using both tooth loss and clinical signs of disease in a population-based sample of 8,363 men and women aged 52 to 75 years from four U.S. communities. Each subject participated in a complete periodontal examination, assessment of missing teeth, assessment of prevalent CHD, and a number of laboratory tests and questionnaires. High attachment loss was defined as > or = 10% of sites with attachment loss > 3 mm and high tooth loss was defined as fewer than 17 remaining teeth. RESULTS: Individuals with both high attachment loss and high tooth loss (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1 to 2.0) and edentulous individuals (OR 1.8, CI 1.4 to 2.4) had elevated odds of prevalent CHD compared to individuals with low attachment loss and low tooth loss, while controlling for a number of traditional risk factors for CHD. CONCLUSIONS: These results suggest that tooth loss and periodontal disease are associated with prevalent CHD, but only when both are present. The weaker relationships between periodontal disease and CHD that have been found among older adults may be due to older adults having fewer teeth. Future longitudinal studies should be designed to ascertain the cause of tooth loss during follow-up.

Black or African American↗
PubMed2006

Factors affecting tooth loss among rural Khon Kaen adults: analysis of two data sets.

BACKGROUND: Tooth loss is an oral health problem affecting Thai people and people of other nations as well. Not much of epidemiologic evidence concerning factors affecting tooth loss among Thai people has been reported although severity of tooth loss among Thai people has never been decreased. METHODS: This study employed two existing data sets to evaluate the role of health behaviors such as tobacco smoking and betel quid chewing (a common habit prevalent among rural Thai females), together with other factors in relation to tooth loss among rural Thai people. The study population in the first (phase I) and second (phase II) data sets included 1484 and 3471 male and female adults residing in rural areas of Khon Kaen province, Thailand during 1990-1991 and 1992-1994, respectively. The data were obtained through oral examination and interview. Employing descriptive, bivariate, and multivariable Poisson regression, key risk indicators of tooth loss were identified for both data sets. RESULTS: The findings from final multivariable Poisson regression models were consistent in that tobacco smoking, betel quid chewing, age, dental caries (defined as decayed plus filled teeth) and periodontitis were significantly related to tooth loss among these rural populations. CONCLUSION: Therefore, preventive programs aiming at discouraging Thai people from smoking tobacco and/or chewing betel quid should be established so that healthy natural teeth can be maintained.

Adult↗
PubMed2005

Periodontal disease and the incidence of tooth loss in postmenopausal women.

BACKGROUND: The role of periodontal disease as a predictor of incident tooth loss in postmenopausal women has not been determined. The aim of this cohort study was to determine the extent of the association between baseline periodontal status and incident tooth loss in a population of postmenopausal women. METHODS: The study population included 106 dentate white postmenopausal women who participated in a cross-sectional study between 1989 and 1991 who were willing and eligible to have a repeat examination after 10 to 13 years. At baseline, full-mouth assessment of periodontal status was performed clinically and radiographically. Assessment of tooth loss during follow- up was assessed clinically by a periodontist. Odds ratio (OR) and its 95% confidence interval (CI) for each periodontal variable was obtained from separate multiple logistic regression analyses adjusting for the effect of age, household income, smoking, hormone therapy, snack consumption, and number of decayed teeth. RESULTS: Sixty-one (57.5%) subjects lost at least one tooth during follow-up. Mean tooth loss per person was 1.81 +/- 2.77. After adjusting for confounders, each millimeter of alveolar bone loss at baseline increased the risk of tooth loss 3-fold (OR = 3.26; 95% CI: 1.60 to 6.64). The risk of tooth loss also increased 2.5 times for each millimeter of clinical attachment loss (OR = 2.50; 95% CI: 1.24 to 5.07). Probing depth (OR = 2.53; 95% CI: 0.98 to 6.53), gingival bleeding (OR = 1.99; 95% CI: 0.21 to 18.94), calculus (OR = 2.05; 95% CI: 0.91 to 4.61), and plaque (OR = 0.70; 95% CI: 0.13 to 3.34) were not significantly associated with incident tooth loss. CONCLUSION: Periodontal disease, especially measured by alveolar bone loss, is a strong and independent predictor for incident tooth loss in postmenopausal women.

Aged↗
PubMed1995

Three-year tooth loss among black and white older adults in North Carolina.

The distribution and determinants of tooth loss in older adults are poorly defined, especially in Blacks, who have been underrepresented in previous studies. This study investigated, epidemiologically, the distribution and predictors of tooth loss in elder Blacks and Whites by following a random sample of older adults in North Carolina for three years. It was hypothesized that Blacks would be at greater risk of tooth loss and would have different risk factors for tooth loss. Data from 263 Blacks and 228 Whites were collected by dental examinations and interviews conducted in the participants' homes. During the three-year follow-up, 53% of Blacks and 29% of Whites lost at least one tooth. Blacks lost 13% of their remaining teeth compared with 4% for Whites. Logistic regression models showed that factors related to tooth loss for Blacks were: more S. mutans in stimulated saliva, deeper periodontal pockets, more P. intermedia in subgingival plaque, high blood pressure, limited help from others, and few symptoms of depression. For Whites, significant factors were: more lactobacilli in stimulated saliva, history of current oral pain at baseline, more alcohol consumption, no history of past use of calcium or xerostomic medications, higher income, lower occupational prestige, and increased numbers of negative life events. This study showed that older Blacks were at greater risk of tooth loss than older Whites. For both races, factors such as oral bacteria, periodontal conditions, oral symptoms, and psychosocial and economic factors are related to increased risk of tooth loss.

Black or African American↗
PubMed2005

The natural history of periodontal disease in humans: risk factors for tooth loss in caries-free subjects receiving no oral health care.

AIM: No long-term studies have reported on risk factors for tooth loss in subjects without home or professional dental care. The purpose of this report is to identify potential risk factors for tooth loss among male Sri Lankan tea labourers who participated in a 20-year investigation of the natural history of periodontal disease. MATERIAL AND METHODS: Data for this report were obtained from the 455 subjects who participated in multiple examinations over the 20-year period from 1970 to 1990. Analyses included data from interim examinations in 1971, 1973, 1977, 1982 and 1985. Oral health assessments included the following: (1) attachment levels in millimetres on all mesial and mesio-buccal surfaces, excluding third molars; (2) plaque index; (3) gingival index; (4) calculus index; (5) caries index; and (6) missing teeth. Other variables included age, history of smoking and betel nut use. Statistical analyses included descriptive statistics and multivariate repeated-measures modelling with generalized estimating equations. RESULTS: Tooth loss was significantly dependent upon interactions between the mean attachment loss and betel nut use (Z=3.40; p=0.0007) and history of missing teeth (Z=-3.70; p=0.0002). The effect of attachment loss on tooth loss was increased in the presence of betel nut and diminished when teeth were already missing at baseline. CONCLUSION: History of missing teeth, betel nut use and increasing attachment loss were significant predictors of tooth loss over time. Betel nut use increased the effect of attachment loss on loss of teeth, while history of missing teeth diminished the effect of attachment loss on tooth loss.

Adolescent↗