Risk Of Tooth Loss Research Articles

A multilevel analysis of the importance of oral health instructions for preventing tooth loss: The 8020 Promotion Foundation Study of Japanese Dental Patients

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.

Obesity as a risk factor for tooth loss over 5years: A population-based cohort study.

To assess obesity as a risk factor for tooth loss over 5years in an urban sample of Brazilian adults. A total of 1586 individuals were surveyed using a multistage probabilistic approach. Five years later, 635 individuals 14-64years old were re-examined. An incident case of tooth loss was determined for a participant that had lost at least one tooth over time. Obesity was evaluated by calculating body mass index at baseline and by the change in obesity status over time. Incident cases of tooth loss were significantly more frequent among obese (47.1%) than normal-weight individuals (32.4%) (p=.004). Obese individuals had 31% higher risk [relative risk (RR) =1.31; 95% confidence interval (95%CI) 1.04-1.65] for tooth loss than normal-weight individuals adjusting for age, socio-economic status, smoking, dental care and periodontitis. This association was significant for females (RR=1.47, 95%CI 1.08-2.01), but not for males. The risk for tooth loss was also modified by presence of periodontitis at baseline and lifetime smoking exposure. There was an increased risk for tooth loss for those that remained obese than those that remained normal weight. Obesity is associated with higher risk for tooth loss. This association was modified by sex, periodontal status and smoking.

Long-Term Survival of Enamel-Defect-Affected Teeth

There has been considerable research focussed on the occurrence and aetiology of developmental defects of enamel, but less is known about the extent to which enamel-defect-affected teeth may be at greater risk for dental caries. The Dunedin Multidisciplinary Health and Development Study is a prospective cohort study of 1,037 children born in Dunedin, New Zealand, between April 1, 1972, and March 31, 1973. Participants were examined for the presence of developmental defects of enamel at the age of 9 years and then repeatedly for the occurrence of dental caries through to the age of 45 years. After controlling for confounding variables, incisor teeth affected by demarcated opacities at the age of 9 were 3.4 times more likely to be restored than teeth unaffected by defects. Incisors with diffuse opacities and hypoplasia or combinations of defects were 2.8 times more likely to be restored. Molars with enamel defects of any type did not have any significantly different risk for being subsequently restored or lost due to caries than unaffected molars, except those affected by diffuse opacities, which were at 0.4 times the risk of being lost due to caries. Dental clinicians should be aware that enamel-defect-affected teeth are not necessarily at greater risk for tooth loss due to caries in the long term, but permanent incisors affected by enamel defects are at higher risk of receiving restorative intervention.

Massive data analyses show negative impact of type 1 and 2 diabetes on the outcome of periodontal treatment

ObjectivesThe aim was to evaluate the impact of diabetes on the outcome of periodontal treatment based on massive data analyses.Materials and methodsData originated from the database of a major German National Health Insurance. Patients who underwent periodontal treatment were allocated to four groups according to their medical condition: type 1 diabetes (D1), type 2 diabetes with the intake of oral anti-diabetics (D2M), type 2 diabetes without the intake of oral anti-diabetics (D2), and a control group without diabetes (ND). Four-year Kaplan-Meier survival analyses on the patient level and multivariate regression analyses were conducted for tooth extraction.ResultsOf 415,718 patients, 4139 matched the criteria for D1, 22,430 for D2M, and 23,576 for D2. At 4 years, the cumulative survival rate (no extraction) was 51.7% in the D1 group, 54.0% in the D2M group, and 57.7% in the D2 group. The ND control group had a significantly higher survival rate of 65.9% (P < 0.0001). In the multivariate analyses, both diabetes types were significantly associated with further tooth loss after periodontal treatment.ConclusionsThe diagnosis of diabetes type 1 or 2 seems to be associated with a higher risk of tooth loss after periodontal treatment.Clinical relevanceThe long-term prognosis of teeth in diabetes patients should be judged carefully.

An investigation of tooth loss factors in elderly patients using panoramic radiographs.

