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The emotional effects of tooth loss in a group of partially dentate people: a quantitative study.

This study investigated the reactions to tooth loss in a partially dentate group of 100 people using a questionnaire-based method. Partially dentate people who experienced difficulties in accepting their tooth loss were more likely to feel less confident, restrict food choice, enjoy food less, avoid laughing in public and avoid forming close relationships than those people who had no difficulties accepting tooth loss. Also, they were more likely to feel that they had not been adequately prepared for the effects that tooth loss had on their confidence, daily living activities and appearance.

Activities of Daily Living↗

Tooth loss among habitual chewing-stick and plastic toothbrush users in the adult population of Mtwara, rural Tanzania.

OBJECTIVES: The aim of this study was to determine the extent and type of tooth loss in relation to habitual chewing-stick (CS) and plastic toothbrush (PT) users in adults. METHODS: A cross-sectional descriptive study was conducted in Mtwara's rural population aged >or=40 years. A total of 206 randomly selected study participants - males (55.8%) and females (44.2%) - were interviewed on oral hygiene practices using a structured questionnaire, and a clinical examination performed for assessment of tooth loss. RESULTS: Of the total, 93.2% were partially edentulous, 2.4% completely edentulous and those with no tooth loss 4.4%. The total number of missing teeth were 1728 (mean, 8.38 +/- 7.9), and the causes were caries (74.9%), mutilation (4.8%) and others including periodontal and trauma (20.3%). There was no significant difference in the mean number of tooth loss between the upper and lower jaw, and between males and females. However, the mean number of missing teeth in the lower jaw was higher in females than in males (P = 0.04), and on lower left than lower right jaw (P = 0.008). Lower molars, especially first molars, were the teeth lost most often. Tooth-cleaning devices included PT (51.5%), CS (25.7%), both type (BT; 17.0%) and unspecified (5.8%). The differences in the mean number of missing teeth were higher in CS than habitual PT users (P = 0.024) and in BT (P = 0.029). Tooth loss was also higher among those who brushed once when compared with those who brushed two times or more per day (P = 0.046). CONCLUSION: Tooth loss was significantly higher in CS than PT habitual users and affected mostly the lower molars and especially the first molar. However, for economical reasons, effective use of CS should be promoted for enhanced tooth retention.

Adult↗

Pattern of permanent tooth loss in Nigerian children and their prosthetic replacement.

The pattern of permanent tooth loss and prosthetic replacement in 76 children were studied. Dental caries and its sequelae were the most frequent cause of tooth loss (64.47%) followed by trauma (21.05%). Molars accounted for 64.20% of tooth type lost due to dental caries and its sequelae while loss of incisors (19.75%) was due to trauma. It was observed that only incisors were replaced (81.25%) due to their conspicuous position in the mouth whereas a large number of molars were lost and none was replaced. The need to periodically assess children after tooth loss for prosthetic replacement was emphasised.

Adolescent↗

Total tooth loss and prevalent cardiovascular disease in men and women: possible roles of citrus fruit consumption, vitamin C, and inflammatory and thrombotic variables.

BACKGROUND AND OBJECTIVE: Tooth loss has been associated with cardiovascular disease (CVD), but the mechanisms are unclear. We evaluated the association of total tooth loss with prevalent CVD in men and women; as well as with citrus fruit consumption, plasma vitamin C, and inflammatory and thrombotic variables. METHODS: We used an age-and sex-stratified population survey, of men and women aged 25-74 years, in North Glasgow. RESULTS: Thirty-eight percent of women and 29% of men were edentulous. Total tooth loss was associated with prevalent CVD in both sexes. After adjustment for major potential confounders (age, sex, smoking, and social class), the odds ratio (95% CI) for prevalent CVD was 1.55 (1.13, 2.13) in the edentulous. Total tooth loss was also associated with low citrus fruit consumption and low plasma vitamin C levels, increased plasma C-reactive protein in men, and with increased plasma interleukin-6, fibrinogen, and factor VIII levels in women. CONCLUSION: Prevalent CVD is associated with total tooth loss. Possible mechanisms include low intake of citrus fruit, and hence, low plasma vitamin C levels, and a predisposition to low-grade inflammation and thrombosis. It may be prudent to ensure adequate vitamin C intake in people with no teeth.

