Rate Of Tooth Loss Research Articles

Tooth loss in Sri Lankan adults

To determine the prevalence and correlates of tooth loss in Sri Lankan adults. A descriptive cross sectional study. Colombo district of Sri Lanka. Adults aged 20 years and above. Data were collected by means of an interviewer administered questionnaire and an oral examination. The overall prevalence of tooth loss was 81.6% while 1.9% of the sample was edentulous. The prevalence rates of tooth loss in the 20-39, 40-59 and ≥ 60-year-old were 71%, 93% and 96%, respectively, while 0%, 1.5% and 11.4% were edentulous in the three groups. Age (OR = 1.10; 95% CI = 1.08-1.11), having received 11 or more years of education (OR = 0.38; 95% CI = 0.15-0.97), use of fluoride toothpaste (OR = 0.44; 95% CI = 0.30-0.66), brushing frequency (OR = 0.62; 95% CI = 0.43-0.89) and use of dental services (OR = 2.08; 95% CI = 1.12-3.84) were significantly associated with having more than 12 missing teeth. The overall prevalence of tooth loss is high among Sri Lankan adults.

Tooth Loss and Periodontal Disease Predict Poor Cognitive Function in Older Men

To determine whether rates of tooth loss, periodontal disease progression, and caries incidence predict cognitive decline in men. Prospective study. Community-dwelling men enrolled in the Veterans Affairs Dental Longitudinal Study. Five hundred ninety-seven dentate men aged 28 to 70 at study baseline who have been followed up to 32 years. Oral examinations were conducted approximately every 3 years. Periodontal disease measures included probing pocket depth and radiographic alveolar bone height. Participants underwent cognitive testing beginning in 1993. Low cognitive status was defined as less than 25 points or less than 90% of the age- and education-specific median on the Mini-Mental State Examination (MMSE) and less than 10 points on a spatial copying task. Each tooth lost per decade since the baseline dental examination increased the risks of low MMSE score (hazard ratio (HR)=1.09, 95% confidence interval (CI)=1.01-1.18) and low spatial copying score (HR=1.12, CI=1.05-1.18). Risks were greater per additional tooth with progression of alveolar bone loss (spatial copying: HR=1.03, CI=1.01-1.06), probing pocket depth (MMSE: HR=1.04, CI=1.01-1.09; spatial copying: HR=1.04, CI=1.01-1.06), and caries (spatial copying: HR=1.05, CI=1.01-1.08). Risks were consistently higher in men who were older than 45.5 at baseline than in younger men. Risk of cognitive decline in older men increases as more teeth are lost. Periodontal disease and caries, major reasons for tooth loss, are also related to cognitive decline.

Long‐term outcomes for cross‐arch stabilizing bridges in periodontal maintenance patients – a retrospective study

Cross-arch bridges are used to stabilize teeth for patients with reduced periodontal support. Little is known about technical or biological complications, whether teeth and implants can be combined in this type of bridge and the long-term effects on tooth loss. All patients treated in a specialist periodontal practice who received cross-arch stabilizing bridgework and were subsequently maintained for at least 7 years were included in the study. The patients were selected from all patients who underwent initial periodontal therapy after 1986 in a Norwegian periodontal practice. The bridges were assessed for biological and technical complications. Bridges retained by teeth or by a combination of teeth and implants were included in the study. Ninety-four rigid fixed bridges (77 teeth supported, 17 teeth and implant supported) in 80 patients (46 females, 34 males) were observed for an average of 10 years (range 7-22 years). In four patients, a bridge became loose and had to be re-cemented, and in one case the metal framework of a bridge fractured and the bridge had to be remade. In total, eight abutment teeth were lost from five patients but no implant abutments were lost. Overall, a higher rate of tooth loss was observed for patients provided with stabilizing bridges compared with control maintenance patients not treated with bridgework (p<0.0001); however, the rates in both groups were very low. Cross-arch stabilizing bridges constructed for periodontal patients as part of their periodontal maintenance therapy had few complications and were associated with low rates of abutment tooth loss. Combining teeth and implants did not affect the performance of these bridges.

