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PubMed1997

Tooth loss due to periodontal abscess: a retrospective study.

This retrospective study focused on the frequency of tooth loss due to periodontal abscess among 42 patients who were treated by a single clinician over a 5- to 29-year period. A total of 114 patients were selected from the active periodontal recall schedule of a single periodontist at The University of Iowa College of Dentistry. The criteria for inclusion in the study included having a history of moderate to advanced periodontitis, being on 3 to 6 month recall periodontal maintenance care, and completion of active periodontal therapy prior to October 1987. Other parameters evaluated were age; gender; number of teeth present and missing at the initial, reevaluation, and last periodontal recall visit; initial periodontal prognosis; furcation involvement; non-surgical and surgical periodontal therapy; and reasons for tooth loss. Patients were grouped according to the number of teeth lost following active periodontal treatment into well-maintained (0 to 3), downhill (4 to 9), and extreme downhill (10 to 23) groups. Forty-two of the 114 patients were identified as having one or more periodontal abscesses. A total of 109 teeth were affected by periodontal abscess of which 49 (45%) teeth were lost and 60 (55%) were successfully maintained over an average of 12.5 years (5 to 29 years). More furcated teeth were lost than nonfurcated teeth and teeth given a hopeless prognosis were lost more consistently than those given a questionable prognosis in all groups. The frequency of periodontal abscess and tooth loss per patient was greater in the downhill and extreme downhill response groups than the well-maintained group. This suggests that teeth with a history of periodontal abscess can be treated and maintained for several years.

Female↗
PubMed2004

The relation of tobacco smoking to tooth loss among young adults.

Earlier studies have associated smoking with a higher rate of dental caries, periodontal disease and tooth loss. The aim of this cross-sectional study was to determine whether smoking is associated with tooth loss among young adults. The data consist of the 1966 birth cohort of Northern Finland, which is an unselected general population birth cohort (n = 12 058). The data were collected using a postal questionnaire in 1997-98 (n = 8690). Prevalence odds ratios and confidence intervals were estimated by applying a logistic regression model. It was found that smoking was associated with tooth loss in an exposure-dependent manner. The odds for those who smoked 16 or more pack-years were 5.30 (CI = 2.35-11.2) after adjustment for socio-economic and behavioral factors. Differences in socio-economic or health behavior are not likely to explain the findings since an exposure-response pattern was seen even when data was stratified according to sex, education and health-oriented lifestyle. A possible explanation for this association is a combination of treatment decisions and dental diseases, which are most likely associated with smoking in an exposure-dependent manner.

Adult↗
PubMed2000

Risk indicators associated with tooth loss in Jordanian adults.

OBJECTIVES: The purpose of this study was to evaluate the risk indicators of tooth loss in Jordanian adults. METHODS: A sample of 509 Jordanian adults was randomly selected. The subjects were interviewed regarding demographics, social economic status, smoking habits, and oral hygiene practices and then clinically examined by a single examiner. Multiple regression analysis was performed to estimate the simultaneous impact of risk indicators on tooth loss. RESULTS: The subjects' mean age was 42.6 years with an average of 20.9 teeth remaining per person. The overall educational level of the subjects was low. More than 40% reported not brushing their teeth regularly and 56% had had no professional teeth cleaning during the last year. Monthly family income averaged JOD 231, and about a third of the subjects were smokers. The mean number of remaining teeth decreased significantly with age. Smokers, those who brushed irregularly, and those who had not had professional teeth cleaning in the last year had significantly fewer remaining teeth. Men also had significantly fewer remaining teeth. Education and income were also significantly associated with the number of remaining teeth. Age, income, brushing, prophylaxis, and gender collectively explain 75.1% of the variance in the number of remaining teeth. CONCLUSION: Modification of non-disease independent factors could reduce tooth loss and improve oral health in Jordanians.

Adolescent↗
PubMed2003

Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST).

