Self-Reported Oral Diseases and Their Association with the Frailty index among Older Japanese People: Four-Year Follow-Up.

BACKGROUND: Oral health is a relevant component for overall health. Oral disease onset at an early age and may harm several health dimensions, especially among older people, and has been associated with frailty. OBJECTIVE: To evaluate associations between the Frailty Index (FI) and self-reported oral diseases among older, community-dwelling Japanese people. DESIGN: Cross-sectional and prospective analyses were performed. SETTING AND PARTICIPANTS: We analyzed data from 2,529 participants at the baseline and four-year follow-up of the Nihon University Japanese Longitudinal Study of Aging, which had a four-year follow-up. MEASUREMENTS: We used the self-reported number of teeth, self-reported satisfaction with dentures, and self-reported ability to chew hard food as independent variables. We computed an FI that included 40 deficits as the dependent variable. The FI score ranged from 0 to 1, with a higher score associated with adverse health outcomes and mortality. Considering a gamma distribution and controlling for age, gender, marital status, education, working status, and residence area, we fitted generalized linear models. RESULTS: We found that dissatisfied denture users had a 2.1% (95% CI 1.006-3.279) higher frailty score than non-denture users at the baseline and a 2.1% (95% CI 0.629-3.690) higher frailty score than non-denture users at the four-year follow-up. In the cross-sectional analysis, with each additional reported tooth at the baseline, the FI score was lower by 1.5% (95% CI -2.878 to -0.208) at the four-year follow-up. In both the cross-sectional and the prospective analyses, the FI scores increased as the ability to chew hard food decreased. CONCLUSIONS: Self-reported oral diseases are associated with the FI score cross-sectionally and prospectively. Identifying factors prospectively associated with frailty may improve strategies for the next generation of older people. Considering oral diseases may help clinicians personalize treatment plans for older people.

Association of tooth loss and nutritional status in adults: an overview of systematic reviews.

BACKGROUND: Association of tooth loss and nutritional status has been widely researched with conflicting results. This overview aimed to analyse and summarize findings from systematic reviews on association of tooth loss with nutritional status, in view of their quality assessment and methodological characteristics. METHODS: Overview was conducted as per Cochrane Overviews of Reviews guidelines. 5 databases (PubMed, Dentistry and Oral Sciences Source, Scopus, Cochrane Register of Systematic Reviews, Epistemonikos.org) and one online source (Google Scholar) were searched for systematic reviews published between 2010 - July 2022, with inclusion criteria; population: participants aged 18 years or above, intervention/exposure: loss of teeth, comparison: not applicable, outcome: nutritional status, study: systematic reviews and meta-analysis. Reviews on association of prosthetic interventions with nutritional status were not included. Data were extracted for study characteristics, details of primary studies, and main findings. Narrative synthesis of data, overlap of primary studies and quality assessment of studies were done using AMSTAR 2 tool (A Measurement Tool to Assess Systematic Reviews). RESULT: Of 1525 articles found, seven systematic reviews were selected (four were systematic reviews, three were systematic reviews with meta-analysis). Five studies showed some or positive association, one found weak association and for one study the association was unclear. Overlap of primary studies was 'very slight'. Meta-analysis of two studies concluded fully or partially edentulous individuals were more likely to be malnourished or at risk of malnutrition, (RR = 1.095, 95% CI 1.007 to 1.190, p = 0.033. RR = 1.22; 95% CI 1.11 to 1.32 p < 0.01), but one found that edentulism was not associated with malnutrition. (RR = 1.072, 95% CI 0.9657-1.200). Quality assessment revealed four studies were 'high', one was 'low' and two were 'critically low.' CONCLUSION: This overview confirms the association between tooth loss and nutritional status specially in elderly. It is evident that tooth loss increases the likelihood of poor nutritional status. Overall, studies show high heterogeneity in the methodology and quality assessment reveals low confidence in the available evidence. Future studies should use standard assessment tools for tooth loss and nutritional status.

Number of Healthy Teeth Can Predict the Response of Rectal Cancer to Chemoradiotherapy: A Retrospective Study.

