Denture use mitigates the cognitive impact of tooth loss in older adults.

Abstract

Denture use may contribute to maintaining cognitive function by addressing the masticatory difficulties caused by tooth loss. However, reports on the association between tooth loss and cognitive impairment have been inconsistent. The impact of changes in tooth number and denture use on the development of cognitive impairment in older adults remains unclear. This study aimed to evaluate these impacts among community-dwelling older adults. This 7-year longitudinal prospective cohort study included 64,520 community-dwelling Taiwanese older adults aged ≥65 years without cognitive impairment at baseline. The primary outcome was cognitive impairment assessed using the Short Portable Mental Status Questionnaire. Older adults with 10-19, 1-9, and 0 teeth, including natural teeth and dentures, had higher risks of developing cognitive impairment than those with ≥20 teeth, with adjusted odds ratios (ORs) of 1.40 (95% confidence intervals [CIs], 1.14-1.71), 1.85 (95% CI, 1.40-2.43), and 2.56 (95% CI, 1.74-3.76), respectively. Furthermore, among those with 10-19 teeth (OR, 0.71; 95% CI, 0.52-0.98) or 1-9 teeth (OR, 0.43, 95% CI, 0.27-0.68) at baseline, an increase of more than one level in tooth number during follow-up (e.g., from 10-19 to ≥ 20 teeth and dentures through the acquisition of dental prosthetics such as dentures, bridges, or implants) was associated with a lower risk of developing cognitive impairment compared to those with a stable tooth number. Our findings suggest that prompt denture use and maintaining >20 teeth (including natural teeth and dentures) mitigate the risk of cognitive impairment associated with tooth loss among community-dwelling older adults.