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PubMed1996

Increased risk of tooth loss is related to bone loss at the whole body, hip, and spine.

Increased systemic bone loss may be a risk factor for tooth loss by contributing to the resorption of tooth-supporting alveolar bone. Concurrent longitudinal associations between tooth loss and bone loss at the whole body, femoral neck, and spine were examined in 189 healthy, white, dentate, postmenopausal women who participated in three intervention trials conducted within a 7-year period. None of the subjects was taking estrogen. Bone mineral density (BMD) was measured by dual photon or dual energy X-ray absorptiometry. Teeth were counted at baseline; number and timing of teeth lost over the observation period were assessed by questionnaire. All analyses were controlled for years since menopause, body mass index, number of teeth at baseline, smoking status, and the assigned treatment during each study. These interventions were calcium (Ca) or placebo (P) in Study I, vitamin D+Ca or P+Ca in Study II, and 1 of 2 doses of vitamin D+Ca in Study III. Age at baseline (mean +/- SD) was 59 +/- 6 years and the number of teeth remaining was 23 +/- 7. Women who lost teeth during the 7-year follow-up (n = 45) experienced less favorable changes in BMD at all sites compared with 144 women who lost no teeth (whole body mean +/- SE, -0.35 +/- 0.08%/year versus -0.11 +/- 0.05, P < 0.01; femoral neck -0.48 +/- 0.38%/year versus -0.14 +/- 0.35, P < 0.05; and spine, +0.05 +/- 0.21%/year versus +0. 45 +/- 0.16, P < 0.05). For each 1%/year decrement in BMD, relative risks (and 95% CI) of losing a tooth were significantly elevated at the whole body (RR = relative risks, CI = confidence interval) (RR = 4.83, CI = 1.72-13.52, n = 180), femoral neck (1.50, 1.02 to 2.22, n = 189), and spine (1.45, 1.00 to 2.11, n = 167). These results provide support for a role of systemic bone loss in the development of tooth loss among postmenopausal women.

Female↗
PubMed2005

Tooth loss, denture wearing and oral health-related quality of life in elderly Chinese people.

OBJECTIVES: To investigate the relationship between tooth loss, denture wearing and oral health-related quality of life (OHQoL) among community-dwelling elderly people in Hong Kong. METHODS: A questionnaire study of elderly people aged 60-80 years who were recruited at neighborhood social centres for the elderly. The Chinese version of the General Oral Health Assessment Index (GOHAI) was used and information about natural tooth number and denture wearing were obtained. RESULTS: 233 elderly subjects were recruited and interviewed. Around 20% of the partially dentate subjects had their last tooth loss within the previous year and a quarter within the last five years. Significantly fewer edentulous subjects had their last tooth loss within the previous year (3%) and within the last five years (12%, p < 0.001). Twenty two percent of the subjects had difficulty in accepting tooth loss. More edentulous subjects (69%) were satisfied with their dentures than partially dentate denture wearers (37%, p < 0.001). Edentulous elderly subjects had a higher mean GOHAI score (53.0) than partially dentate denture wearers (49.1, p < 0.001). Results from a multiple factor ANOVA revealed that elderly subjects who had loose teeth, difficulty in accepting tooth loss and were not satisfied with their removable dentures had a lower mean GOHAI score. CONCLUSIONS: In general, tooth loss and denture wearing did not have a major impact on OHQoL in elderly Chinese people. However, partially dentate denture wearers experienced a greater adverse impact on OHQoL than edentulous subjects most probably due to less satisfaction with their dentures and discomfort associated with loose teeth.

Aged↗
PubMed1985

Prosthetic contingencies for future tooth loss.

Possible contingencies for future natural tooth loss that can and should be built into prostheses have been reviewed. These contingencies provide a measure of security to the patient and the dentist when attempting to maintain teeth that appear to have a guarded prognosis. Without a contingency these questionable teeth would be extracted early in therapy from fear that a completely new prosthesis would have to be made if they were lost at a later time. In maintaining more natural teeth, the patient has better function, more occlusal and vertical support, longer maintenance of the alveolar ridge, more support for the prosthesis, and more remaining teeth to share all the forces. This approach of building in contingencies for future tooth loss allows the patient and the dentist the freedom to attempt therapy on abutments with a guarded prognosis with little financial risk.

Crowns↗
PubMed1989

[Relationships between tooth loss and electromyographic activities of masticatory muscles].