BACKGROUND: It has been reported that the oral and gut microbiomes are associated with the prognosis in patients who undergo surgery, chemotherapy, and radiation for colorectal cancer. This study is the first to identify a correlation between the number of healthy teeth, which is an oral health indicator, and the efficacy of preoperative chemotherapy for rectal cancer. METHODS: This retrospective single-center study included 30 patients who underwent radical surgery after preoperative chemoradiotherapy (CRT) between December 2013 and June 2021. The relationship between number of teeth before CRT and the efficacy of CRT, CRT-related adverse events, postoperative complications, and long-term postoperative outcomes was examined. RESULTS: The number of healthy teeth was significantly greater in patients with downstaging of their disease than in those without downstaging (P = .027) and in patients with a complete response according to the Response Evaluation Criteria in Solid Tumors than in those who did not have a complete response (P = .014). Patients were divided into two groups according to whether they had ≥15 teeth or ≤14 teeth. There was no significant between-group difference in CRT-related adverse events. The incidence of all postoperative complications and grade II postoperative complications tended to be higher in patients with ≥15 teeth (P = .071 and P = .092, respectively), as did the 5-year overall survival rate (P = .083) and the 5-year disease-free rate (P = .007). DISCUSSION: The number of healthy teeth predicted the response to preoperative CRT, postoperative complications, and the outcome of subsequent surgery in patients with rectal cancer.

Exploring the association between number of teeth, food intake, and cognitive function: A 9-year longitudinal study.

OBJECTIVES: This study aimed to investigate the association between the number of teeth, food intake, and cognitive function in Japanese community-dwelling older adults. METHODS: This 9-year longitudinal study included a total of 293 analyzable participants who participated in baseline and follow-up surveys. Dental status (number of teeth and periodontal pocket depth), dietary assessment using the brief-type self-administered diet history questionnaire, cognitive function, and the following confounding factors were evaluated: educational level, financial satisfaction, living situation, smoking and drinking habits, history of chronic diseases, apolipoprotein E-ε4 carrier, body mass index, handgrip strength, instrumental activities of daily living, and depressive symptomatology. The Japanese version of the Montreal Cognitive Assessment was used to evaluate cognitive function. A multinomial logistic regression analysis for the intake level of each food categorized into three groups (low, moderate, high), and a generalized estimating equation (GEE) for cognitive function over nine years were performed. RESULTS: After controlling for confounding factors, the number of teeth was shown to be associated with the intake of green-yellow vegetables and meat. Furthermore, the GEE indicated that the lowest quartile of intake of green-yellow vegetables significantly associated with lower cognitive function (unstandardized regression coefficient [B] = -0.96, 95 % confidence interval [CI]: -1.72 to -0.20), and the lowest quartile of intake of meat significantly associated with lower cognitive function (B = -1.42, 95 % CI: -2.27 to -0.58). CONCLUSIONS: The intake of green and yellow vegetables and meat, which is influenced by the number of teeth, was associated with cognitive function in Japanese community-dwelling older adults. CLINICAL SIGNIFICANCE: There are few studies that have examined the association between oral health, food intake, and cognitive function. This 9-year longitudinal study suggests that it is important to maintain natural teeth to enable the functional means to consume green-yellow vegetables and meat, and thereby help maintain cognitive function.

Nutrition Status Plays a Partial Mediation Role in the Relationship between Number of Teeth and Frailty: A Cross-Sectional Multicenter Study.

INTRODUCTION: Although the relationship between the number of teeth and frailty has been extensively studied, the mediating role of nutrition status in the association between the number of teeth and frailty remains to be clarified. METHODS: A number of 6,664 participants lived in the communities of West China were analyzed in our study. Physical frailty was determined based on the phenotype established by Fried. Nutrition status was evaluated using the Mini Nutrition Assessment-Short Form (MNA-SF) scale. Multiple linear regression was employed to evaluate the direct relationships between the number of teeth, nutrition, and frailty. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of nutrition status in the relationship between the number of teeth and frailty. RESULTS: Among the 6,664 participants aged over 50 years old, the prevalence of frailty was 6.2%. Multiple linear regression analysis showed a significant total relationship between the number of teeth (ß = -0.359, 95% CI: -0.473 to -0.244, p < 0.001) and frailty. After adjusting for MNA-SF scores, the relationship between the number of teeth and frailty remained significant (ß = -0.327, 95% CI: -0.443 to -0.211, p < 0.001), indicating a partial mediating effect of nutrition. Mediation analysis verified that nutrition partially mediated the relationship between the number of teeth and frailty (indirect effect estimate = -0.0121, bootstrap 95% CI: -0.0151 to -0.0092; direct effect estimate = -0.0874, bootstrap 95% CI: -0.1086 to -0.0678) in the fully adjusted model. This mediating effect occurred through influencing weight loss, low level of physical activity, and debility. SEM framework pathway analysis confirmed the association between the number of teeth, nutrition, and frailty. CONCLUSIONS: Our findings demonstrated that frailty was correlated with the number of teeth and poorer nutritional status, with nutrition partially mediating the correlation between the number of teeth and frailty. Our results supported early nutritional evaluation and intervention in oral health to decrease the risk of frailty.

Association between tea types and number of teeth: a cross-sectional study of the Chinese Longitudinal Healthy Longevity Survey.