Tooth Loss in 776 Treated Periodontal Patients

The most common form of periodontitis is a variably progressive dynamic pathologic process that causes attachment loss, destroys the alveolar bone supporting a tooth, and terminates with tooth loss. We evaluated the loss of teeth of treated periodontal patients categorized by severity and risk. Each of nine periodontists evaluated 100 consecutive periodontal maintenance patients. The disease severity and risk level were determined from data at the initial examination. The number of teeth lost was determined from data at the initial and maintenance visits. A stepwise regression analysis showed that disease (P = 0.0000478) and risk (P = 0.00129) scores predicted the mean tooth loss rate. The adjusted R(2) statistic was 88.56%. The ordinal logistic regression model showed that only the disease score (P <0.0005) was significantly associated with the probability of patients losing a specific number of teeth. Categorizing a patient by severity may be beneficial in the management of the periodontal patient. The disease score can be used to establish a criterion and target for care. For example, treatment can result in nearly no lost teeth when the severity is low, and this benefit is lost when the severity is high. The disease score provides an objective means to quickly determine severity. An increase in the disease score provides evidence that a new treatment plan is needed. Therefore, the effect of the routine use of the disease score could result in fewer patients with severe disease and reduce the number of teeth lost.

Prevalência de capacidade mastigatória insatisfatória e fatores associados em idosos brasileiros

We estimated the prevalence of poor self-rated mastication and associated factors among Brazilian elders. The study used data from a national survey of 5,124 Brazilian elderly in 250 cities. Data collection included dental examinations and household interviews with the elderly. The outcome was self-rated mastication. Data analyses used Poisson regression, and the prevalence of poor self-rated mastication was 49.7% (95%CI: 47.5-51.8). Adjusted analyses showed that increased prevalence was associated with: black color/race (PR = 1.13; 95%CI: 1.02-1.26); low income (PR = 1.22; 95%CI: 1.12-1.33.); high rates of tooth loss (PR = 1.66; 95%CI: 1.02-2.66); untreated caries (PR = 1.16; 95%CI: 1.08-1.25); never having visited a dentist (PR = 1.26; 95%CI: 1.10-1.44); toothache (PR = 1.47; 95%CI: 1.39-1.57); use of partial (PR = 0.87; 95%CI: 0.76-0.99) or total prostheses (PR = 0.81; 95%CI: 0.75-0.88); and need for partial (PR = 1.13; 95%CI: 1.03-1.25) or total prostheses (PR = 1.27; 95%CI: 1.16-1.39). The high prevalence emphasizes the dental care needs of this older group. Policies to deal with the problem should take the associated factors into account.

Nicotine and periodontal tissues.

Tobacco use has been recognized to be a significant risk factor for the development and progression of periodontal disease. Its use is associated with increased pocket depths, loss of periodontal attachment, alveolar bone and a higher rate of tooth loss. Nicotine, a major component and most pharmacologically active agent in tobacco is likely to be a significant contributing factor for the exacerbation of periodontal diseases. Available literature suggests that nicotine affects gingival blood flow, cytokine production, neutrophil and other immune cell function; connective tissue turnover, which can be the possible mechanisms responsible for overall effects of tobacco on periodontal tissues. Inclusion of tobacco cessation as a part of periodontal therapy encourages dental professionals to become more active in tobacco cessation counseling. This will have far reaching positive effects on our patients’ oral and general health.

Parameters Affecting Tooth Loss during Periodontal Maintenance in a Greek Population

Investigators have evaluated predictive parameters of tooth loss during the maintenance phase (MP). The authors conducted a retrospective study to evaluate the rate of tooth loss and to explore the parameters that affect tooth loss during MP in a Greek population. A periodontist administered periodontal treatment and maintenance care to 280 participants with severe periodontitis for a mean period +/- standard deviation of 10.84 +/- 2.13 years. The periodontist recorded the following parameters for each participant: oral hygiene index level, simplified gingival index level, clinical attachment level, probing depth measurements, initial tooth prognosis, smoking status, tooth loss during active periodontal treatment and MP, and compliance with suggested maintenance visits. The authors found that total tooth loss during active treatment (n = 1,427) was greater than during MP (n = 918) and was associated with the initial tooth prognosis, tooth type group, participants' compliance with suggested maintenance visits, smoking status and acceptability of the quality of tooth restorations. Most of the teeth extracted during maintenance had an initial guarded prognosis (n = 612). Participants whose compliance was erratic had a greater risk of undergoing tooth extraction than did participants whose compliance was complete. Participants' initial tooth prognosis, tooth type, compliance with suggested maintenance visits and smoking status affected tooth loss during MP. Initial guarded prognosis and erratic compliance increased the risk of undergoing tooth extraction during maintenance. Determining predictive parameters for disease progression and tooth loss provides critical information to clinicians so that they can develop and implement rational treatment planning.

