Abstract
Objectives The purpose of this study was to investigate if edentulism is associated with all-cause mortality. The aims were to analyze the association between age, socioeconomic factors, and mortality in edentulous patients treated with either removable dentures or implant-supported prostheses. Methods All patients who became edentulous according to the Swedish Social Insurance Agency (SSIA) between 2009 and 2013 (N = 8463) were analyzed regarding prosthetic treatment, age, gender, and socioeconomic status. The patients were divided into two groups, depending on whether they were treated with dental implants (implant group; IG) or with conventional removable dentures (denture group; DG). Data on mortality for all included individuals were obtained from the Swedish National Cause of Death Register and compared to a reference population. Cumulative survival rates were calculated, and a multivariable regression analysis for the included variables was performed. Results Between 2009 and 2018, 2192 of the patients (25.9%) were treated with implant-supported dental prostheses (IG) and 6271 patients (74.1%) were treated with removable dentures without support of dental implants (DG). Altogether 2526 patients (30%) died until December 31, 2019, and the overall mortality was significantly higher for the DG compared to the IG during follow-up (p < 0.001). Younger edentulous patients (≤59 years) presented a higher mortality than the reference population, while implant patients over 79 years of age demonstrated a lower mortality. The final results from the multivariable logistic analysis showed that lower equalized disposable income (EDI) and the choice of conventional removable dentures are the most important factors for increased patient mortality (p < 0.001). Conclusions Edentulous patients have an overall higher mortality compared to a reference population. Low socioeconomic status increases all-cause mortality. Individuals treated with dental implants show statistically significant lower 10-year mortality compared to patients treated with conventional removable dentures, regardless of socioeconomic status.
Highlights
Oral health is one of the topics that the World Health Organization (WHO) has on its agenda. e WHO declares that oral health is a key indicator of the overall health, wellbeing, and quality of life (QoL). e oral health is affected by a wide range of oral diseases such as dental caries, periodontal disease, oral cancer, orodental trauma, and general diseases as diabetes, immunomodulating diagnoses, and medications among others. e Global Burden of Disease Study 2017 estimated that oral diseases affect nearly 3.5 billion people worldwide, with untreated dental caries in permanent teeth being the most common condition [1]
All these patients who were restored with conventional removable dentures or implant-supported fixed or removable prostheses until December 2018 were included and analyzed. e patients were divided into two groups with regard to whether they were treated with implants or not: without dental implants and with dental implants in one or both jaws
Key Results. e findings of the present study showed that completely edentulous individuals in Sweden had a 18% increased 10-year mortality risk compared to a reference population. is is in agreement with previous publications [30,31,32,33] where edentulous patients presented higher mortality patterns as compared to the reference populations
Summary
Oral health is one of the topics that the World Health Organization (WHO) has on its agenda. e WHO declares that oral health is a key indicator of the overall health, wellbeing, and quality of life (QoL). e oral health is affected by a wide range of oral diseases such as dental caries, periodontal disease, oral cancer, orodental trauma, and general diseases as diabetes, immunomodulating diagnoses, and medications among others. e Global Burden of Disease Study 2017 estimated that oral diseases affect nearly 3.5 billion people worldwide, with untreated dental caries in permanent teeth being the most common condition [1]. E Global Burden of Disease Study 2017 estimated that oral diseases affect nearly 3.5 billion people worldwide, with untreated dental caries in permanent teeth being the most common condition [1]. Orodental trauma is the 5th most prevalent disease/injury in the world [2] and the treatment is often difficult and costly and can sometimes even lead to tooth loss, resulting in complications for facial and psychological development and decreased QoL [3]. Severe periodontitis, trauma, and cancer are the most common reasons for severe tooth loss and edentulism [4,5,6]. E adequate dental treatment of edentulism can be divided into rehabilitation with conventional removable complete dentures and rehabilitation with implant-supported prostheses. The treatment is time-consuming and costly compared to the rehabilitation with conventional removable dentures
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