BACKGROUND AND PURPOSE: Chronic infections, including periodontal infections, may predispose to cardiovascular disease. The present study investigates the relationship of periodontal disease and tooth loss with subclinical atherosclerosis. METHODS: We enrolled 711 subjects with a mean age of 66+/-9 years and no history of stroke or myocardial infarction in the Oral Infections and Vascular Disease Epidemiology Study. Subjects received a comprehensive periodontal examination, extensive in-person cardiovascular disease risk factor measurements, and a carotid scan using high-resolution B-mode ultrasound. Regression models were adjusted for conventional risk factors (age, sex, smoking, diabetes, systolic blood pressure, low- and high-density lipoprotein cholesterol, race-ethnicity, education, physical activity) and markers of cultural background, healthy lifestyle, and psychosocial health. RESULTS: Measures of both current and cumulative periodontitis became more severe as tooth loss increased. A significant association was observed between tooth loss levels and carotid artery plaque prevalence. Among those with 0 to 9 missing teeth, 46% had carotid artery plaque, whereas among those with >or=10 missing teeth, carotid artery plaque prevalence was approximately 60% (P<0.05). CONCLUSIONS: Our data suggest that tooth loss is a marker of past periodontal disease in this population and is related to subclinical atherosclerosis, thereby providing a potential pathway for a relationship with clinical events.

Age Distribution↗
PubMedDate not supplied

[Reasons and factors which are causing tooth loss in the population of Greece].

The aim of this study was to determine the reasons for tooth loss among the population of Greece and the factors which contribute to it. A total of 600 individuals, ages 18-50, was included in this study. During the examination the following were recorded: 1) The number of teeth which had already been lost and the number of teeth which had to be extracted. 2) The dental disease which was responsible for tooth loss. 3) The age, the socioeconomic status, the oral hygiene habits and the dental care of the individual. For the entire age group the percentages of teeth which had to be extracted due to caries, periodontal disease or other reasons were 68.7%, 12.3% and 19.0% respectively. The percentages of teeth which had been lost due to caries, periodontal disease or other reasons were 56.5%, 10.8% and 32.8%. The mean number of extractions of individuals was inversely related to their oral hygiene habits and frequency of visits to their dentist. Tooth loss was greater among the rural population than the urban population. People of the higher socioeconomic class tend to have a lower number of extractions.

Adolescent↗
PubMed1998

Changes in the prevalence of residual pockets and tooth loss in treated periodontal patients during a supportive maintenance care program.

Bleeding on probing and the presence of deep periodontal pockets are considered to be the best site-specific indicators for periodontal disease progression during the maintenance phase of periodontal therapy. A major emphasis of supportive periodontal care (SPC) programs, therefore, has been the control of bleeding pockets. This investigation retrospectively evaluated the changes in the prevalence of bleeding on probing, periodontal pockets, bleeding periodontal pockets and the prevalence of tooth loss in a random sample of 273 periodontal patients participating in a supportive maintenance care program at a University Clinic. During an observation period of 67+/-46 months (range 5 months to 23 years), the overall incidence of all causes of tooth mortality was 0.23+/-0.49 teeth per patient per year of observation. 56% of subjects, however, did not experience any tooth loss, while less than 10% of patients lost more than 3 teeth. Thus, participation in the SPC program was effective in preventing tooth loss in the majority of patients. During the SPC period, however, a significant increase in the prevalence of periodontal pockets, and of bleeding on probing positive periodontal pockets, in particular, was observed. At completion of active periodontal therapy, 56.4% of patients were free from bleeding pockets. This decreased to a mere 13.6% at the latest SPC evaluation. The observed increases in the number of bleeding pockets was significantly associated with: longer times since completion of active periodontal therapy, more advanced periodontal diagnosis, higher %s of bleeding sites in the dentition, cigarette smoking, lack of inclusion of periodontal surgery in the active treatment phase, tooth loss, and the response to the active phase of periodontal treatment. The data presented in the paper indicate that the observed increase in the prevalence of bleeding pockets and tooth loss was not homogeneously distributed in the studied SPC population. Rather, high risk groups of individuals could be identified. It is suggested that better knowledge of risk indicators may lead to improved and more efficient risk management efforts during periodontal maintenance care.

Adolescent↗
PubMed2003

The impact of restorative treatment on tooth loss prevention.

