Abstract
BackgroundCross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design.MethodsThis prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures.ResultsAt baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs – but higher dental care use – than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures.ConclusionsIt was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants).
Highlights
The prevalence of edentulism has declined: more and more elderly retain their natural dentition until advanced age
19% of elderly ≥85 years were edentulous with a conventional dentures (CD), 11% had natural dentition and 6% had implant-retained overdentures (IOD)
This study showed that edentulous elderly had higher prevalence of general health problems, increased medication use and higher healthcare costs when compared to elderly with a natural dentition
Summary
The prevalence of edentulism has declined: more and more elderly retain their natural dentition until advanced age. In Europe, the prevalence of edentulism among adults ≥65 years old ranges from 69% in Albania to 15% in Austria [4, 5]. This decline of edentulism is primarily the result of improved dental care and the changing attitudes towards oral health and dental care over the last four decades [2]. Cross-sectional studies have shown that elderly with a natural dentition have better general health [6, 7]. Cross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design
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