Associations between oral health and risk of dementia in a 37-year follow-up study: the prospective population study of women in Gothenburg.

OBJECTIVES: To investigate the association between incident dementia and previous number of teeth measured over a long interval. DESIGN: Retrospective analysis of a 37-year cohort study. SETTING: Prospective Population Study of Women in Gothenburg. PARTICIPANTS: Women with (n = 158) and without (n = 539) dementia in 2000 to 2005. MEASUREMENTS: Tooth counts in 1968-69, 1980-81, and 1992-93. Covariates included age, education, stroke, myocardial infarction, diabetes mellitus, smoking status, blood pressure, body mass index, and cholesterol level. RESULTS: After adjustment for age, odds ratios (ORs) for dementia in 2000-05, comparing first with fourth tooth count quartiles, were 1.81 (95% confidence interval (CI) = 1.03-3.19) for tooth counts measured in 1968, 2.25 (95% CI = 1.18-4.32) for those in 1980, and 1.99 (0.92-4.30) for those in 1992. After further adjustment for education, ORs were 1.40 (95% CI = 1.03-3.19) for 1968, 1.96 (95% CI = 0.98-3.95) for 1980, and 1.59 (95% CI = 0.71-3.53) for 1992, and after additional adjustment for vascular risk factors, ORs were 1.38 (95% CI = 0.74-2.58) for 1968, 2.09 (95% CI = 1.01-4.32) for 1980, and 1.61 (95% CI = 0.70-3.68) for 1992. CONCLUSION: In most of the analyses, lower tooth count was not associated with dementia, although a significant association was found for one of the three examinations. Further research may benefit from more-direct measures of dental and periodontal disease.

Trends in tooth loss in relation to socio-economic status among Swedish women, aged 38 and 50 years: repeated cross-sectional surveys 1968-2004.

BACKGROUND: Oral diseases are a health problem worldwide. Differences in oral health status may vary with geographical locations, but also within the same country and between groups with different social backgrounds. The specific aims were to describe secular trends in oral health status regarding number of remaining teeth and also to describe differences in socio-economic status, among 38- and 50-year-old women, over a 36-year period. METHODS: Cross-sectional health surveys were performed at four occasions; 1968/69 (n = 746), 1980/81 (n = 532), 1992/93 (n = 165) and 2004/05 (n = 500), including randomly selected women aged 38 and 50 years. The number of teeth was determined using panoramic radiographs and self-reported measures of marital status, social class, educational level, and income were recorded. RESULTS: The mean number of teeth among women has increased significantly. The educational level has increased while fewer women are married/cohabiting over time. There has been a shift in the social group the women belong to, where proportionally more women were categorized in a higher social group in 2004/05 than in 1968/69. Moreover, there is a significant relationship between fewer teeth and a lower social group, and among the 50-year-old women, this was irrespective of examination year. However, multivariate analyses showed that the risk to be edentulous or not, or to have fewer remaining teeth was significantly higher for women of lower social group, or living alone, in all studies over the 36 year-period. This was independent of age group, even though the risk diminished over the study period. CONCLUSIONS: Cohort comparisons of women aged 38 and 50 years during 36 years showed that dental status improved, with (i) a decreasing prevalence of edentulism and, (ii) an increasing number of remaining teeth in dentate individuals over time. Differences due to social group and education were still present, with more remaining teeth in the women in the higher social group. A time trend analysis indicated that in the later examination years the individuals had fewer teeth lost, irrespective of age, marital status and, social group.

Oral health-related quality of life, sense of coherence and dental anxiety: an epidemiological cross-sectional study of middle-aged women.

BACKGROUND: Few publications report on the relationship between salutogenesis, as measured by the concept of sense of coherence, and oral health-related quality of life. Even less information is to be found when the behavioural aspect of dental anxiety is added. The aim of the present study was to evaluate how oral health-related quality of life is related to sense of coherence and dental anxiety. METHOD: The study had a cross-sectional design and included 500 randomly selected women in Gothenburg, Sweden, 38 and 50 years of age, from health examinations in 2004-05. The survey included questionnaires covering global questions concerning socio-economic status, oral health/function and dental care behaviour, and tests of oral health-related quality of life, sense of coherence, and dental anxiety. RESULTS: High dental anxiety and low sense of coherence predicted low oral health-related quality of life. In addition, socioeconomic status as measured by income, perceived oral functional status as captured by chewing ability and self-reported susceptibility to periodontal disease were also important predictors of oral health-related quality of life. CONCLUSION: Dental anxiety and sense of coherence had an inverse relationship with regard to oral health-related quality of life. These associations were stronger than other risk factors for low oral health-related quality of life.

Oral health-related quality of life--associations with oral health and conditions in Swedish 70-year-old individuals.

OBJECTIVE: The aim of this study was to evaluate oral health-related quality of life (OHRQoL) in relation to different chronic oral conditions and perception of oral health among elderly individuals. BACKGROUND: Health-related quality of life is important to assess and understand the impact of different diseases and conditions on individuals' well-being. MATERIAL AND METHODS: Randomly selected 70-year-old individuals (N = 561) were included in this analysis. They were clinically examined and answered a questionnaire. Variables used were perceived oral health, satisfaction with appearance of teeth, problems with chewing and dry mouth, burning mouth syndrome, dental anxiety and dental visiting habits. To measure the participants' perception of the impact of oral conditions on their well-being, the Oral Health Impact Profile (OHIP-14) was used. RESULTS: The OHIP-14 distribution of sum of scores showed a floor effect but revealed acceptable psychometric properties with regard to reliability and validity. Multivariable logistic regression revealed three highly predictive variables for individuals with high OHIP-14 scores: using dentures, having chewing problems and being dissatisfied with appearance of teeth. CONCLUSION: Use of dentures, having chewing problems and being dissatisfied with appearance of teeth are associated with high OHIP-14 sums, indicating strong influence on OHRQoL.

Association between periodontal disease and ischemic heart disease among Swedish women: a cross-sectional study.

OBJECTIVE: The aim of this cross-sectional study was to analyze the relationship between chronic periodontitis and ischemic heart disease (IHD). MATERIAL AND METHODS: A cross-section of women aged 38 to 84 years were examined in 1992-93 (analysis based on n=1056). Medical and dental examinations were included in the analysis specifically with regard to IHD and periodontitis. Other well-known risk factors for IHD were used as covariates in multivariable statistical analysis. RESULTS: Among the dentate women in this study (n=847), 74 had IHD and 773 did not. There was no statistically significant difference between numbers of pathological gingival pockets between these groups (58.1% had one or more pathological pockets in the IHD group compared to 57.6% in the non-IHD group). Bivariate analysis of dentate individuals showed significant associations between IHD and number of missing teeth, age, body mass index, waist/hip ratio, life satisfaction, hypertension, and levels of cholesterol and triglycerides. However, in the final multivariable logistic regression model, with the exception of age, only number of teeth (<17 teeth) OR = 2.13 (CI 1.20; 3.77) was found to be significantly associated with IHD. Moreover, edentulous women had an OR of 1.94 (CI 1.05; 3.60) in relation to IHD (age-adjusted model). CONCLUSIONS: In the present study, periodontitis did not seem to have a statistically significant relationship with IHD. The number of missing teeth showed a strong association with IHD, and this may act as a proxy variable tapping an array of different risk factors and behaviors.