A cross-sectional study was carried out to analyze tooth loss resulting from caries in relation to the number of times the extracted tooth had been restored, the type of caries diagnosed (primary or secondary), and socioeconomic indicators of patients from the city of Recife, Brazil. Ten public health centres and ten centres associated with health insurance companies were randomly selected. The size of the sample was calculated using a standard error of 2.5%. A confidence interval of 95% and a 50% prevalence of reasons for extractions were used for calculating the sample. The minimum size of the sample for meeting these requirements was 381 patients. Patients were randomly selected from the list of adults registered at each centre. A total of 410 patients were invited to take part in the study. The response rate was 100%, but 6 patients were excluded due to incompleteness of data in the questionnaire applied. An assessment was made to obtain the number of decayed, missing or filled teeth (DMFT index) and the reasons for extraction. The results showed a highly significant (p < 0.001) relationship between the number of times the tooth indicated for extraction had been restored and the reason for extraction being caries. Furthermore, the majority of teeth extracted due to caries had been restored two or more times. A highly statistically significant association was also observed between one indicator of use of dental services (F/DMFT) and extraction due to caries (p < 0.001). The findings questioned the belief that tooth loss can be prevented in the general population by merely providing restorative treatment.

Adolescent↗
PubMed2003

Pattern of tooth loss in Nigerian juvenile and plaque-induced chronic periodontitis patients.

The aim of this study was to determine the pattern of tooth loss in chronic periodontitis patients and hence help the clinician to plan preventive treatment against the loss of these teeth. Dental record notes of all the subjects, the periapical radiographs and actual intra-oral examinations of the juvenile periodontitis patients were done to determine the number and types of tooth loss. It was observed that the pattern of tooth loss in both groups of chronic periodontitis (plaque Induced periodontitis (PIP) and juvenile periodontitis (JP) was different as the most frequently lost teeth in PIP was incisors and lower incisor in JP while the least lost in PIP was the upper canines and the lower premolars in JP.

Adolescent↗
PubMed2001

Epidemiological study on improving the QOL and oral conditions of the aged--Part 2: Relationship between tooth loss and lifestyle factors for adults men.

Oral health in early- and mid-adulthood is essential for the improvement of one's QOL, this study was investigated to include an epidemiological analysis of the relationship between tooth loss and life style, such as smoking, regular exercise, and the food habits of approximately 2,000 employees. Compared with the group with mild or no periodontal disease (CPI of 0, 1, or 2), the frequency of tooth loss in the group with advanced periodontal disease (CPI of 4) was 2.00 times (odds ratio, 2.00; 95% confidence limit, 1.37 to 2.93). The probability of tooth loss showed statistical significance in relation to smoking, alcohol drinking, and frequency of meals. Compared with non-smokers, the probability that current smokers will lose teeth is 1.53 times greater (odds ratio, 1.53; 95% confidence limit, 1.20 to 1.96). It was concluded that periodontal disease and smoking must be averted for preventing tooth loss.

Adult↗
PubMed1998

Type 1 diabetes mellitus and oral health: assessment of tooth loss and edentulism.

OBJECTIVE: The oral health of an adult population previously diagnosed with juvenile onset insulin dependent-diabetes was comprehensively assessed. The goal of this exploratory cross-sectional evaluation was to described the characteristics related to partial tooth loss edentulism in subjects with Type 1 diabetes mellitus. METHODS: An adult population of 406 Type 1 diabetes mellitus subjects, who had been monitored for 6-8 years as part of a University of Pittsburgh longitudinal study of medical complications associated with diabetes, received an oral health examination for missing teeth, edentulism, coronal and root caries, periodontal status, and oral health behaviors. RESULTS: Of the 406 subjects evaluated, 204 had no missing teeth, 186 had partial tooth loss (1-27 missing teeth), and 16 were edentulous. Patients who had partial tooth loss or who were edentulous were generally older; had lower incomes and levels of education; and had higher rates of nephropathy, neuropathy, retinopathy, and peripheral vascular disease. A logistic regression model found partial tooth loss to be significantly associated with extensive periodontal disease in remaining teeth (OR = 7.35), a duration of diabetes longer than 24 years (OR = 5.32), not using dental floss (OR = 2.37), diabetic neuropathy (OR = 2.29), household income less than $20,000 (OR = 2.21), multiple coronal caries and fillings (OR = 1.98), and bleeding on probing (OR = 1.82). CONCLUSIONS: Although the majority of these adult Type 1 diabetes patients had serious medical complications associated with their diabetes, the possible impact of diabetes mellitus on oral health should be included in their overall management.