BACKGROUND: Previous studies have suggested that tea consumption may have a positive impact on oral health. However, the effects of different tea types on oral health remain unclear. Therefore, this study aimed to determine the association between residual teeth and consumption habits of different types of tea (green tea, black tea, oolong tea, and scented tea) in older adults. METHODS: We conducted a secondary analysis using data from the Chinese Longitudinal Healthy Longevity Survey in 2018. In a sample of 6,387 older adults, we performed logistic regression analysis to examine the relationship between persistent tea consumption and oral health according to sex and brushing frequency. The indices for particularly healthy oral health and relative health were set at more than 20 teeth and more than 10 teeth, respectively. RESULTS: The study included 2,725 males and 3,662 females, both aged 65 and older. Among individuals with more than 20 teeth, drinking green tea significantly improved oral health in men (adjusted odds ratio [ORs]: 1.377; 95% confidence interval [CI]: 1.082-1.752) and drinking black tea significantly improved the oral health of women (ORs: 2.349, 95%CI: 1.028-5.366). In the daily brushing group, green tea had a significant beneficial effect on increasing the number of teeth in men and black tea had a significant beneficial effect in women. Among individuals with more than 10 teeth, drinking green tea significantly improved oral health in men (ORs: 1.539; 95% CI: 1.209-1.959) and drinking green tea and scented tea significantly improved the oral health of women (ORs: 1.447, 95%CI: 1.052-1.991; ORs: 1.948, 95%CI: 1.137-3.340). In the daily brushing group, consumption of green tea and black tea had significant beneficial effects on increasing the number of teeth in men, whereas that of green tea, black tea, and scented tea had significant beneficial effects in women. CONCLUSION: Long-term green tea consumption in males and black tea consumption in females were significantly associated with maintaining functional dentition (≥20 teeth). Similarly, long-term green tea consumption in males and green tea and scented tea consumption in females were associated with avoiding severe tooth loss (≥10 teeth). Furthermore, in the daily tooth brushing group, long-term consumption of black tea was associated with avoiding severe tooth loss in both sexes. However, tea consumption alone had no effect on oral health without good brushing habits.

Empirically derived dietary patterns in relation to periodontitis and number of teeth among Norwegian adults.

OBJECTIVES: To explore dietary patterns in relation to periodontitis and number of teeth. DESIGN: A cross-sectional study. SETTING: We used data from the seventh survey of the Tromsø Study in Norway, 2015-2016. Three periodontitis groups were compared: (i) no periodontitis/slow bone loss; (ii) moderate bone loss; and (iii) rapid bone loss. Number of teeth was categorised as 25-28, 20-24 and ≤ 19. Dietary patterns were identified by principal component analysis. Multiple logistic regression was applied to examine associations between tertiles of dietary pattern scores and periodontitis, and between these same tertiles and number of teeth. PARTICIPANTS: 1487 participants (55·5 % women) aged 40-79 years who were free of major chronic diseases, attended an oral health examination and completed a FFQ. RESULTS: Four dietary patterns were identified, which explained 24 % of the total variability in food intake: fruit and vegetables, Westernised, meat/fish and potatoes, and refined grain and dessert. The fruit and vegetables pattern was inversely associated with periodontitis characterised by rapid bone loss when compared with no periodontitis/slow bone loss (OR tertile 3 v. 1 0·49, 95 % CI: 0·25, 0·98). Participants who were in the highest tertile of the refined grain and dessert pattern (tertile 3 v. 1) had 2·38- and 3·52-fold increased odds of having ≤ 19 than 20-24 and 25-28 teeth, respectively. CONCLUSION: Out of four identified dietary patterns, only the fruit and vegetables pattern was negatively associated with advanced periodontitis. A more apparent positive association was observed between the refined grain and dessert pattern and having fewer teeth (≤ nineteen teeth).

Associação entre número de dentes, próteses dentárias e disfagia autorreferida em idosos brasileiros: estudo populacional / Association between number of teeth, dental prostheses, and self-reported dysphagia in brazilian old people: a population-based study

RESUMO Objetivo Verificar a associação entre o número de dentes e uso de prótese dentária removível e a ocorrência de disfagia autorreferida em idosos de 60 anos ou mais. Método Estudo transversal de base populacional com 5.432 idosos, que participaram da linha de base do Estudo Longitudinal da Saúde do Idoso (ELSI-Brasil). O desfecho "disfagia" foi associado ao número de dentes permanentes e ao uso de prótese dentária removível. As variáveis independentes sociodemográficas (idade, sexo e cor/raça) e de histórico clínico (nenhuma morbidade, uma morbidade ou mais de duas morbidades) utilizando Regressão de Poisson com variância robusta e seus respectivos intervalos de confiança (IC) de 95% foram analisados. Resultados A prevalência de disfagia autorreferida nos idosos não institucionalizados foi de 30%. O grupo de idosos com 10 - 19 dentes permanentes apresentou um risco de 52% de queixa de disfagia autorreferida (RPaj 1,565 IC95% 1,34;1,826) se comparado com seus pares com mais dentes. Conclusão foi encontrada associação entre o menor número de dentes e próteses removíveis com a ocorrência de disfagia.