Population ageing and dental care

Population ageing is a fact in both developed and developing countries. The concern about population ageing largely arises from the combination of a greater number of older people requiring greater amounts of healthcare services and pensions, and relatively fewer people working to pay for them. Oral health and dental care are important aspects of health and health care. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Traditionally, economic studies of ageing have focused on the fiscal implications of ageing, projecting the increased burden on health and welfare services that accompanies ageing. It assumed that ageing is the major driver of recent changes and those past trends will simply be amplified by faster population ageing in the future. Less work has been done to understand other past drivers of increased healthcare spending and their implications for the future. The conclusion of these reports is usually that population ageing is unaffordable with current policy settings. They have proposed policies to deal with population ageing which focused on increasing workforce participation and worker productivity to increase the tax base and reducing entitlements. However, the affordability question is as much political as a numerical. There are no clearly articulated criteria for affordability and little opportunity for public discourse about what citizens are willing to pay in taxes to support an ageing population. While the reports do not necessarily reflect public opinion, they will certainly shape it. Predicting the future for oral health is more fraught than for general health, as oral health is in the midst of an epidemiological transition from high rates of edentulism and tooth loss to low rates. Changes in the pattern of dental expenditure in the past do not mirror the experience of rapid increases in per capita expenditure on older age groups as regards general health. Dentistry's marginal status means that less work has been done to understand the future consequences of these changes and how they will interact with population ageing. Further than this though, we need to understand why the future might look as these projections suggest, so that we may look at ways that it can be shaped.

Periodontitis Severity Plus Risk as a Tooth Loss Predictor

Tooth loss can be a consequence of the natural history of periodontitis. Stratification of periodontitis severity, risk, and tooth loss exists within the United States adult population, and tooth loss correlates to severity and risk. We evaluated the loss of teeth for a periodontitis-affected population categorized by the combination of severity and risk in which the subjects predominantly did not receive periodontal treatment. The clinical records of 523 subjects enrolled in the Veterans Affairs Dental Longitudinal Study, covering a period of 15 years, were used. Disease severity, risk level, and the number of teeth lost for each subject were determined. A stepwise regression analysis showed that disease and risk scores predicted mean tooth loss rate. The P value for the disease score was <0.0005, and the P value for the risk score was 0.001. The ordinal logistic regression model showed that disease (P = 0.002) and risk scores (P = 0.000) were significantly associated with the probability of subjects losing a specific number of teeth. Tooth loss is more precisely and accurately predicted by the combination of risk score and periodontal disease score than by either score alone. The combined scores may be a surrogate variable for periodontal status. Because the scores are derived from routine clinical measurements, they may be useful for population surveillance and dynamics, practice management, patient care decisions, practice-based research, and the determination of treatment effectiveness and the factors required for successful treatment, resulting in improved oral health and higher clinician productivity and income.

Tooth loss and implant outcomes in patients refractory to treatment in a periodontal practice

The aim of this study was to investigate the factors associated with continued significant tooth loss due to periodontal reasons during maintenance following periodontal therapy in a specialist periodontal practice in Norway. A case-control design was used. Refractory cases were patients who lost multiple teeth during a maintenance period of 13.4 (range 8-19) years following definitive periodontal treatment in a specialist practice. Controls were age- and gender-matched maintenance patients from the same practice. Characteristics and treatment outcomes were assessed, and all teeth classified as being lost due to periodontal disease during follow-up were identified. The use of implants in refractory cases and any complications relating to such a treatment were recorded. Only 27 (2.2%) patients who received periodontal treatment between 1986 and 1998 in a specialist practice met the criteria for inclusion in the refractory to treatment group. Each refractory subject lost 10.4 (range 4-16) teeth, which represented 50% of the teeth present at baseline. The rate of tooth loss in the refractory group was 0.78 teeth per year, which was 35 times greater than that in the control group. Multivariate analysis indicated that being in the refractory group was predicted by heavy smoking (p=0.026), being stressed (p=0.016) or having a family history of periodontitis (p=0.002). Implants were placed in 14 of the refractory patients and nine (64%) of these lost at least one implant. In total, 17 (25%) of the implants placed in the refractory group were lost during the study period. A small number of periodontal maintenance patients are refractive to treatment and go on to experience significant tooth loss. These subjects also have a high level of implant complications and failure. Heavy smoking, stress and a family history of periodontal disease were identified as factors associated with a refractory outcome.

