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Tooth loss and tooth retention in a multitribal group of Bantu-speaking South African blacks: a study on 500 dry mandibles.

Tooth loss and tooth retention in adult South African Bantu-speaking Negroes were studied from data derived from 500 dry mandibles. The tribe, sex, and stated age of the specimens were available. Mandibles were equally distributed over the third to seventh decade of life. The presence of dental units was recorded and analysed within and between decade age groups. The mandibles carried a total of 5,459 dental units. Between the third and fourth decades of life and between the sixth and seventh decades, the reduction of the frequency of dental units was mild and statistically not significant. It was, however, severe and significant between the fourth and fifth, and the fifth and sixth decades. In the third-decade group, most teeth were found in the anterior region with a tendency to diminish in number posteriorly. After the third decade there was a definite persistence of first premolars and canines with significant tendency toward loss of teeth anterior and posterior to them. Only the incisors and third molars showed significant reduction in number from the third to the fourth decade. The reduction of all teeth was statistically significant later, until the sixth decade of life. Although there was loss of teeth from the sixth to the seventh decade, it was not significant for any of the homologous dental units. There is a possibility that some dietary differences existed between the older subjects (50-70 years old) and the younger ones (20-49 years old) which may have had some influence on the results.

Adult

Causes of tooth loss in a veteran population.

Tooth loss in adults over age 35 usually is attributed to periodontal diseases. However, certain adult populations are known to have high caries rates. It is not clear to what extent caries contributes to tooth loss in adults. This pilot study examined the causes of tooth loss in a veteran population residing in an 800-bed, primarily long-term care facility. The study retrospectively reviewed 572 patients' dental records and documented causes for dental extractions. Of the sample population, 168 teeth were extracted in 51 patients who had 860 teeth present before treatment. Mean age of the patients undergoing extractions was 57.7 years, lower than the sample population of 60.1 years. Of the 168 teeth extracted, 105 (63%) were attributed to caries and 33 (20%) were documented as root tips, suggesting the presence of root caries. Fifty-five (33%) were extracted due to periodontal disease and six (4%) were extracted for prosthodontic reasons. Of the maxillary teeth, 67 percent were extracted for caries and 25 percent of periodontal reasons. Caries accounted for 57 percent and periodontal disease accounted for 42 percent of the mandibular teeth extracted. The order in which teeth were most frequently extracted was maxillary anteriors, mandibular anteriors, maxillary and mandibular premolars, and maxillary and mandibular molars. This study supports the recent work of authors who have found caries contributing significantly to tooth loss in adult populations.

Adult

[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

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

Prevalence and demographic correlates of tooth loss among the elderly in the United States.

The aging of the United States population and the contribution of tooth loss to oral health make it important to describe tooth loss among the elderly in this country. Data from the National Survey of Oral Health in US Employed Adults and Seniors: 1985-1986, conducted by the National Institute of Dental Research, were analyzed to examine the prevalence and demographic correlates of tooth loss among the elderly. Results show that there were important differences in tooth loss among subgroups of the elderly sample (overall n = 5,649 persons aged 65+ years attending senior centers). The oldest seniors and those with the least education or income were the most likely to be edentulous. The oldest dentulous seniors, blacks, those with the least education or income, and those who lived in New England or the Northeast had the fewest number of teeth present. These findings suggest that efforts to reduce tooth loss among the elderly should target those with the least education and income.

Age Distribution

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

[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

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

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

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

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

A preliminary investigation of postmortem tooth loss.