ABSTRACT Purpose To investigate the association between the number of permanent teeth and the use of removable dental prostheses with self-reported dysphagia occurrence in individuals aged 60 years or older. Methods A population-based cross-sectional study was conducted with 5,432 old individuals who participated in the baseline of the Brazilian Longitudinal Study of Elderly Health (ELSI-Brazil). The outcome "dysphagia" was associated with the number of permanent teeth and the use of removable dental prostheses. Sociodemographic independent variables (age, sex, and race/ethnicity) and clinical history variables (no morbidity, one morbidity, or more than two morbidities) were analyzed using Poisson Regression with robust variance and their respective 95% confidence intervals (CI). Results The prevalence of self-reported dysphagia in non-institutionalized old individuals was 30%. The group of old individuals with 10 - 19 natural teeth showed a 52% increased risk of self-reported dysphagia complaint (PRadj 1,565 IC95% 1,34;1,826) compared to their counterparts with more teeth. Conclusion An association was found between a lower number of teeth and removable prostheses with the occurrence of dysphagia.

Association of the Number of Teeth With Physical Function and Length of Hospital Stay After Hip Fracture Surgery: A Prospective Observational Study at a Tertiary Hospital in Japan.

OBJECTIVES: Although lower-extremity muscle strength is associated with physical function, there are challenges in assessing the muscle strength of patients after hip surgery due to pain or limited cognitive function. The number of teeth is a characteristic that can be easily examined. Although the relationship between the number of teeth and physical function has been reported in recent years, there are no reports examining the relationship with prognosis in patients with hip fractures. Therefore, this study aimed to investigate the relationship between the number of teeth and physical function and length of hospital stay after hip fracture surgery and to evaluate the predictive efficacy of the number of teeth on postoperative prognosis. METHODS: This prospective cohort study was conducted in a tertiary clinical care facility. Patients aged ≥65 years who underwent hip surgery were included. A total of 101 patients (mean age: 85.1±8.0 years) were included. The factor analyzed was the number of teeth at admission. Patients were divided into two groups according to the number of teeth: those with ≥20 and those with ≤19 teeth. The outcomes were knee extension muscle strength-to-weight ratio at two weeks postoperatively and the length of hospital stay. A multiple regression analysis was performed to determine the association between the two groups. RESULTS: Of 101 patients, 79 (78.2%) had ≤19 teeth, whereas 22 (21.8%) had ≥20 teeth. The mean muscle strength-to-weight ratio and length of hospital stay were 0.26±0.11 kgf/kg and 57.5±31.4 days, respectively. Multiple regression analysis revealed that the number of teeth was significantly associated with the muscle strength-to-weight ratio (ß=-0.26, p=0.04) but not with the duration of hospitalization (ß=0.17, p=0.09). CONCLUSIONS: We suggest that assessment of the number of teeth at admission may be a useful predictor of patient physical function.

Association of a lesser number of teeth with more risk of developing depressive symptoms among middle-aged and older adults in Japan: A 20-year population-based cohort study.

OBJECTIVES: This 20-year prospective cohort study aimed to longitudinally explore the relationship between the number of teeth and the incidence of depressive symptoms among community-dwelling middle-aged and older adults. METHODS: Data were collected from the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) database from 2002 to 2022 (3rd-9th waves). Data of adults aged ≥40 years were analyzed and those who had depressive symptoms at baseline (3rd wave), had missing data, or did not participate in follow-up, were excluded. We collected data on the number of teeth at baseline. Depressive symptoms were defined as a score of ≥16 on the Center for Epidemiologic Studies Depression Scale. The generalized estimating equation (GEE) model was used to examine the longitudinal relationships between the number of teeth at baseline and the subsequent incidence of depressive symptoms. RESULTS: The final analysis included 1668 participants, with a mean (standard deviation) age of 58.8 (11.1) years and a mean follow-up time of 12.9 years. After GEE analysis with adjustment for multiple covariates, compared to participants with ≥20 teeth, participants with 10-19 teeth and < 10 teeth at baseline were associated with a higher risk of depressive symptoms. The subgroup analysis showed that the effect was stronger in men than in women. CONCLUSIONS: Among middle-aged and older community dwellers, particularly men, a small number of teeth after the age of 40 was associated with the future incidence of depressive symptoms.

Association between number of remaining teeth and incident depression in a rural Chilean cohort.