Factors Influencing Interstate Variation in Tooth Loss

The term for the loss of all natural permanent teeth is edentulism. In 2004, the Centers for Disease Control and Prevention (CDC) released data on the edentulism rate by state (2004 Behavioral Risk Factor Surveillance System Survey). Measured as a percentage of state residents over 65, the edentulism rate for the average state was 22.1%. West Virginia had the highest rate of complete tooth loss at 42.8% and Connecticut had the lowest rate at 13.5%. The high edentulism rate in West Virginia is surprising given that the state has fluoridation rates well above the national average. According to the CDC, 91.5% of West Virginians live in areas with fluoridated water compared to 70% in the average state. This suggests that other factors besides access to fluoridated water must be contributing to the high rate of edentulism in West Virginia. The medical literature points to several possible reasons for tooth loss in addition to water fluoridation. Income, poverty status, limited access to dental care due to geography, poor attitudes towards dental care and smoking have all been linked to tooth loss. A review of the literature found no studies examining the determinants of interstate variation in edentulism. To better investigate the role of each of these factors in determining why some states have high rates of tooth loss and others do not, I regressed the edentulism rate by state against the following variables: the percentage of adults with a bachelor’s degree or higher, the elderly poverty rate, state per capita personal income, urban population percentage, percentage of residents that are everyday smokers, and the percentage of the population with fluoridated water (Data, sources, and results at: http://joshua.c.hall.googlepages.com/papers/). Int Adv Econ Res (2008) 14:262–263 DOI 10.1007/s11294-008-9139-x

Sex and Gender Related Health Status Differences in Ancient and Contemporary Skeletal Populations

Human skeletal and dental remains are an invaluable source of information for interpreting the way of life of past people and also provide the only direct evidence of non-living populations’ health status. This research paper discusses the sex-related health differences observed in two skeletal populations from Greece, an ancient and a modern, by employing multiple health indicators, and aims at determining the biological and possible social factors that contribute to this variation. Particular emphasis is given to the importance of hypotheses-driven, population-based studies of human remains as the most effective means of reconstructing life in the past. The results showed that fracture (<em>ancient</em>: females 0.08%, males 0.12%; <em>modern</em>: females 0.38%, males 0.19%) and osteoarthritis (<em>ancient</em>: females 0.7%, males: 3.0%; <em>modern</em>: females 4.4%, males 3.2%) frequencies were higher for male individuals than females in the ancient population, which can be explained by greater engagement in strenuous and risky activity. Dental caries (<em>ancient</em>: females 1.2%, males 1.8%; <em>modern</em>: females 23.6%, males 17.4%) and ante-mortem tooth loss (<em>ancient</em>: females 12.3%, males 7.7%; <em>modern</em>: females 69.5%, males 49.5%) rates were higher for females than males (with the exception of the almost equal caries rates for the ancient population), most likely due to hormonal fluctuations, saliva content and flow, because female teeth erupt earlier and also perhaps as a result of differences in dietary habits. Periodontitis levels were more elevated in males (<em>ancient</em>: females 9.6%, males 30.1%; <em>modern</em>: females 29.1%, males 38.3%), possibly due to poor oral hygiene practices and excessive masticatory loading. Dental enamel defects rates showed that in the ancient population, males had more chances of surviving childhood stress than females (females 19.5%, males 20.0%), whereas, in the modern population, the exact opposite was the case (females 6.1%, males 22.7%).

Prehistoric dental disease and the dietary shift from cactus to cultigens in northwest Mexico

AbstractDifferences in dental health of prehistoric human groups are commonly attributed to specific subsistence practices, whereby food foragers generally have a lower incidence of dental disease than agriculturalists. Dental health was assessed on a sample of 135 human skeletons from northwest Mexico that date to the Early Agricultural period (1600 BC–AD 200), which coincides with the initial introduction of domesticated cultigens into the region c. 2000 BC. High rates of dental caries (13.5%) and antemortem tooth loss (17.6%) encountered in these prehistoric forager‐farmers from the Sonoran Desert were determined to be the result of the consumption of highly cariogenic local wild resources such as cactus. These patterns mask the degree of reliance on agriculture in the area and highlight the importance of constructing local nutritional histories to better understand the diversity of human diets and their relationships to health and disease. Copyright © 2007 John Wiley &amp; Sons, Ltd.

Tooth loss in well‐maintained patients with chronic periodontitis during long‐term supportive therapy in Brazil

The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (> 60 years) and smoking were statistically significant (p < 0.05). The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss.