Adult↗

Non-carious cervical tooth loss: Part 1.

Non-carious cervical tooth loss is not always attributable to a single causative factor, as evidenced by the numerous terminologies used. In this, the first of two articles, the aetiology and prevalence of non-carious tooth loss are discussed. Guidelines are suggested as to how it may be diagnosed, prevented and monitored. A further article will cover the restorative management.

Adult↗

Malocclusion at adolescence related to self-reported tooth loss and functional disorders in adulthood.

It has been argued that malocclusion may predispose to tooth loss and functional disorders of the masticatory system. It was the purpose of this study to examine relationships between untreated malocclusion, recorded at adolescence, and self-reported tooth loss and functional disorders in adulthood. In 1965-66, the occurrence of morphologic traits of malocclusion was recorded in 977 Danish adolescents who did not have access to organized orthodontic care. Fifteen years later, 841 (86%) of these subjects responded to a questionnaire screening for tooth loss, symptoms involving the temporomandibular joints and muscles, and some other symptoms of dysfunction. The occurrence of malocclusion was related to the symptoms of the temporomandibular joints and muscles and other functional symptoms. Only a few significant coefficients of correlation were observed. Extreme maxillary overjet (greater than 9 mm) and frontal open bite showed significant correlations with unsatisfactory biting ability. Crossbite was correlated positively with speech defects but negatively with tenderness or fatigue of the cheeks; unilateral crossbite was associated with locking of the mandible. It was concluded that the untreated morphologic traits of malocclusion did not seem to predispose to tooth loss or functional disorders of the masticatory system as reported at the age of 30 years.

Adolescent↗

Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss.

BACKGROUND: Our purpose was to test the hypotheses that cigar and pipe smoking have significant associations with periodontal disease and cigar, pipe, and cigarette smoking is associated with tooth loss. We also investigated whether a history of smoking habits cessation may affect the risk of periodontal disease and tooth loss. METHODS: A group of 705 individuals (21 to 92 years-old) who were among volunteer participants in the ongoing Baltimore Longitudinal Study of Aging were examined clinically to assess their periodontal status and tooth loss. A structured interview was used to assess the participants' smoking behaviors with regard to cigarettes, cigar, and pipe smoking status. For a given tobacco product, current smokers were defined as individuals who at the time of examination continued to smoke daily. Former heavy smokers were defined as individuals who have smoked daily for 10 or more years and who had quit smoking. Non-smokers included individuals with a previous history of smoking for less than 10 years or no history of smoking. RESULTS: Cigarette and cigar/pipe smokers had a higher prevalence of moderate and severe periodontitis and higher prevalence and extent of attachment loss and gingival recession than non-smokers, suggesting poorer periodontal health in smokers. In addition, smokers had less gingival bleeding and higher number of missing teeth than non-smokers. Current cigarette smokers had the highest prevalence of moderate and severe periodontitis (25.7%) compared to former cigarette smokers (20.2%), and non-smokers (13.1%). The estimated prevalence of moderate and severe periodontitis in current or former cigar/pipe smokers was 17.6%. A similar pattern was seen for other periodontal measurements including the percentages of teeth with > or = 5 mm attachment loss and probing depth, > or = 3 mm gingival recession, and dental calculus. Current, former, and non- cigarette smokers had 5.1, 3.9, and 2.8 missing teeth, respectively. Cigar/pipe smokers had on average 4 missing teeth. Multiple regression analysis also showed that current tobacco smokers may have increased risks of having moderate and severe periodontitis than former smokers. However, smoking behaviors explained only small percentages (<5%) of the variances in the multivariate models. CONCLUSION: The results suggest that cigar and pipe smoking may have similar adverse effects on periodontal health and tooth loss as cigarette smoking. Smoking cessation efforts should be considered as a means of improving periodontal health and reducing tooth loss in heavy smokers of cigarettes, cigars, and pipes with periodontal disease.

Adult↗

Socio-economic and behavioural risk factors for tooth loss from age 18 to 26 among participants in the Dunedin Multidisciplinary Health and Development Study.