OBJECTIVES: Previous studies have established an association between tooth loss and depression. However, longitudinal evidence is scarce and needs to be verified in other populations. The aim of this study was to examine the longitudinal association between the number of remaining teeth and incident depression at 2- and 4-years follow-up in individuals enrolled in the Maule cohort (MAUCO) in Chile. METHODS: This prospective study used the information of individuals, aged 38 to 74 years, excluding those with depression at baseline. The number of remaining teeth at baseline was determined in four groups: "20 or more teeth", "10 to 19 teeth", "1 to 9 teeth" and "no natural teeth". Depression was measured through the PHQ-9. Logistic regression was performed to calculate the odds ratios (OR) for incidence depression at both periods of follow-ups, adjusting for age, sex, educational attainment, diabetes mellitus II, and stressful events at follow-up. Also, we performed adjusted multinomial logistic models to analysis the association between the number of remaining teeth and depression severity. RESULTS: In total individuals (n = 3335 at follow 1, n = 2461 at follow 2), all groups have ORs for incident depression above 1 considering 20 or more teeth as reference. In men, those with 10-19 teeth have 2.44 times higher odds of incident depression than those with 20 or more teeth (OR 2.44, CI 95% 1.33-4.50). Edentulous subjects at 4 years follow-up had 2.24 times higher odds of depression than those with more than 20 teeth (OR 2.24 CI 95%1.35-3.72). In women, the ORs (CI 95%) of incident depression were 2.56 (1.50-4.39), 1.56 (1.02-2.40) and 1.27 (0.90-1.81) for "none", "1-9", "10-19" respectively in comparison to the reference group. In edentulous individuals at baseline, the odds for each of the comparisons "mild vs no", "moderate vs no", "moderately severe vs no" and "severe vs no" were above 1, at both follow-ups. CONCLUSION: Individuals with less than 20 teeth in the mouth could had higher odds of incident depression at 2- and 4-years follow-up, with differences between men and women. Also, in our study, edentulism was associated with increased odds of incident depression at 4-years follow-up in women, and with higher levels of severity of depressive symptoms.

Number of Teeth According to Hand Strength in Adults: A Cross-Sectional Study of 11,499 South Korean Adults.

Background and Objectives: Grip strength is a measure of general health and is associated with oral health. This study aimed to investigate the relationship between the number of teeth and grip strength in Korean adults. Methods and Materials: We recruited adult participants who underwent oral examinations in the Korean National Health and Nutrition Examination Survey (KNHANES) between 2016-2018. When performing the KNHANES oral examination, an experienced dentist performed it according to the oral examination guidelines and recorded the results. A total of 24,269 participants from the 2016-2018 KNHANES were included in this study. Of these, only 16,489 participants underwent oral screening. A total of 3209 were non-adult children and adolescents, and 1781 did not respond to the grip strength test; those who did not respond to the main independent confounder were excluded. The relationships between grip strength, general characteristics, general health, oral health, and the number of remaining teeth were analyzed. There were 11,499 subjects in total in this study, with 4839 males and 6660 females. The age groups were 19-65 years of age, with 8387 subjects, and 65 years and older, with 3112 subjects, and the number of remaining teeth was 0-9 for 936 subjects, 10-19 for 1015 subjects, and 20-28 for 9548 subjects. Results: The probability that the higher the grip strength, the higher the residual number of gingiva was estimated by multinomial logistic regression analysis using complex sampling. The higher the grip strength, the higher the probability of having 20-28 teeth remaining (adjusted odds ratio, 1.59; 95% confidence interval, 1.19-2.13). Conclusions: Maintaining general health is related to maintaining teeth; the higher the grip strength, the higher the number of remaining teeth.

Influence of Meal Sequence and Number of Teeth Present on Nutrient Intake Status: A Cross-Sectional Study.

Intake of fiber, as well as protein, and lipid preloading help to control postprandial glycemic elevation in people with type 2 diabetes and in healthy individuals. However, there are few studies on the awareness of meal sequence and nutrient intake status that consider oral conditions. This cross-sectional study aimed to determine the effects of meal sequences on nutrient intake status and whether these relationships were related to the number of teeth present. The subjects were recruited from the Medical and Dental Collaboration Center of Kanagawa Dental University Hospital between 2018 and 2021. Medical and dental examinations were performed, and a questionnaire was used to determine whether the diet consisted of vegetables, meat or fish, and carbohydrates in that order. Nutrient intake status was assessed using the brief-type self-administered diet history questionnaire. Data were collected from 238 participants. The group with awareness of meal sequence ingested increased nutrients such as n-3 fatty acids, total dietary fiber, calcium, and vitamin C. Saturated fatty acid intake increased in those with fewer teeth, while it was not significantly related to meal sequence. In conclusion, our results showed that meal sequence was associated with nutrient intake status. In addition, the intake of saturated fatty acids increased when many teeth were lost, regardless of meal sequence.