Forensic anthropologists have found a seemingly increased frequency of dismemberment cases and subsequent scattering of the elements that mandates developing unconventional methods of estimating postmortem interval. The chronological sequence in postmortem tooth loss has been investigated as an indicator for estimation of time since death. The anterior dentitions of cadavera were observed to discern patterns in "drop time" based on age, periodontal health, seasonality and location of body placement. Individuals deposited in the summer months lost teeth much more rapidly than those deposited in the late fall or winter months. Similarly, individuals exposed to direct sunlight, a micro-environment where rapid decomposition has been noted, lost teeth before individuals in shaded locales. Since tooth loss is dependent on the deterioration of the soft tissues which bind the tooth into the alveolar bone, we found tooth loss to be correlated with general soft tissue decomposition rates as dictated by season and environment. When utilized as sole indicator, the patterns of postmortem tooth loss can not be used for estimating time since death. However, when used in conjunction with other indicators, tooth loss patterns may provide useful information for more accurate estimation of the postmortem interval.

Adult

Tooth loss and skeletal bone density in healthy postmenopausal women.

Associations between dental status and skeletal bone density were investigated in a group of 329 healthy postmenopausal women with normal bone density. Bone mineral density (BMD) of the lumbar spine, femoral neck and distal radius were measured by dual- or single-photon absorptiometry. Number of teeth remaining were counted and presence of complete dentures noted by a nurse practitioner. Forty-eight women (15%) wore a complete maxillary and/or mandibular denture: 22(7%) were completely edentulous and an additional 26 (8%) had one edentulous ridge. Among women without complete dentures (n = 281), significant positive linear relationships were observed between number of teeth and BMD at the spine (p < 0.05) and radius (p < 0.01), controlling for years since menopause, pack-years of smoking, education and body mass index. BMD did not differ between the groups with and without dentures. However, women who acquired dentures after the age of 40 years had significantly lower mean spinal and radial BMD than women who acquired dentures at age 40 years or earlier (at the radius, 0.584 +/- 0.015 v 0.630 +/- 0.017 g/cm2, p < 0.05; at the spine, 1.043 +/- 0.031 v 1.124 +/- 0.029 g/cm2, p = 0.05). In linear regression analysis, significant independent correlations were found among all women (n = 329) between number of teeth and age (partial r = -0.19, p < 0.001), pack-years of cigarette use (partial r = -0.23, p < 0.001) and years of education (partial r = +0.11, p < 0.05). These associations between dental status and BMD support the hypothesis that systemic bone loss may contribute to tooth loss.

Adult

Attitudinal and behavioral characteristics of older Floridians with tooth loss.

In this cross-sectional study of Floridians aged 65 yr or older, 600 persons were interviewed to identify the characteristics of individuals who survived into old age with an intact or nearly intact dentition. Persons with total or partial tooth loss reported less frequent dental care, less ability to pay dental care fees, less frequent dental hygiene, and were more likely to have been smokers or diabetic. Persons with tooth loss also had less positive attitudes toward dentists and dental care. These cross-sectional findings are consistent with tooth loss being the result of disease-, behavior-, and attitude-related causes, and/or their interactions. Tobacco use, diabetes, and infrequent oral hygiene and dental care may increase risk for dental disease; decreased ability to pay for dental treatment may impair utilization of non-extraction treatment options, and negative attitudes toward dental treatment may influence the desire for non-extraction treatment options. Research targeted toward modifying attitudes toward dental treatment may be useful in preventing or delaying tooth loss, and measurement of attitudes may be a useful way to identify individuals at the greatest risk for tooth loss for intervention studies.

Aged

Incidence of tooth loss among elderly Iowans.

This study investigated the 18-month incidence of tooth loss in a random sample of 451 dentate noninstitutionalized Iowans aged 65 and older residing in two rural counties. They had a mean of 19.0 teeth at baseline and lost an average of 0.4 teeth during the subsequent 18 months. Twenty-one per cent of the population lost at least one tooth. Four people had all their teeth extracted. Of the teeth present at baseline, 1.9 per cent subsequently were extracted. The highest incidence of tooth loss occurred among mandibular molars (3.7 per cent), followed by maxillary premolars and canines (3.1 per cent each). The best predictors of tooth loss were previous coronal and root caries.

Aged