The aim of this study was to observe the dental condition in a group of elderly patients over a period of 10years in order to clarify important risk factors. Participants were elderly patients (in their eighties) who took panoramic radiographs between 2015 and 2016, and for whom panoramic radiographs taken around 10year earlier were also available. The number of remaining and lost teeth, the Eichner Index, the presence or absence of molar occlusion, the respective condition of dental pulp, dental crowns, alveolar bone resorption, as well as periapical lesions were investigated through the analysis of panoramic radiographs. Additionally, other important variables were collected from patients' medical records. From the obtained panoramic radiograph sets, the patients' dental condition was investigated, and a systematic comparison was conducted. The analysis of the panoramic radiographs showed that the number of remaining teeth decreased from an average of 20.8-15.5, and the percentage of patients with 20 or more teeth decreased from 69.2 to 26.9%. A factor analysis investigating tooth loss risk suggested that tooth loss was associated with the bridge, P2 or greater resorption of the alveolar bone, and apical lesions, and gender (with males having a higher risk compared to females). Teeth showing P2 or greater alveolar bone resorption, bridge, and apical lesions on panoramic radiographs are most likely to be lost in an elderly patient's near future. Consequently, this group should be encouraged to visit their dental clinics regularly and receive comprehensive instruction on individual self-care methods.

Closure of maxillary midline diastema after frenectomy and nonsurgical periodontal therapy – a case report

ABSTRACT: Maxillary midline diastema is an aesthetic problem and is more common in children, but can affect the individuals at any age. The etiology of maxillary diastema includes physiological, pathological or iatrogenic factors. Different therapeutic approaches are used for its correction in dental practice: orthodontic, surgical, restorative and prosthetic therapy. AIM: The aim of this case report is to evaluate the effect after frenectomy of the maxillary labial frenulum and the performed non-surgical periodontal therapy in the closing of the maxillary diastema without subsequent orthodontic treatment. MATERIAL AND METHODS: Nonsurgical periodontal therapy and a maxillary labial frenectomy were performed on a 34-year-old male with severe periodontitis with risk of tooth loss (stage III). RESULTS: Complete closure of the maxillary midline diastema was observed 9 months after treatment. CONCLUSION: This clinical case demonstrates the efficacy of frenectomy as a self-sufficient approach for the correction of maxillary midline diastema.

Is the Association between Green Tea Consumption and the Number of Remaining Teeth Affected by Social Networks?: A Cross-Sectional Study from the Japan Gerontological Evaluation Study Project.

Consumption of green tea without sugar, as well as social networks, are associated with a lower risk of tooth loss. There is a possibility of confounding both factors because tea is often drunk with friends. Therefore, the present study aimed to examine whether green tea consumption is beneficially associated with the number of remaining teeth, while considering social networks. This cross-sectional study was based on the Japan Gerontological Evaluation Study (JAGES) in 2016. Self-administered questionnaires containing questions about green tea consumption were mailed to 34,567 community-dwelling residents aged ≥ 65 years. We used the number of remaining teeth as a dependent variable, and green tea consumption and the number of friends met over the past month (social network size) as independent variables. Linear regression models with multiple imputation were used. A total of 24,147 people responded (response rate = 69.9%), and 22,278 valid data were included into our analysis. Participants’ mean age was 74.2 years (standard deviation = 6.3), and 45.9% were men. Among the participants, 52.2% had ≥ 20 teeth, 34.2% drank 2–3 cups of green tea per day, and 32.6% met ≥ 10 people over the past month. After adjusting for all potential confounders, both higher green tea consumption and a larger social network size were associated with more remaining teeth (both p for trend < 0.001). The association of green tea was greater among those with smaller social networks (p for interaction < 0.05). The protective association of green tea was remarkable among people with smaller social networks.