[Multivariable analysis of tooth loss in subjects with severe periodontitis over 4-year natural progression].

OBJECTIVE: To evaluate the characteristics of severe periodontitis with various number of tooth loss during 4-year natural progression, and to analyze the factors related to higher rate of tooth loss. METHODS: A total of 217 patients aged 15 to 44 years with severe periodontitis were included, who participated in a 4-year natural progression research. Data obtained from questionnaire survey, clinical examination and radiographic measurement. Tooth loss during 4-year natural progression was evaluated. The baseline periodontal disease related and caries related factors were calculated, including number of teeth with bone loss > 50%, number of missing molars, number of teeth with widened periodontal ligament space (WPDL), number of teeth with periapical lesions and etc. Characteristics of populations with various number of tooth loss and the related factors that affected higher rate of tooth loss were analyzed. RESULTS: In 4 years of natural progression, 103 teeth were lost, and annual tooth loss per person was 0.12±0.38. Nine patients lost 3 or more teeth. Thirty-four patients lost 1 or 2 teeth, and 174 patients were absent of tooth loss. Molars were mostly frequent to lose, and canines presented a minimum loss. The number of teeth with WPDL, with periapical lesions, with intrabony defects, with probing depth (PD)≥7 mm, with PD≥5 mm, with clinical attachment loss≥5 mm, with bone loss > 50% and with bone loss > 65% were positively correlated to number of tooth loss. Results from orderly multivariate Logistic regression showd that the number of teeth with bone loss > 50% OR=1.550), baseline number of molars lost (OR=1.774), number of teeth with WPDL (1 to 2: OR=1.415; ≥3: OR=13.105), number of teeth with periapical lesions (1 to 2: OR=4.393; ≥3: OR=9.526) and number of teeth with caries/residual roots (OR=3.028) were significant risk factors related to higher likelihood of tooth loss and multiple tooth loss. CONCLUSION: In 4 years of natural progression, the number of teeth with bone loss > 50%, baseline number of missing molars, number of teeth with WPDL, baseline number of teeth with periapical lesions and number of teeth with caries/residual roots were significantly related to higher risk of tooth loss and multiple tooth loss among Chinese young and middle-aged patients with severe periodontitis in rural areas.

Frailty index and ten oral conditions in the Coyoacan cohort study: A cross-sectional analysis.

OBJECTIVES: To analyse the relationship between the Frailty Index and 10 oral conditions controlling for nutritional status among Mexican community-dwelling older people. BACKGROUND: Studies suggest that the association between frailty and oral conditions are mediated by nutrition. MATERIALS AND METHODS: This cross-sectional analysis includes 487 community-dwelling men and women aged ≥70 years old. Interview and clinical examinations were performed at participants' homes. Objective (number of natural teeth, root remnants, dental condition, utilisation and functionality of removable dental prostheses and periodontitis) and subjective (utilisation of dental services, self-rated oral health, chewing difficulties and xerostomia) oral variables were collected by trained personnel. The Frailty Index was calculated considering 35 deficits. Nutritional status measured with the Mini-Nutritional assessment (MNA), age, sex, education, and marital status were included as covariates. We fitted 11 multivariate generalised linear models (one for each oral condition), assuming gamma distribution for Frailty Index as the outcome. RESULTS: Participants average age was 78.1 years, 52.1% were women. We observed a higher Frailty Index among those rating their oral health as worse than others their age (5.1%), reporting chewing difficulties often (4.9%) and fairly and very often (7.0%), and xerostomia (4.8%). Age, gender and MNA were consistently associated with the Frailty Index. CONCLUSION: Subjective oral conditions are compatible with the Frailty Index after controlling for older people's nutritional status and covariates.