Adolescent↗
PubMed1995

Tooth loss and mandibular osteopenia.

The relationship between mandibular bone mass and tooth loss was studied in 269 patients who had neither metabolic disease nor local lesions affecting the mandibular cortex. In all of the subjects, the outline of the mental foramen was distinctly disclosed on unilateral or bilateral panoramic radiographs. Mandibular bone mass was evaluated by determining the mandibular cortical width in the mental region with the use of panoramic radiographs. The relationships of mandibular cortical width to patient age and sex and the number of teeth present were also investigated. In male subjects, there was no significant correlation between the number of teeth present and the mandibular cortical width. Among women in their seventh decade, those with 15 or more teeth showed significantly greater mandibular cortical width than those with fewer teeth. Decrease of mandibular bone mass was positively correlated with tooth loss in female subjects.

Absorptiometry, Photon↗
PubMed2006

Fish oil reduces tooth loss mainly through its anti-inflammatory effects?

Competing at several steps of arachidonic acid metabolism, n-3 fatty acids reduce production of highly active prostaglandins and leukotrienes and exert anti-inflammatory effects. They are also experimentally shown to be anti-osteoporotic. Periodontitis is responsible for most tooth loss in adult populations. If enough n-3 fatty acids are provided, periodontitis with alveolar bone resorption may be controlled, and tooth loss may be prevented. In fact, n-3 fatty acid administration lowered prostaglandin E(2) production, tooth movement and alveolar bone resorption in animal experiments. Aggression, which may be related with tooth loss, was also controlled with fish oil. Our cross-sectional data supported our hypothesis. We recruited 256 men (22-59 y of age) and 95 women (22-66 y), counted the numbers of their remaining teeth, and analyzed the fatty acid composition of the total phospholipid fraction of RBCs. The beta-coefficient of the numbers of remaining teeth and EPA concentrations in the fraction was 0.89 (per 1% EPA, p=0.007) after adjustment for 9 possible confounding factors. Long-term intervention studies with fish oil planned in the future should be able to test our hypothesis by just adding another very simple endpoint in those studies: tooth loss during the intervention period. This hypothesis may explain the linkage between periodontitis/tooth loss and coronary heart disease.

Adult↗
PubMed1994

Correlates of tooth loss in a Canadian adult population.

Oral health data collected from a mail survey of an Ontario population of adults aged 18 years and over were used to conduct a preliminary investigation of the incidence and correlates of tooth loss and to explore its functional, psychological and social consequences. Of the sample of 500 dentate subjects, 10 per cent reported losing one or more teeth in the previous year. Comparisons between those with and without tooth loss showed significant differences according to age, household income and place of birth. Those subjects wearing partial dentures, possessing fewer teeth at the start of the study period, or who only attended the dentist when having pain or other trouble, were also more likely to have experienced tooth loss in the preceding year. Logistic regression analysis identified only age as a significant independent risk factor. Subjects who lost teeth were significantly more compromised in their oral functions and psychosocial behaviors, as measured by a battery of subjective oral health indicators. Whether or not these problems were pre-existing or the consequences of losing teeth during the past year cannot be determined from this study. This investigation suggests that tooth loss is still a concern for many Canadian adults, and demonstrates the importance of teeth in their overall well-being.

Adolescent↗
PubMed1990

Risk factors for tooth loss over a 28-year period.

