Abstract
BackgroundMany studies have reported risk factors for tooth loss. Oral health instruction is considered effective at improving oral health behavior and oral health. However, few studies have examined the relationship of dental clinic factors, such as the number of dental hygienists and implementation of oral health instructions, with tooth loss. Here, we conducted a multilevel analysis to clarify the dental clinic risk factors associated with tooth loss.MethodsBaseline surveys were conducted at 1216 dental clinics in 46 prefectures in Japan, and 12,399 dental patients aged 20 years and over underwent oral examinations and completed a questionnaire. The dental clinics also completed a questionnaire at baseline. A 3-year follow-up survey included 2488 patients in 585 dental clinics. Multilevel multivariate logistic regression analysis was used to examine the risk of tooth loss at the patient and clinic levels.ResultsOf the patient variables, older age, higher mean probing pocket depth, current or past smoking, and bleeding during tooth brushing were associated with higher risks of tooth loss. Individuals with many teeth who visited dental clinics for maintenance were at significantly lower risk of tooth loss. Of the clinic variables, patients attending dental clinics with four or more dental hygienists had a significantly lower risk of tooth loss (OR 0.68, 95% CI 0.50–0.99). Patients attending dental clinics that provide oral health instructions for 20 min or more had a significantly lower risk of tooth loss (OR 0.69, 95% CI 0.50–0.96).ConclusionsIn addition to individual risk factors for tooth loss, dental clinic factors such as length of oral health instruction and number of dental hygienists are associated with tooth loss. In dental clinics, ensuring sufficient time for dental hygienists to provide oral health instructions can help prevent tooth loss in dental patients.
Highlights
Many studies have reported risk factors for tooth loss
Two-thirds of the dental clinics had one to three dental hygienists, and dental clinics providing 1–9 or 10–19 min of oral health instructions each accounted for a third
Age, numbers of teeth and decayed teeth, mean probing pocket depth (PPD), Breeding on probing (BOP), gender, smoking, history of diabetes mellitus, tooth brushing frequency, bleeding during tooth brushing, eating between meals, reason for dental visit, education level, and working status were significantly associated with tooth loss
Summary
Many studies have reported risk factors for tooth loss. Few studies have examined the relationship of dental clinic factors, such as the number of dental hygienists and implementation of oral health instructions, with tooth loss. We conducted a multilevel analysis to clarify the dental clinic risk factors associated with tooth loss. Saito et al BMC Oral Health (2020) 20:328 ability and swallowing function by retaining many teeth may help to extend the healthy lifespan [3, 4]. A study of people older than 75 years showed that those with fewer teeth had higher medical costs associated with stroke [5]. Preventing tooth loss may help to curb medical expenses [6]
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