OBJECTIVE: To determine the risk factors associated with tooth loss between the ages of 18 and 26. METHODS: Dental examinations at ages 18 and 26 were conducted on Study members in the Dunedin Multidisciplinary Health and Development Study, and sociodemographic and dental service use data were collected using a self-report questionnaire. At age 15, an estimate of socio-economic status (SES) for each Study member had been obtained by classifying the occupation of the male parent. A case of tooth loss was defined as an individual who had lost one or more teeth (excluding third molars) due to caries between ages 18 and 26. Logistic regression and Poisson analysis were used to model the occurrence of tooth loss. RESULTS: Among the 821 study members who were examined at both ages, one or more teeth were lost because of caries by 85 (10.3%). After controlling for sex, SES and visiting pattern, baseline caries experience predicted subsequent tooth loss, with the odds increasing by 2.8 for every increase by 1 in the number of decayed surfaces present at age 18. Episodic dental visitors had 3.1 times the odds of their routine visiting counterparts of losing a tooth over the observation period. The number of teeth lost was, on average, 2.3 times higher among episodic dental visitors. CONCLUSIONS: Socio-economic inequalities in tooth loss appear to begin early in the life course, and are modified by individuals' SES and dental visiting patterns.

Adolescent↗

Permanent tooth loss among adults and children in Saudi Arabia.

OBJECTIVE: The objective of this study was to assess tooth loss among various age-groups in Saudi Arabia as a part of a national epidemiological study on oral conditions. DESIGN: Methodology was based on the WHO International Collaborative Study II. The sampling strategy covered Kingdom-wide sites in 10 regions with stratified cluster random samples. Data collection was confined to age-groups 6 to 7, 12 to 13, 15 to 19, 20 to 29, 35 to 44 and 65 to 74 years. SETTING: Children and adults from the schools and households of the ten provinces of Saudi Arabia. Clinical examinations were performed in daylight to determine oral clinical status and the prevalence of tooth loss. SUBJECTS: A total of 7,377 children and adults in the specified age-groups. OUTCOME MEASURES: Loss of permanent teeth assumed due to caries, assessed on clinical examination. Examiners reliability was calibrated using the kappa statistic. RESULTS: Tooth loss due to caries was 0.03 in the 6 to 7-year age-group; 0.12 at 12 to 13 years; 0.29 at 15 to 19 years; 1.24 at 20 to 29 years; 4.15 at 35 to 44 years; and 15.79 in the 65 to 74-year age-group. When compared by gender, a statistically significant difference was found between males and females for those aged 6 to 7, 15 to 19, 20 to 29, and 35 to 44 years. CONCLUSIONS: This study indicated that tooth loss increases with age and differs for gender and socio-economic status. No differences found based on city or rural lifestyles.

Adolescent↗

Post-menopausal hormone use and tooth loss: a prospective study.

Nearly 32 percent of U.S. women aged 65 to 69 years have no teeth. Because some tooth loss may reflect systemic osteoporosis, and because estrogen therapy seems to protect against osteoporosis, the authors examined the risk of tooth loss in relation to hormone use in a prospective study of 42,171 post-menopausal women. The risk of tooth loss was lower in women who currently used hormones. Although few studies have examined this issue, this research suggests that estrogen may reduce tooth loss.

Adult↗

Clinical and socio-behavioral correlates of tooth loss: a study of older adults in Tanzania.

BACKGROUND: Focusing 50 year olds and above, this study assessed the frequency, extent and correlates of tooth loss due to various reasons. Frequency and correlates of posterior occluding support was also investigated. METHOD: A cross-sectional household survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. One thousand and thirty-one subjects, mean age 62.9 years participated in a clinical examination and completed interviews. RESULTS: The prevalence of tooth loss due to any reason was 83.5%, due to caries 63.4% and due to other reasons than caries, 32.5%. A total of 74.9% had reduced number of posterior occluding units. Compared to subjects having less than 5 teeth lost due to caries, those with 5 or more lost teeth were more likely to be females, having decayed teeth, confirming dental attendance and to be among the least poor residents. Compared to subjects who had lost less than 5 teeth due to reasons other than caries, those who had lost 5 or more teeth were more likely to be of higher age, having mobile teeth, being males, being very poor and to disconfirm dental attendance when having problems. Predictors of prevalence of tooth loss (1 or more lost tooth) due to various reasons and reduced number of occluding units followed similar patterns of relationships. CONCLUSION: The results are consistent with prevalence and extent of tooth loss due to caries and due to reasons other than caries being differently related to disease- and socio- behavioral risk indicators. Caries was the principle cause of tooth loss and molar teeth were the teeth most commonly lost.