For purpose of evaluating the characteristic of electromyographic activities of masticatory muscles with front or molar tooth loss, electromyographic activities of masticatory muscles and mandibular movements during tooth tapping and gum chewing were investigated in each group of tooth loss, and were compared with those of control group. The results were as follows. 1. In reference to the group with front tooth loss, 1) On tooth tapping, each S.D. of the time parameters of electromyographic activities of jaw closing muscles especially masseter and posterior temporalis was small, and that of jaw opening muscle was large. 2) On gum chewing, offset of jaw closing muscles' activities especially masseter and anterior temporalis were delayed. 3) On both tooth tapping and gum chewing, there was no difference in mandibular movements from control group. 2. In reference to the group with molar tooth loss, 1) On both tooth tapping and gum chewing, each S.D. of the time parameters of electromyographic activities of jaw closing muscles was large. 2) On tooth tapping, S.D. of opening ratio was large. 3) On gum chewing, both S.D. of chewing cycle and opening ratio were large.

Electromyography↗
PubMed2005

Tooth loss and associated risk indicators in an adult urban population from south Brazil.

The aim of the present study was to assess the prevalence, extent, and risk indicators of tooth loss in a representative adult, urban population in the Brazilian state of Rio Grande do Sul. A sample of 974 subjects (ages 30 to 103 years, mean 48.7, SD 13.4) representative of the metropolitan area of Porto Alegre, Brazil was selected by a multi-stage probability cluster sampling strategy. In all, 94% of the subjects had experienced tooth loss. The mean tooth loss was 11.2 teeth, and varied between 5.5 and 20.2 teeth in the 30-39 and 60 + years age groups, respectively. The multivariable analysis, adjusted for age, showed that subjects who had lost 7-13 or > or = 14 teeth were more likely to be females (odds ratio (OR) = 1.4, 2.4), of low (OR = 2.8, 5.1) or middle socio-economic status (OR = 2.3, 3.4), and heavy smokers (OR= 2.0, 2.3) than those with 6 or fewer missing teeth. Furthermore, loss of > or = 14 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR= 5.7), and loss of 7-13 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR = 2.4) and having 15-30% or > 30% decayed-filled teeth (OR = 2.7 and 4.1). In conclusion, tooth loss is highly prevalent in this urban Brazilian population. Gender, socio-economic status, cigarette smoking, caries experience, and attachment loss are important risk indicators. A reduction in the population's tooth loss may be achieved by the implementation of community programs for the prevention and treatment of dental caries and periodontal diseases.

Adult↗
PubMed1995

Eighteen-month incidence of tooth loss among older adults in North Carolina.

This study investigated tooth loss in North Carolina adults 65 years of age or older. A random sample of 335 Blacks and 284 Whites participated in dental examinations and interviews at baseline and again after 18 months. Blacks were more likely than Whites to lose at least one tooth (36% vs 19%), and they lost more teeth on average (1.0 vs 0.4). Several oral disease conditions and symptoms were related to tooth loss, but many other hypothesized factors were not. Risk models were inconclusive in the identification of factors related to risk of tooth loss.

Aged↗
PubMed2003

Tooth loss and dentures: patients' perspectives.

OBJECTIVE: Despite dramatic improvements in tooth retention around the world, a substantial proportion of older adults have lost natural teeth and many wear removable partial and complete dentures. Problems associated with tooth loss and denture wearing remain important in the context of global ageing. The purpose of this paper is to examine the effects of tooth loss and denture wearing on their day-to-day lives from the patient perspective. DESIGN: Cross-sectional study. SETTING: Greater Boston area, USA. PARTICIPANTS: Community-dwelling older men. METHODS: Brief examination and survey. MAIN OUTCOME MEASURES: Self-reported oral health measures including the single-item self-rating of oral health, the Oral Health Impact Profile (OHIP), the Geriatric Oral Health Assessment Index (GOHAI), Oral-Health-related Quality of Life (OHQOL) and a newly-developed short-form instrument (the DELTA). RESULTS: Men with > or = 25 teeth had better self-rated oral health by all measures. The new, brief DELTA differentiates between dentition/denture groupings as well as or better than existing instruments. Over 80% of men with > or = 25 teeth rated their oral health as excellent, very good or good, compared with 70% of men with no teeth (and dentures) and 54% of men with 1-24 teeth. Avoidance of certain foods discriminates well between dentition groups. To a lesser extent, difficulty with relaxation, pain and distress, and avoidance of going out are associated with tooth loss and/or denture wearing.

Aged↗
PubMed2000

The emotional effects of tooth loss: a preliminary quantitative study.