Dental trauma and antemortem tooth loss in prehistoric Canary Islanders: prevalence and contributing factors

AbstractDifferential diagnosis of the aetiology of antemortem tooth loss (AMTL) may yield important insights regarding patterns of behaviour in prehistoric peoples. Variation in the consistency of food due to its toughness and to food preparation methods is a primary factor in AMTL, with dental wear or caries a significant precipitating factor. Nutritional deficiency diseases, dental ablation for aesthetic or ritual reasons, and traumatic injury may also contribute to the frequency of AMTL. Systematic observations of dental pathology were conducted on crania and mandibles at the Museo Arqueologico de Tenerife. Observations of AMTL revealed elevated frequencies and remarkable aspects of tooth crown evulsion. This report documents a 9.0% overall rate of AMTL among the ancient inhabitants of the island of Tenerife in the Canary Archipelago. Sex‐specific tooth count rates of AMTL are 9.8% for males and 8.1% for females, and maxillary AMTL rates (10.2%) are higher than mandibular tooth loss rates (7.8%) Dental trauma makes a small but noticeable contribution to tooth loss among the Guanches, especially among males. In several cases of tooth crown evulsion, the dental root was retained in the alveolus, without periapical infection, and alveolar bone was in the initial stages of sequestering the dental root. In Tenerife, antemortem loss of maxillary anterior teeth is consistent with two potential causal factors: (a) accidental falls while traversing volcanic terrain; and (b) interpersonal combat, including traditional wrestling, stick‐fighting and ritual combat. Steep‐walled valleys (barrancos) and lava fields (malpaís) required agile locomotion and occasional vaulting with the aid of a wooden staff. Accidental falls involving facial injury may have contributed to AMTL. Traditional conflict resolution involved competitive wrestling (lucha canaria), stick‐fighting (juego del palo), and ritualised contests involving manual combat. These activities made a small but recognisable impact on anterior dental trauma and tooth loss. Inter‐personal behaviours of such intensity leave their mark on skeletal and dental remains, thereby providing insight into the lives and cultural traditions of the ancient Guanches. Copyright © 2006 John Wiley &amp; Sons, Ltd.

Statin Use and Tooth Loss in Chronic Periodontitis Patients

Statins have anti-inflammatory and bone stimulating properties that may positively affect chronic periodontitis. Our objective in this study was to evaluate whether statin use by chronic periodontitis patients had a beneficial impact on tooth loss. In a retrospective cohort study (N patients = 1,021; mean follow-up = 7.1 years), dental records were merged with pharmacy data. Any statin use during 3 years, statin use during each of 3 consecutive years (regular use), and any statin use during the first 3 years after the initial periodontal exam were evaluated as predictors of tooth loss using negative binomial regression models with adjustment for potential confounding factors. Any statin use during 3 years was not associated with tooth loss rate in the year subsequent to the 3-year period (rate ratio [RR] = 1.00; 95% confidence interval [CI] = 0.56 to 1.81). Regular statin use during 3 years was associated with a non-significant 37% reduced tooth loss rate in the year subsequent to the 3-year period (RR = 0.63; 95% CI = 0.32 to 1.25). Any statin use during the first 3 years after the initial periodontal exam was associated with a 48% decreased tooth loss rate in year 4 and subsequent years (RR = 0.52; 95% CI = 0.29 to 0.95). Our findings were mixed for an association of statin use with reduced tooth loss in chronic periodontitis patients. Lack of control for some potential confounders, particularly smoking, and evaluation of different patterns of statin usage hamper the interpretation of the results. Exploration of these findings in additional epidemiological studies may be worthwhile.

Tooth wear and dental pathology at the advent of agriculture: New evidence from the Levant