Long-term tooth retention in periodontitis patients in four German university centres

ObjectivesIn this retrospective study, we compared tooth loss between patients receiving periodontal therapy (PT) in four German university centres, stratified according to periodontal treatment phase. Materials and MethodsOverall, 896 patients (Kiel (KI) n = 391; Greifswald (GW) n = 282; Heidelberg (HD) n = 174; Frankfurt a.M. (F) n = 49) were examined initially (T0), after active periodontal therapy (APT, T1) and after supportive periodontal therapy (SPT, T2). Descriptive analyses and multivariable negative binomial regression models were performed. ResultsFollow-up periods differed significantly between the centres, ranging between 6.7 ± 3.0 (GW) and 18.2 ± 5.5 (KI) years (p < 0.001). At T0, age, gender, smoking and diabetes showed notable regional distinctions (p < 0.001). However, the number of teeth per patient was similar (between 24.0 ± 4.6 (F) and 24.5 ± 4.1 (HD); p = 0.27). During PT, the number of extracted teeth differed significantly between centres, with greater differences during SPT (0.9 ± 1.8 (GW) to 2.3 ± 2.8 (KI), p < 0.001) compared to APT (0.4 ± 0.9 (F) to 1.0 ± 2.1 (KI), p = 0.02). Annual tooth loss during SPT remained low in all centres (between 0.10 ± 0.14 (F) to 0.15 ± 0.30 (HD), p < 0.001). ConclusionWithin the limitation of the study, PT leads to a low risk of tooth loss in all university centres irrespective of patients’ baseline characteristics. Clinical RelevanceWithin the limitations of this retrospective investigation, long-term tooth retention seems to be feasible for most patients, as long as a systematic and structured treatment approach is applied.

DEFB4A Promoter Polymorphism Is Associated with Chronic Periodontitis: A Case–Control Study

Background: Human β-defensin-2 is an antimicrobial peptide with antibiotic properties secreted by the oral cavity to protect the host against microbial attack. The inter-individual differences in defensin expression profiles due to genetic variation might be partly responsible for differences in disease susceptibility. Aims: The objective of this study was to examine whether variation in the human β-defensin-2 gene (DEFB4A) is associated with chronic periodontitis (CP). Materials and Methods: This case-control study used Sanger sequencing to analyze two promoter polymorphisms of the DEFB4A gene with potential functional consequences using DNA samples collected from 200 unrelated individuals. Results: The DEFB4A rs1339258595 promoter polymorphism is associated with CP risk and clinical attachment level (CAL) but the rs3762040 polymorphism is not. Carriers of the T allele (rs1339258595) were approximately three times less likely to develop periodontitis compared with noncarriers (p = 0.0004, odds ratio = 0.35). Consistent with a protective role, the carriers of T allele had a lower CAL compared with the wild-type (G) allele. Moreover, the wild-type diplotype (GGGG) had a significantly higher risk of tooth loss compared with other diplotypes (p = 0.016). Conclusion: This study demonstrates that genetic variation in the promoter region of DEFB4A likely affects resistance to periodontal infection and might be a potential marker for CP risk and severity.

How to Increase Number of Present Teeth in Elderly: Consideration of Percentile Curves for Present Teeth in Tokyo.

Maintaining dental and oral health and increasing healthy life expectancy are important issues for Japan as it deals with the rapid aging of its population. The purpose of this study was to determine effective dental health measures aimed at increasing the number of present teeth in the elderly. Change in the number of present teeth was determined based on data obtained from the 2009 and 2014 "Good Teeth Tokyo (Ii-ha Tokyo)" surveys carried out by the Tokyo Metropolitan Government. The number of present teeth and percentile curves were compared between these two time points. The number only showed a significant increase in individuals aged 60 years in 2014 (p<0.05). This may have been due to the establishment of a national public insurance system. The number of present teeth showed an increase in 2014 in the 25th, 50th, and 75th percentile curves. In the 75th and 90th percentile curves, tooth loss accelerated when the number of present teeth was fewer than 25. This finding is consistent with studies reporting that tooth loss itself is a risk for tooth loss. Tooth loss showed a slight acceleration between the ages of approximately 20 and 45 years in the 90th percentile curve. These results indicate that dental check-ups at universities and companies, periodontal disease check-ups performed by local governments, and health instruction at these check-ups are necessary to increase the number of present teeth in the elderly. They further suggest that implementing measures to promote periodic visits to dental clinics and providing incentives to undergo treatment for tooth defects are necessary in high-risk individuals. In conclusion, dental check-ups, health instruction, and strategies for high-risk individuals in their 20s and 40s are necessary to increase the number of present teeth in the elderly.