AIM: To establish how widespread the emotional effects of tooth loss are. METHOD: A questionnaire, distributed to 100 edentulous people undergoing routine prosthetic care in the Department of Prosthetic Dentistry at Guy's, King's and St Thomas' Dental Institute (GKT), was used to explore the emotional effects of tooth loss. RESULTS: Ninety four people completed the questionnaire of whom 42 stated that they had experienced difficulties in accepting the loss of their teeth. In comparison with people who had no difficulties in accepting the situation, these people were: more likely to feel less confident about themselves; more likely to feel inhibited in carrying out everyday activities; and less able to accept the inevitable change in facial shape which occurs following the loss of teeth. Additionally, they took longer to come to terms with their tooth loss (All these differences were statistically significant). Just over three-quarters of the people who were unprepared for the loss of their teeth, felt that an explanation from the dentist prior to dental extractions would have helped. CONCLUSION: The impact that tooth loss can have on people and their lives should not be underestimated. In this study it affected 45% of the participants.

Activities of Daily Living↗
PubMed1996

Dental caries and tooth loss in adolescents with early-onset periodontitis.

The aim of this study was to assess the caries experience and tooth loss over 6 years in subjects with early-onset periodontitis as compared to their matched controls, and to describe the characteristics of teeth lost during this period. A multi-stage probability sample representing 8th to 12th grade U.S. schoolchildren were screened during the 1986/1987 school year to identify subjects with early-onset periodontitis (cases). The examination included measuring the clinical attachment level, presence of caries and dental restorations, and tooth loss. A random sample of controls without early-onset periodontitis were selected for a follow-up examination and were matched to cases on gender, race, age, and geographic location. A total of 266 subjects, with a mean age of 16 years at baseline, were examined during the 1992/1993 school year and were classified into localized (LJP) and generalized juvenile periodontitis (GJP), incidental attachment loss (IAL), and control groups. Whites had more caries experience than Blacks and Hispanics, but there were no significant differences in tooth loss between the ethnic groups. The LJP and the IAL groups, respectively, had higher and lower overall caries experience than the control group. The LJP group had a significantly higher number of missing teeth at follow-up, and exhibited more extensive tooth mortality during 6 years than the control group. The GJP group also showed more tooth loss than the control group, but the difference was not statistically significant. In the LJP, GJP, IAL, and control groups, respectively, 43%, 32%, 26%, and 18% of the subjects lost teeth over 6 years due to disease. The findings showed differences in caries activity between the early-onset periodontitis groups and a variation by race. The findings suggest that loss of periodontal support was the principal cause for tooth loss in the LJP and GJP groups, and that dental caries was the principal cause for tooth extraction in the IAL and the control groups.

Adolescent↗
PubMedDate not supplied

Spinal bone density and tooth loss in a cohort of postmenopausal women.

Osteoporosis has been suggested to contribute to the edentulous condition. However, studies specifically designed to examine the relationship between tooth loss and osteoporosis are scarce, and reported results have been mixed. This study investigated the correlation between tooth loss and spinal bone density in a nonHispanic white female population. Forty-four subjects were recruited and divided into high and low spinal bone density groups based on whether the bone density was higher or lower than the age-adjusted population mean bone density. Missing teeth and periodontal status in these groups were assessed and analyzed. Tooth loss was not significantly different between subjects with low spinal bone density (4.90 +/- 0.89 teeth) and high spinal bone density (3.81 +/- 0.90 teeth). Tooth loss did not differ after age and periodontal adjustment. However, the loss of attachment levels (relative to the cementoenamel junction) was greater in the low spinal bone density subjects (3.42 +/- 0.30 mm) than in the high spinal bone density subjects (2.37 +/- 0.26 mm) (P < .05). The difference may have resulted from gingival recession (P < .05), because the gingival pocket depths were not significantly different between the two groups. In this study, total tooth loss was not directly associated with systemic bone density. However, periodontal disease was negatively associated with spinal bone density. Whether periodontal disease will ultimately lead to greater tooth loss in low spinal bone density group merits further investigation.

Aged↗
PubMed1998

Possible explanations for the tooth loss and cardiovascular disease relationship.

Several studies have shown relationships between periodontal disease and cardiovascular disease (CVD). A few studies have also shown that tooth loss may be associated with increased risk of coronary heart disease and stroke. We have reviewed the relevant literature to assess possible explanations for the reported associations between tooth loss and CVD. In particular, we considered whether the reported association between tooth loss and CVD could be explained by antecedent periodontal disease, antecedent caries, the extraction process, dietary changes following tooth loss, or confounding or bias from other sources. Since access to care and attitudes to health care may influence the decision to extract teeth, as well as cardiovascular disease risk, one needs to be cautious about confounding from behaviorally related factors. Available evidence suggests that further studies are needed to rule out that confounding is a possible explanation for the tooth loss and CVD relationship, that prior periodontal disease may not completely explain the tooth loss-CVD relationship, and that the role of diet needs to be further explored

Attitude to Health↗
PubMed2005

Active and passive smoking and tooth loss in Japanese women: baseline data from the osaka maternal and child health study.