Journal Article↗

Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil.

AIM: The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. MATERIAL AND METHODS: A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. RESULTS: Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (> 60 years) and smoking were statistically significant (p < 0.05). CONCLUSION: The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss.

Adult↗

Statin use and tooth loss in chronic periodontitis patients.

BACKGROUND: Statins have anti-inflammatory and bone stimulating properties that may positively affect chronic periodontitis. Our objective in this study was to evaluate whether statin use by chronic periodontitis patients had a beneficial impact on tooth loss. METHODS: In a retrospective cohort study (N patients = 1,021; mean follow-up = 7.1 years), dental records were merged with pharmacy data. Any statin use during 3 years, statin use during each of 3 consecutive years (regular use), and any statin use during the first 3 years after the initial periodontal exam were evaluated as predictors of tooth loss using negative binomial regression models with adjustment for potential confounding factors. RESULTS: Any statin use during 3 years was not associated with tooth loss rate in the year subsequent to the 3-year period (rate ratio [RR] = 1.00; 95% confidence interval [CI] = 0.56 to 1.81). Regular statin use during 3 years was associated with a non-significant 37% reduced tooth loss rate in the year subsequent to the 3-year period (RR = 0.63; 95% CI = 0.32 to 1.25). Any statin use during the first 3 years after the initial periodontal exam was associated with a 48% decreased tooth loss rate in year 4 and subsequent years (RR = 0.52; 95% CI = 0.29 to 0.95). CONCLUSIONS: Our findings were mixed for an association of statin use with reduced tooth loss in chronic periodontitis patients. Lack of control for some potential confounders, particularly smoking, and evaluation of different patterns of statin usage hamper the interpretation of the results. Exploration of these findings in additional epidemiological studies may be worthwhile.

Adult↗

Tooth loss and hormone use in postmenopausal women.

Nearly 32% of US women aged 65 to 69 have no teeth. Because some tooth loss may reflect systemic osteoporosis, and postmenopausal hormone therapy protects against osteoporosis, the authors examined the risk of tooth loss in relation to hormone use in a prospective study of 42,171 postmenopausal women. Overall, the risk of tooth loss was 24% lower in women who were currently using hormones, although there was little effect for women who had stopped taking hormones. This decreased risk for current hormone users was observed regardless of the duration of use and was similar for a variety of hormone preparations and doses. Although few studies have examined the issue, this research suggests that hormone therapy may reduce tooth loss.

Age Factors↗

A transcultural perspective on the emotional effect of tooth loss in complete denture wearers.

PURPOSE: The purpose of this study was to compare the emotional effects of tooth loss in three edentulous populations. MATERIALS AND METHODS: A questionnaire study involved 142 edentulous subjects undergoing routine prosthodontic care at Guy's, King's and St Thomas's Dental Institute, London; the Dental School, Dundee, Scotland; and the Faculty of Dentistry, University of Hong Kong. Data were analyzed using the chi-squared test. RESULTS: Difficulty in accepting tooth loss was a relatively common experience (44%) in all groups, with almost half feeling that their confidence had been affected. The majority (66%) felt that their choice of food was restricted and that the overall eating experience was less enjoyable, particularly the Hong Kong group. A significant proportion of the participants were concerned about their appearance without dentures, although the trend was less marked in Hong Kong. Forty-three percent felt that they were not adequately prepared for tooth loss, although the Hong Kong group was least concerned. CONCLUSION: In general, the emotional effect of tooth loss was significant in all groups. The restrictions on daily activities were generally greater in the Hong Kong group. However, this group was much less inhibited by denture wearing. The differences observed in the Hong Kong Chinese are most likely due to different cultural values and expectations associated with these aspects of daily living.

Activities of Daily Living↗

Tooth loss and obstructive sleep apnoea.