Multivariable analysis of tooth loss in subjects with severe periodontitis over 4-year natural progression / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the characteristics of severe periodontitis with various number of tooth loss during 4-year natural progression, and to analyze the factors related to higher rate of tooth loss.@*METHODS@#A total of 217 patients aged 15 to 44 years with severe periodontitis were included, who participated in a 4-year natural progression research. Data obtained from questionnaire survey, clinical examination and radiographic measurement. Tooth loss during 4-year natural progression was evaluated. The baseline periodontal disease related and caries related factors were calculated, including number of teeth with bone loss > 50%, number of missing molars, number of teeth with widened periodontal ligament space (WPDL), number of teeth with periapical lesions and etc. Characteristics of populations with various number of tooth loss and the related factors that affected higher rate of tooth loss were analyzed.@*RESULTS@#In 4 years of natural progression, 103 teeth were lost, and annual tooth loss per person was 0.12±0.38. Nine patients lost 3 or more teeth. Thirty-four patients lost 1 or 2 teeth, and 174 patients were absent of tooth loss. Molars were mostly frequent to lose, and canines presented a minimum loss. The number of teeth with WPDL, with periapical lesions, with intrabony defects, with probing depth (PD)≥7 mm, with PD≥5 mm, with clinical attachment loss≥5 mm, with bone loss > 50% and with bone loss > 65% were positively correlated to number of tooth loss. Results from orderly multivariate Logistic regression showd that the number of teeth with bone loss > 50% OR=1.550), baseline number of molars lost (OR=1.774), number of teeth with WPDL (1 to 2: OR=1.415; ≥3: OR=13.105), number of teeth with periapical lesions (1 to 2: OR=4.393; ≥3: OR=9.526) and number of teeth with caries/residual roots (OR=3.028) were significant risk factors related to higher likelihood of tooth loss and multiple tooth loss.@*CONCLUSION@#In 4 years of natural progression, the number of teeth with bone loss > 50%, baseline number of missing molars, number of teeth with WPDL, baseline number of teeth with periapical lesions and number of teeth with caries/residual roots were significantly related to higher risk of tooth loss and multiple tooth loss among Chinese young and middle-aged patients with severe periodontitis in rural areas.

Cross-sectional study of the factors associated with the number of teeth in middle-aged and older persons with intellectual disabilities.

BACKGROUND: We investigated the number of teeth in middle-aged and older individuals with intellectual disability and evaluated the related factors. METHODS: A questionnaire survey on oral health was administered to 604 persons over 40 years old with intellectual disabilities in Aichi Prefecture, Japan. The questionnaire designed for this study included items on diagnosis of disability, severity of intellectual disability and type of residence. As oral-health-related factors, the proxy-reported number of teeth, family dentist, regular dental check-ups, problems during dental treatment and tooth-brushing frequency were evaluated. A multinomial logistic regression analysis was performed using the proxy-reported number of teeth (≥20, 10-19 or 0-9) as the dependent variable, and the odds ratios (ORs) and 95% confidence intervals (CIs) of independent variables were calculated. In addition, linear regression analysis was performed using the proxy-reported number of teeth as the dependent variable. RESULTS: In the multivariate multinomial logistic regression analysis, age, diagnosis of disability and type of residence were significantly associated with having 10-19 versus ≥20 teeth. Participants with autism spectrum disorder had a significantly lower OR for 10-19 teeth compared with those with intellectual disability [OR (95% CI): 0.49 (0.22-1.08)]. Age, diagnosis of disability, regular dental check-ups and tooth-brushing frequency were significantly associated with having 0-9 versus ≥20teeth. Participants with Down syndrome had a significantly higher OR for 0-9 teeth compared with those with intellectual disability [OR (95% CI): 3.17 (1.09-9.23)]. The ORs for 0-9 teeth of participants who did not attend regular dental check-ups and who brushed their teeth 1 time/day compared with ≥3 times/day were significantly high, and the OR (95% CI) was 2.37 (1.06-5.30) and 4.76 (1.09-20.77), respectively. [Corrections made on 22 August 2022, after first online publication: in the previous sentence, "who attend" has been changed to "who did not attend".] In the multivariate linear regression analysis, age, diagnosis of disability and regular dental check-ups were significantly associated with the proxy-reported number of teeth. The proxy-reported number of teeth was -0.42 less with each 1-year increase in age. With autism spectrum disorder, the proxy-reported number of teeth was 0.74 more compared with intellectual disability. In Down syndrome, the proxy-reported number of teeth was -0.93 less compared with intellectual disability. The proxy-reported number of teeth was -2.12 less for those who did not have regular dental check-ups. CONCLUSIONS: The number of teeth in middle-aged and older individuals with intellectual disability was related to age and the type of disability. Regular dental visits may be effective at preventing tooth loss in middle-aged and older persons with intellectual disability.

Nutrition mediates the relationship between number of teeth and sarcopenia: a pathway analysis.

