Research Article

Dental Health Behaviors, Dentition, and Mortality in the Elderly: The Leisure World Cohort Study

Table 5

Studies which evaluated the relationship between dentition status and all-cause mortality in the elderly.

First author
year [ref]
PopulationSample sizeFollowup (years)Age (years)Stratification and adjustmentaDental exam
% edentulous mean/median no. of teeth
Hazard ratio
(95% confidence interval)

Appollonio
1997 [1]
Brescia, Italy 1137 6.5 70–75 Sex, nutrition, smoking, functional status, and health service utilization, education, SES Yes Females only
0.67 (0.39–1.15) for adequate dentition
0.83 (0.54–1.27) for inadequate with dentures versus inadequate without dentures

Shimazaki
2001 [2]
Kitakyushu City, Japan1762659–107 Age, sex, physical mental-health status, cardiovascular disease, musculoskeletal disease, and institution, other chronic diseases Yes
52%
1.8 (1.1–2.8) for 0 teeth without dentures
1.3 (0.8–2.4) for 0 teeth with dentures
1.5 (0.9–2.4) for 1–19 without dentures
1.3 (0.8–2.0) for 1–19 teeth with dentures versus 20+ teeth

Hämäläinen
2003 [3]
Jyväskylä, Finland2261080Sex, number of chronic diseases, self-rated health Yes
59%
Mean = 11.8 in dentate
2.67 (1.15–6.22) for 1–19 teeth
2.56 (1.12–5.85) for 0 teeth
versus 20+ teeth (univariate analysis)
1.03 (1.00–1.05) per missing tooth (adjusted)

Cabrera
2005 [4]
Göteborg, Sweden14172438, 46, 50, 54, 60Age, SESYes 1.27 (1.09–1.47) for >10 missing teeth
Women onlyMedian = 20

Nakanishi
2005 [5]
Settsu Japan1405965+ Sex, age, overall disability, use of dental health checks, use of general health checks, daily health promotion practices, participation in social activities, life worth living, finding relationships with people difficultNo 1.63 (1.30–2.03) for self-assessed masticatory disability versus no disability

Abnet
2005 [6]
Linxian, China 29584 1544–59 Sex, age, and smokingYes in those reporting missing teeth
median = 26
1.07 (1.01–1.14) in females
1.09 (0.98–1.21) in male never-smokers
1.24 (1.16–1.32) in male ever-smokers for loss of > age-specific median of number of teeth

Hämäläinen
2005 [7]
Jyväskylä, Finland94585Number of chronic diseases, urgent need of dental treatment, and sex, self-rated health, education, FEV, ESR, CPITN Yes
39% M, 60% F
0.93 (0.87–0.99) for number of teeth

Yoshida
2005 [8]
Kure City, Japan 1030 8 Mean = 74 Sex, age Yes 0.78 (0.60–0,99) for adequate occlusion
1.08 (0.85–1.36) for insufficient occlusion versus no occlusion
1.52 (1.24–1.83) for denture non-users versus denture uses among those with no occlusion with their own teeth

Morita
2006 [9]
Tokoname, Japan1186.5Mean = 82Matched on sex, age, health status, living environment; adjusted for smoking, alcohol21% M, 30% F 2.71 (1.05–7.05) for < 20 versus ≥ 20 teeth in males; not significant in females

Österberg
2007 [10]
Glostrup, Denmark
Jyväskylä, Finland
Göteborg, Sweden
1044 7 75 Sex, location, smoking, BMI, self-assessed health, physical activity, circulation disease, ADL No
45%, 58%, 23%
in the 3 locations
0.80 (0.72–0.89) among females
0.92 (0.84–1.01) among males for number of teeth and adjusted only for location
0.87 (0.78–0.97) for women fully adjusted; not significant in men

Österberg
2008 [11]
Göteborg, Sweden 1803 7 70 Sex, ischemic heart disease, number of drugs, plasma glucose, blood hemoglobin, serum triglycerides, BMI, feeling not healthy and others Yes
16% to 38%
in 4 birth cohorts
MalesFemales
7-year mortality
0.65 (0.46–0.91) 0.71 (0.42–1.20) for 1–9
0.51 (0.36–0.74)0.65 (0.41–1.02) for 10–19
0.38 (0.24–0.60)0.36 (0.19–0.66) for 20–32
versus 0 teeth
18Sex, ischemic heart disease, number of drugs, hypertension, plasma glucose, blood hemoglobin, smoking, social activity, and others18-year mortality
1.02 (0.82–1.27) 0.81 (0.61–1.07) for 1–9
0.74 (0.58–0.94)0.94 (0.74–1.20) for 10–19
0.64 (0.48–0.84)0.70 (0.51–0.96) for 20–32
versus 0 teeth

Paganini-Hill (current study)Leisure World, California, USA56111752–105Sex, age, smoking, alcohol, caffeine, exercise, BMI, 7 chronic diseasesNoSee previous tables.
11%
median = 24

aSome included only significant variables in the multivariate models. Those not included are preceded by and.
SES: socioeconomic status, FEV: forced respiratory volume, ESR: erythrocyte sedimentation rate, CPITN: community periodontal index of treatment needs, BMI: body mass index, ADL: activities of daily living.