BACKGROUND: Complete tooth loss (edentulism) produces anatomical changes that may impair upper airway size and function. The aim of this study was to evaluate whether edentulism favours the occurrence of obstructive sleep apnoea (OSA). METHODS: Polysomnography was performed in 48 edentulous subjects on two consecutive nights, one slept with and the other without dentures. Upper airway size was assessed by cephalometry and by recording forced mid-inspiratory airflow rate (FIF50). Exhaled nitric oxide (eNO) and oral NO (oNO), were measured as markers of airway and oropharyngeal inflammation. RESULTS: The apnoea/hypopnoea index (AHI) without dentures was significantly higher than with dentures (17.4 +/- 3.6 versus 11.0 +/- 2.3. p = 0.002), and was inversely related to FIF50 (p = 0.017) and directly related to eNO (p = 0.042). Sleeping with dentures, 23 subjects (48%) had an AHI over 5, consistent with OSA, but sleeping without dentures the number of subjects with abnormal AHI rose to 34 (71%). At cephalometry, removing dentures produced a significant decrease in retropharyngeal space (from 1.522 +/- 0.33 cm to 1.27 +/- 0.42 cm, p = 0.006). Both morning eNO and oNO were higher after the night slept without dentures (eNO 46.1 +/- 8.2 ppb versus 33.7 +/- 6.3 ppb, p = 0.035, oNO 84.6 +/- 13.7 ppb versus 59.2 +/- 17.4 ppb, p = 0.001). CONCLUSION: These findings suggest that complete tooth loss favours upper airway obstruction during sleep. This untoward effect seems to be due to decrease in retropharyngeal space and is associated with increased oral and exhaled NO concentration.

Aged↗

Tooth loss in treated periodontitis patients responsible for their supportive care arrangements.

AIM: To identify risk indicators associated with tooth loss and periodontitis in treated patients responsible for arranging supportive periodontal care (SPC). MATERIALS AND METHODS: Ninety-seven Chinese subjects (34-77 years) who showed favourable responses to periodontal therapy provided in a teaching hospital 5-12 years previously were recalled. They were advised to seek regular SPC on discharge. Background information, general health status, smoking, oral hygiene habits, follow-up dental care, tooth loss, and periodontal parameters were investigated. Multiple regression analysis was performed. RESULTS: Two hundred and fifty-six teeth had been lost, 195 because of self-reported periodontal reasons. Up to 26.8% sites were with pockets > or =6 mm. Positive correlations were found between total/periodontal tooth loss and (i) smoking pack-years, (ii) time spent on oral hygiene, (iii) years since therapy's conclusion, (iv) age, and negative correlations with (v) inter-dental brush use, and (vi) education levels. Tooth loss by arch was correlated with wearing of removable partial denture in that arch. Percentage sites with pockets > or =6 mm were significantly negatively correlated with percentage sites without bleeding on probing. CONCLUSIONS: Smokers, more elderly patients, removable partial denture wearers, and patients with lower education levels or not using inter-dental brushes ought to be targeted for clinic-based SPC.

Adult↗

Non-surgical periodontal therapy and tooth loss. A cohort study.

BACKGROUND: No reliable evidence is available regarding the effect of periodontal therapy on major disease endpoints such as tooth loss, edentulism, or quality of life. The primary objective of this study was to assess the association between tooth loss and the non-surgical periodontal treatment history of 1,021 members of the Kaiser Permanente Dental Care Program. METHODS: Tooth loss rates were estimated using Poisson regression models, adjusting for some of the potentially confounding variables such as initial disease severity and extent. RESULTS: Continuous non-surgical therapy (one or more non-surgical procedures performed during 3 successive years), as opposed to no therapy during such a 3-year period, reduced the subsequent tooth mortality rate by 58% (relative rate, 0.42; 95% confidence interval, 0.29-0.61). Intermittent non-surgical therapy reduced the tooth mortality rate by 48% (RR = 0.52; 95% confidence interval, 0.34-0.80). As the number of non-surgical procedures increased, tooth loss rates decreased. CONCLUSIONS: These findings suggest that non-surgical periodontal therapy may be associated with a substantial reduction in tooth mortality. Different study designs and populations are needed to confirm these findings.

Adult↗