Over 500 residents of Tecumseh, Michigan, were dentially examined in 1959 as part of a community-wide health study. In 1987, the dental examinations were repeated, with use of the same criteria as in 1959, for 167 dentate persons from the original group. Another 28 reported by telephone that they had become edentulous since 1959. This report uses a historical cohort analysis for exploration of the risk factors for tooth loss, both total and partial, over the 28-year period. Over that time, the edentulous lost an average of 18.0 teeth (95% confidence interval 15.5, 20.7), whereas the age-matched 90 dentate persons lost only 3.2 (2.2, 4.2) teeth each. Descriptive data showed the edentulous to have higher baseline scores for plaque, calculus, and gingivitis, and a higher proportion of them smoked, though only loss of periodontal attachment (LPA) of 4 mm or more, early loss of first molars, and educational attainment were significant risk factors in regression analysis. Odds ratios for these three variables were 4.0 (1.2, 12.8), 2.0 (1.3, 3.1), and 0.6 (0.4, 0.9), respectively. The strongest risk factors for partial tooth loss among 116 dentate persons were baseline gingivitis (which was correlated with LPA of 4 mm or more) and the baseline number of teeth present, with odds ratios of 2.4 (1.2, 5.2) and 0.8 (0.7, 1.0), respectively. While the analysis had to be carried out without caries data, it was concluded that total tooth loss is a social-behavioral issue as much as it is disease-related. Social-behavioral factors were less clearly related to partial tooth loss in dentate persons; oral disease characteristics were the most prominent risk factors for partial tooth loss.

Cohort Studies↗
PubMed1986

Pattern of tooth loss in a selected population in Greece.

The pattern of tooth loss with age for individual teeth was examined in a selected population. The survey covered patients attending the Dental School of Athens University. Tooth loss increased steadily with age and was higher for the periodontitis than the gingivitis group. Mortality of individual teeth was analyzed for each type of tooth within the maxillary pair and within the mandibular pair and no statistical significance was found. The statistically highly significant differences in loss rates within most groups of four teeth were clearly attributable to differences between the maxilla and mandible. For the permanent second molars differences in loss were close to the significance level while for the first molars the difference was statistically highly significant. A statistically significant difference was found between losses of the four second premolars while highly significantly differences were noticed between first premolars. Mortality for canines was low, but differences in losses were highly statistically significant. The two mandibular incisors had the lowest rates of loss in our sample, difference in loss between maxillary and mandibular incisors was statistically highly significant. Central incisors had a similar pattern of loss to that of lateral incisors but differences in loss rates were not statistically significant.

Adolescent↗
PubMed2006

The potential prognostic value of some periodontal factors for tooth loss: a retrospective multilevel analysis on periodontal patients treated and maintained over 10 years.

BACKGROUND: The great challenge in clinical periodontology is assigning a prognosis to a periodontally affected patient. Many different factors can affect the long-term maintenance of periodontally compromised teeth. The main questions usually considered by the periodontist are: 1) Will a tooth lose more bone in the future? 2) Will the tooth itself be lost in the future? The purpose of this retrospective study was to evaluate the value of some clinical, genetic, and radiographic variables in predicting tooth loss in periodontal patients (aged 40 to 60 years) treated and maintained for 10 years. METHODS: Sixty consecutive non-smoking patients (aged 46.77 +/- 4.96 years) with moderate to severe chronic periodontitis (CP) were treated with scaling and root planing (SRP). Some patients also underwent additional surgical treatments. All patients were maintained in the same private practice for 10 years. The frequency of recall appointments was 3.4 +/- 1.0 months. At baseline (T(0)) and 10 years later (T(2)) the following clinical variables were evaluated: the number of teeth, probing depths (PD), tooth mobility (TM), and presence of prosthetic restorations (PR). In addition, radiographic measurements were taken of the mesial and distal distances from the cemento-enamel junction (CEJ) to the bottom of the defect (BD), to the bone crest (BC), and to the root apex (RA). At T(2), a genetic test to determine the IL-1 genotype and genetic susceptibility for severe periodontal disease was performed for all 60 patients, and they were classified as IL-1 genotype positive (G+) or negative (G-) according to the test results. Tooth loss was used as the outcome variable. Different predictor variables were then tested using a two-level statistical model (patient and tooth levels). At the patient level, these were: age, gender, mean bone loss (mean CEJ-BD)(T0), the interleukin-1 (IL-1) genotype, the interaction between mean bone loss, and IL-1 genotype (mean CEJ-BD(T0) x IL-1 genotype). At the tooth level, the variables were: TM(T0), prosthetic restorations (PR)(T0), molar teeth (MT)(T0), the infrabony component of the defect (BC-BD)(T0), PD(T0), bone level (CEJ-BD)(T0), and residual supporting bone (BD-RA)(T0). RESULTS: Among the considered predictor variables, the following were significantly associated with the outcome variable: 1) MT(T0) (P <0.0001); 2) BC-BD(T0) (P = 0.0377); and 3) BD-RA(T0) (P <0.0001). MT(T0) were found to be more prone to loss and the amount of BD-RA(T0) prognostic for tooth loss: the lower the residual amount of supporting bone, the higher the probability of tooth loss. Conversely, the BC-BD(T0)was associated with a reduced probability of future tooth loss: the greater the infrabony component, the lower the probability of tooth loss. None of the other considered predictors proved predictive for tooth loss. CONCLUSIONS: Within the scope of this study, many traditional prognostic factors were ineffective in predicting future tooth loss and, therefore, were of no prognostic value. Conversely, a few specific factors at the tooth level emerged as viable prognostic factors. The use of these factors may be of great value to practitioners as predictors of tooth loss when assigning a prognosis.