Differences in patterns of diet and subsistence through the analysis of dental pathology and tooth wear were studied in skeletal populations of Natufian hunter-gatherers (10,500-8300 BC) and Neolithic populations (8300-5500 BC, noncalibrated) from the southern Levant. 1,160 Natufians and 804 Neolithic teeth were examined for rate of attrition, caries, antemortem tooth loss, calculus, periapical lesions, and periodontal processes. While the Natufian people manifest a higher rate of dental attrition and periodontal disease (36.4% vs. 19%), Neolithic people show a higher rate of calculus. Both populations manifested low and similar rates of caries (6.4% in the Natufian vs. 6.7% in the Neolithic), periapical lesions (not over 1.5%), and antemortem tooth loss (3.7% vs. 4.5%, respectively). Molar wear pattern in the Neolithic is different than in the Natufian. The current study shows that the dental picture obtained from the two populations is multifactorial in nature, and not exclusively of dietary origin, i.e., the higher rate and unique pattern of attrition seen in the Natufian could result from a greater consumption of fibrous plants, the use of pestles and mortars (which introduce large quantities of stone-dust to the food), and/or the use of teeth as a "third hand." The two major conclusions of this study are: 1) The transition from hunting and gathering to a food-producing economy in the Levant did not promote changes in dental health, as previously believed. This generally indicates that the Natufians and Neolithic people of the Levant may have differed in their ecosystem management (i.e., gathering vs. growing grains), but not in the type of food consumed. 2) Changes in food-preparation techniques and nondietary usage of the teeth explain much of the variation in tooth condition in populations before and after the agricultural revolution.

The Effect of Cigarette Smoking on Dental Implants and Related Surgery

Cigarette smoking is still considered a common habit. Of smokers, increased plaque accumulation, higher incidence of gingivitis and periodontitis, higher rate of tooth loss, and increased resorption of the alveolar ridge have been found in the oral cavity. Cigarette smoking may adversely affect wound healing, and, thus, jeopardize the success of bone grafting and dental implantation. Bone grafts and sinus lift operations are both common and well-documented procedures before dental implant placement. Heat as well as toxic by-products of cigarette smoking, such as nicotine, carbon monoxide, and hydrogen cyanide, have been implicated as risk factors for impaired healing, and, thus, may affect the success and complications of those surgical procedures. An association among dental implants, grafting procedures (i.e., bone grafts, maxillary sinuses augmentation), and history of smoking has been reported. A higher degree of complication, or implant failure rates, were found in smokers with and without bone grafts. The relationship between cigarette smoking and implant-related surgical procedures, including the incidence of complications associated with these procedures, will be described and discussed based on relevant literature and results of our recent studies.

Abutment tooth loss in patients with overdentures

Since the 1960s, the use of natural teeth as overdenture abutments has become part of accepted clinical practice. Several longitudinal studies have been conducted, but tooth loss has not been reported to be a significant problem. The aim of this study was to identify the incidence and causes of tooth loss in a prospective cohort study of subjects wearing overdentures. The study, conducted between 1973 and 1994, evaluated 273 subjects (62.3 percent male) with a mean age of 59.6 years. Of the 273 subjects with 666 abutments, 74 lost 133 abutments. The most common cause of tooth loss was periodontal disease (29.3 percent) followed by periapical lesions (18.8 percent) and caries (16.5 percent). Through logistic regression, the authors found that subjects who lost teeth were more likely to have medical problems that could cause soft-tissue lesions of the oral mucosa, were less likely to use fluoride daily and were less likely to return for yearly recall visits. The authors found 22 vertical fractures in 17 subjects. Chi2 analysis revealed that overdenture teeth in the maxillary arch that were opposed by natural teeth were more likely to experience vertical fractures. In a study that followed up some patients for as long as 22 years, the rate of tooth loss was 20.0 percent. Many of these failures could have been prevented if patients had practiced better oral hygiene. The findings suggest that if a dentist recommends overdenture therapy, the patient needs to be examined regularly to reduce the risk of experiencing caries and periodontal disease. Also, if the abutments are in the maxilla and are opposed by natural teeth, the dentist should consider using thimble crowns to reduce the risk of vertical fractures.

The relation of tobacco smoking to tooth loss among young adults.

Earlier studies have associated smoking with a higher rate of dental caries, periodontal disease and tooth loss. The aim of this cross-sectional study was to determine whether smoking is associated with tooth loss among young adults. The data consist of the 1966 birth cohort of Northern Finland, which is an unselected general population birth cohort (n = 12 058). The data were collected using a postal questionnaire in 1997-98 (n = 8690). Prevalence odds ratios and confidence intervals were estimated by applying a logistic regression model. It was found that smoking was associated with tooth loss in an exposure-dependent manner. The odds for those who smoked 16 or more pack-years were 5.30 (CI = 2.35-11.2) after adjustment for socio-economic and behavioral factors. Differences in socio-economic or health behavior are not likely to explain the findings since an exposure-response pattern was seen even when data was stratified according to sex, education and health-oriented lifestyle. A possible explanation for this association is a combination of treatment decisions and dental diseases, which are most likely associated with smoking in an exposure-dependent manner.