OBJECTIVES: The relationship between the number of teeth and sarcopenia remains poorly investigated. Although nutrition plays an important role in maintaining bone and muscle health, the complex relationship between number of teeth and nutrition in the pathogenesis of sarcopenia remains to be elucidated. METHODS: A large multi-ethnic sample of 4149 participants aged over 50 years old from West China Health and Aging Trend (WCHAT) study was analyzed. We examined the associations between number of teeth with nutritional status and sarcopenia, and the mediating role of nutrition in the association between number of teeth and sarcopenia. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019. We assessed nutrition using Mini Nutrition Assessment-Short Form (MNA-SF) scale. Direct relationships between number of teeth, nutrition and sarcopenia were assessed using multiple linear regression. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of nutrition in the relationship between number of teeth and sarcopenia. RESULTS: Of 4149 participants aged 50 years old or older, the prevalence of sarcopenia was 22.5, 9.0% for moderate sarcopenia, and 13.5% for severe sarcopenia, respectively. Regression analysis indicated a total association between number of teeth (ß = - 0.327, 95% CI - 0.471 to - 0.237, p < 0.001) and sarcopenia. After adjusted MNA-SF scores, the association between number of teeth and sarcopenia was still significant (ß = - 0.269, 95% CI - 0.364 to - 0.175, p < 0.001), indicating a partial mediation effect of nutrition. Mediation analysis verified nutrition partially mediate the associations between number of teeth and sarcopenia (indirect effect estimate = - 0.0272, bootstrap 95% CI - 0.0324 to - 0.0222; direct effect estimate = - 0.0899, bootstrap 95% CI - 0.1049 to - 0.0738). And this mediation effect was through impacting SMI (indirect effect estimate = - 0.0283, bootstrap 95% CI - 0.0336 to - 0.0232) and grip strength (indirect effect estimate = - 0.0067, bootstrap 95% CI - 0.0094 to - 0.0043). Structural equation model (SEM) framework pathway analysis confirmed the association between number of teeth, nutrition, and sarcopenia. CONCLUSIONS: Our findings indicated that sarcopenia was associated with number of teeth and poorer nutritional status, with nutrition partially mediating the association between number of teeth and sarcopenia. Our findings supported early nutritional assessment and intervention in oral health to mitigate the risk of sarcopenia.

The validity of self-reported number of teeth and edentulousness among Norwegian older adults, the HUNT Study.

BACKGROUND: Number of teeth is an established indicator of oral health and is commonly self-reported in epidemiological studies due to the costly and labor-intensive nature of clinical examinations. Although previous studies have found self-reported number of teeth to be a reasonably accurate measure, its accuracy among older adults ≥ 70 years is less explored. The aim of this study was to assess the validity of self-reported number of teeth and edentulousness in older adults and to investigate factors that may affect the accuracy of self-reports. METHODS: This study included two different samples of older adults ≥ 70 years drawn from the fourth wave of the Trøndelag Health Study (the HUNT Study), Norway. Sample 1 (n = 586) was used to evaluate the validity of self-reported number of teeth and sample 2 (n = 518) was used to evaluate self-reported edentulousness. Information on number of teeth and background variables (education, smoking, cognitive function, and self-perceived general and oral health) were self-reported in questionnaires, while clinical oral health examinations assessed number of teeth, number of teeth restored or replaced by fixed prosthodontics and edentulousness. Spearman and Pearson correlation coefficients, Bland-Altman plot, chi-square test and kappa statistics were used to assess the agreement between self-reported and clinically recorded number of teeth. RESULTS: The mean difference between self-reported and clinically recorded number of teeth was low (- 0.22 teeth), and more than 70% of the participants reported their number of teeth within an error of two teeth. Correlations between self-reports and clinical examinations were high for the total sample (0.86 (Spearman) and 0.91 (Pearson)). However, a lower correlation was found among participants with dementia (0.74 (Spearman) and 0.85 (Pearson)), participants having ≥ 20 teeth (0.76 (Spearman) and 0.67 (Pearson)), and participants with ≥ 5 teeth restored or replaced by fixed prosthodontics (0.75 (Spearman) and 0.77 (Pearson)). Self-reports of having teeth or being edentulous were correct in 96.3% of the cases (kappa value 0.93, p value < 0.001). CONCLUSIONS: Among older Norwegian adults, self-reported number of teeth agreed closely with clinical tooth counts and nearly all the edentulous participants correctly reported having no teeth.

Eruption Timing and Sequence of Primary Teeth in a Sample of Romanian Children.

Teething is considered a significant event in the growth and development of the child by parents and especially by paediatric dentists and forensic scientists. They constantly need an "up-to-date mirror" of its variability for different geographic regions. The aims of the current study were to determine the timing and sequence of primary tooth emergence, and to establish a correlation between tooth eruption and general growth and external parameters in a sample of Romanian children. This study included 70 healthy children (53% girls and 47% boys), and the analysed data resulted from the questionnaires completed by parents during the whole process. General and specific data on primary teeth eruption were obtained. The differences between sexes were insignificant, except for the maxillary and mandibular canines (p = 0.047 and p = 0.018) and lower temporary second molars (p < 0.001), which were significantly increased in boys. The differences found between the two hemiarches were insignificant (p = 0.197). The mean age of eruption of the first tooth erupted was 7.07 ± 1.990 months. The unpaired t-test was used for comparison of the timings of eruption of the first primary teeth, according to the number of previous births and type of diet, and it was insignificant (p = 0.665 and p = 0.983 respectively).