Adult↗
PubMed2002

Retrospective study of tooth loss in 92 treated periodontal patients.

BACKGROUND/AIMS: In this retrospective study, the efficacy of periodontal therapy and maintenance in preventing tooth loss was evaluated. METHODS: The study included 92 patients with 2310 teeth diagnosed with chronic adult periodontitis and observed over a mean period of 6.7 years, with each patient receiving surgical therapy in two or more quadrants. The group was divided into two subgroups: those who complied with the recommended maintenance schedule and those whose compliance was erratic. Individual tooth prognosis was assigned according to radiographic parameters. RESULTS: At the completion of active periodontal therapy, 2184 teeth were present. During the maintenance period, 44 teeth were lost due to periodontal reasons. Tooth mortality revealed a mean annual adjusted tooth loss rate of 0.07/year. Molars were the teeth most frequently lost; canines the least. The number of teeth lost in the three prognostic categories was: one (0.07%) for teeth with good prognoses, 21 (3.63%) for questionable prognoses and 22 (11.34%) for hopeless prognoses. Patients complying erratically with supportive periodontal therapy were at a 5.6 times greater risk for tooth loss following active therapy than regularly compliant patients. CONCLUSIONS: The results demonstrated a low tooth mortality rate in periodontal patients following active treatment combined with a strict maintenance program.

Adult↗
PubMed2006

[Survey of treatment-seeking complete denture wearers concerning tooth loss, retention behavior and treatment expectations].

The aim of the current study was to gather information about time and etiology of tooth loss, and to analyze the reasons for treatment needs with a questionnaire used among edentulous patients. 60 patients (age 44-98 years) who requested dental treatment were included. More than half of the patients were edentulous before the age of 60, in almost all cases the maxilla was affected first. This difference was more pronounced in women, who experienced tooth loss in the maxilla 17 years prior to the mandible. At the time of edentulism women were about ten years younger than men. According to patients'report, periodontal disease was the most common reason for tooth loss. In the mandible, prosthesis retention was influenced by alveolar ridge resorption, while in the maxilla there was no relation between the amount of resorption and perceived retention. This indicates that maxillary prostheses retention is influenced by other factors besides the alveolar ridge morphology. So, permanent intake of drugs potentially causing xerostomia was related to poorer assessment of prostheses retention in the upper jaw. The results of the questionnaire "Patient satisfaction related to prosthetic restoration" before treatment indicated that the general satisfaction with the existing complete denture in the mandible was influenced by functional problems and the impairment of patients'self-confidence (R-squared = 0.754). The main reason for requesting treatment was the poor retention of the lower denture. More than half of the participants stated that they refrained from eating certain foods due to a reduced chewing ability.

Adult↗