PURPOSE: Many studies have shown a positive association between cigarette smoking and oral diseases. Few studies, however, have focused on the relationship between passive smoking exposure and oral health in adults. We investigated the association of active and passive smoking exposure with tooth loss in Japan. METHODS: Study subjects were 1002 pregnant women. Tooth loss was defined as previous extraction of one or more teeth. Adjustment was made for age, gestation, parity, family income, education, and body mass index. RESULTS: Of the 1002 subjects, 256 women had lost one or more teeth. Current light smoking was independently related to an increased prevalence of tooth loss, showing a significant exposure-related association with smoking status. A significant positive association of 8 or more pack-years of smoking with the prevalence of tooth loss was observed. Also, a significant positive relationship was found between current heavy passive smoking at home and tooth loss, but not with pack-years of passive smoking at home. No measurable association between passive smoking exposure at work and tooth loss was indicated. CONCLUSIONS: The present findings suggest that passive as well as active smoking may be associated with an increased prevalence of tooth loss in Japanese young adult women.

Adult↗
PubMed1989

Tooth loss in a selected population in Saskatoon.

Tooth mortality in a population can provide information about the prevalence of dental disease, availability of dental care and attitudes about tooth extraction. The tooth mortality of patients presenting for treatment at the University Dental Clinic (Saskatoon, Canada) during the school terms 1981-1986 was determined to provide base-line data during a time when the dentist-to-population ratio has been increasing, and to compare the results with similar studies carried out in Britain and Greece. The data were analyzed according to the same quinquennial age groups as in the other studies. There were no statistically significant differences between the two time periods at all ages and therefore the data were pooled. Totally edentulous persons were excluded from the analysis for comparison purposes. The prevalence of tooth loss increased with age with a rapid period of tooth loss encompassing the mean ages of 34 to 47 years, a slowing of further loss up to the mean age of 62 and thereafter, a further increase. The initial rapid loss was most apparent for molar teeth and least apparent for mandibular incisor teeth. With the exception of first molars, more teeth were lost in the maxilla than in the mandible. The present data are similar to the findings reported in British and Greek studies.

Adolescent↗
PubMed2004

Diabetes, periodontal diseases, dental caries, and tooth loss: a review of the literature.

Diabetes mellitus, is a common chronic disease, and its prevalence in the United States, particularly type 2 diabetes, is increasing. Complications associated with diabetes impose a heavy burden on many people, especially among certain minority populations. Periodontal diseases, dental caries, and tooth loss also are common conditions in the United States, but their prevalence is generally decreasing. Nevertheless, among important subgroups of the population, particularly certain minority and economically disadvantaged groups, there is a disproportionately higher burden of periodontal diseases, dental caries, and tooth loss. This article reviews the post-1960 English-language literature on the relationship between diabetes and oral health, specifically focusing on periodontal disease, dental caries, and tooth loss. Substantial evidence exists to support the role of diabetes and poorer glycemic control as important risk factors for periodontal disease. Additionally, the evidence provides support for viewing the relationship between diabetes and periodontal diseases as bidirectional. However, additional research is necessary to firmly establish that treating periodontal infections can contribute to glycemic control management and possibly to the reduction of type 2 diabetes complications. The literature does not describe a consistent relationship between type 2 diabetes and dental caries. It reports increased, decreased, and similar caries experiences between those with and without diabetes. This review suggests that currently there is insufficient evidence to determine whether a relationship between diabetes and risk for coronal or root caries exists. Most of the reviewed studies reported greater tooth loss in people with diabetes. However, the differences were slight and not significant in several of the reports. Furthermore, this review of the association between diabetes and tooth loss reveals that valid population-based evidence generalizable to the US population is sparse. Further investigations of the association of diabetes with dental caries and tooth loss are warranted. If adverse effects of diabetes on dental caries and/or tooth loss are substantiated, the results of such studies would help design intervention studies to prevent or reduce the occurrence of dental caries and tooth loss in people with diabetes. These results also may affect existing clinical practice protocols and promote new public policy related to diabetes.

Blood Glucose↗
PubMed1991

Five-year incidence of tooth loss in Iowans aged 65 and older.

The prevalence of missing teeth has been described for US adults, but little is known about the incidence of tooth loss in any segment of the population. This study investigated the 5-yr incidence of tooth loss in a random sample of Iowans aged 65 yr and older residing in two rural counties. These people had an average of 20 teeth at baseline and approximately 40% lost at least one tooth in the subsequent 5 yr. The incidence of tooth loss was highest for mandibular molars and lowest for mandibular canines. Men were more likely than women to lose teeth. Although we were able to identify a number of statistically significant potential risk factors for tooth loss, the multivariate models that incorporated all these factors were not good predictors of which people were at highest risk for tooth loss.

Aged↗
PubMed2003

Association of natural tooth loss with genetic variation at the human matrix Gla protein locus in elderly women.

Natural tooth loss represents a major medical issue within the elderly population, since it impairs masticatory function critical for oral intake of essential nutrition. Contribution of genetic factors has been implicated in the determination of natural tooth loss; degree of reduction in number of natural teeth remaining intact (NTI) varies among individuals; thus, heterogeneity in NTI might reflect genetic variation within the population. One candidate gene, the matrix Gla protein gene (MGP), has been implicated in the pathogenesis of bone loss through a repression of bone/tooth formation. We have investigated a possible association between the CA repeat polymorphism at the human MGP gene locus and the NTI in 458 elderly Japanese women. In 916 chromosomes tested, ten alleles of the polymorphic nucleotide repeat were observed (designated A1-A10), among which five alleles were regarded as major alleles to be tested for the association. Twenty-seven women who possessed an A6 allele (164 bp) had significantly higher NTI than the remaining participants (n=431), who did not carry an allele of that size (mean: 10.0 teeth vs 5.6 teeth; P=0.007, Mann-Whitney test). An eight-year longitudinal follow-up study of NTI suggested that the genetic variations at the MGP locus did not affect the rate of tooth loss in the elderly period. These results suggest that genetic variation at the MGP gene locus is associated with some determinants for tooth loss in elderly women.

Aged↗
PubMed2001

Prevalence of tooth loss and dental service use in older Mexican Americans.

OBJECTIVES: To describe the prevalence of tooth loss, to examine risk factors for having fewer teeth or no teeth, and to describe the use of dental services in an older Mexican-American population. DESIGN: Data from the baseline phase of the Hispanic Established Population for the Epidemiological Study of the Elderly survey conducted from 1993 to 1994, a cross-sectional survey of older Mexican Americans. SETTING: Five southwestern states: Texas, California, Arizona, New Mexico, and Colorado. PARTICIPANTS: 3,050 noninstitutionalized Mexican Americans age 65 to 99. RESULTS: Twenty-seven percent of the sample was completely edentulous and 22% reported visiting or speaking with a dental care professional in the preceding year. Logistic regression analyses showed that being older or being female was significantly associated with tooth loss, adjusting for education, income, smoking status, and diabetes mellitus. Current smokers (odds ratio (OR) = 1.69; 95% CI = 1.31-2.20) and diabetics (OR = 1.53; 95% CI = 1.27-1.84) were more at risk for tooth loss, as were persons of lower socioeconomic status. CONCLUSIONS: The prevalence of tooth loss and use of dental services in this population of older Mexican Americans is lower than what has been previously found among older people in the general population.

Age Distribution↗
PubMedDate not supplied

Emotional effects of tooth loss in community-dwelling elderly people in Hong Kong.

PURPOSE: This study investigated the emotional effects of tooth loss among community-dwelling elderly people in Hong Kong and compared the effects among edentulous and partially dentate elderly. MATERIALS AND METHODS: A questionnaire study involved 233 southern Chinese elderly who were recruited and interviewed at social centers for elderly people throughout Hong Kong. Data were analyzed using chi-square or chi-square exact tests. RESULTS: Twenty-two percent of the participants reported difficulty accepting tooth loss, with no difference between the edentulous and partially dentate. However, 95% stated that their confidence was unaffected. For more than half of elderly people, tooth loss had a negative effect on food choice and enjoyment of food, with removable denture wearers having greater restrictions. Avoiding going out, eating in public, and forming close relationships were less-common problems. Twenty-two percent felt unprepared for the effects of tooth loss, and more than half said that better communication with the dentist would have helped. CONCLUSION: The emotional effects of tooth loss were not marked among elderly people, and there were no differences between edentulous and partially dentate individuals. However, significant disability was experienced because of restrictions in daily living activities. Restrictions were more severe in people who had lost enough teeth to necessitate denture wearing.

Adaptation, Psychological↗