Effect of smoking cessation on tooth loss: a systematic review with meta-analysis

BackgroundSmoking is a major risk factor for periodontitis and tooth loss. Smoking cessation has a positive impact in periodontal treatment. However, so far, no systematic review has evaluated the effect of smoking cessation on tooth loss. Therefore, this review aimed to evaluate if smoking cessation reduces the risk of tooth loss.MethodsObservational (cross-sectional and longitudinal) studies that investigated the association between smoking cessation and tooth loss were included. MEDLINE, EMBASE and LILACS databases were searched for articles published up to November 2018. Pooled results for subgroups of current and former smokers were compared in meta-analysis. Meta-regression was used to test the influence of smoking status on estimates and explore the heterogeneity.ResultsOf 230 potentially relevant publications, 21 studies were included in the qualitative review and 12 in the quantitative analysis. Meta-analysis of cross-sectional studies did not show any differences between former and current smokers in the chance of losing 1 or more teeth (OR = 1.00; 95% CI = 0.80 to 1.24, I2 = 80%), losing more than 8 teeth (OR = 1.02; 95% CI = 0.78 to 1.32, I2 = 0%) or being edentulous (OR = 1.37; 95% CI = 0.94 to 1.99, I2 = 98%). Meta-analysis from longitudinal studies showed that, when compared to never smokers, former smokers presented no increased risk of tooth loss (RR = 1.15; 95% CI = 0.98 to 1.35, I2 = 76%), while current smokers presented an increased risk of tooth loss (RR = 2.60; 95% CI = 2.29 to 2.96, I2 = 61%). Meta-regression showed that, among former smokers, the time of cessation was the variable that better explained heterogeneity (approximately 60%).ConclusionsRisk for tooth loss in former smokers is comparable to that of never smokers. Moreover, former smokers have a reduced risk of tooth loss, when compared to current smokers.

Improved periodontal disease and prevention of tooth loss in osteoporosis patients receiving once-yearly zoledronic acid: a randomized clinical trial.

This randomized, clinical trial investigated whether zoledronic acid combined with oral health maintenance can improve periodontal disease associated with osteoporosis, thus reducing the risk of tooth loss. Participants were those of the ZONE (ZOledroNate treatment in efficacy to osteoporosis) study. None of the participants had symptomatic periodontal disease at baseline. Participants received either zoledronic acid (5 mg; n = 333 [male 21, female 312]) or placebo (n = 332 [male 19, female 313]) once yearly for 2 years, and their age was 74.0 ± 5.3 (65-88) and 74.3 ± 5.4 (65-87) years, respectively. Participants were instructed to maintain good oral hygiene at baseline and every 3 months. Participants with signs or symptoms involving their oral cavity at the monthly visit with their physician were referred to dentists for examination of oral disease. All cases were included to analyze adverse events in this study. Testing for significance was conducted using Fisher exact test (P < 0.05). The incidence of oral adverse events was significantly higher in the control group (67 cases, 20.2%) than in the zoledronic acid group (47 cases, 14.1%; P = 0.04). The frequency of symptomatic periodontal disease observed during the study was significantly higher in the control group (40 cases, 12.0%) than in the zoledronic acid group (18 cases, 5.4%; P = 0.002). Loss of teeth was more frequent in the control group (36 cases, 10.8%) than in the zoledronic acid group (24 cases, 7.2%), although the difference was not significant. Zoledronic acid effectively prevented symptomatic periodontal disease in patients with osteoporosis who maintained good oral hygiene. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A438.

Tooth loss and multivariable analysis after 5-year non-surgical periodontal treatment on molars with furcation involvement

OBJECTIVE To evaluate the tooth loss status of mandibular molars with furcation involvements after 5-year non-surgical periodontal treatment, and to analyze the factors that affected the tooth loss. METHODS A retrospective analysis was conducted in 79 patients with chronic periodontitis, who had received non-surgical periodontal treatment and 5 years of periodontal maintenance treatment in Department of Periodontology, Peking University School and Hospital of Stomatology from 1988 to 2012. Their clinical indexes, including probing depth (PD), bleeding index (BI), furcation index (FI) and tooth mobility were both evaluated before treatment and at the last time of the maintenance treatment. Bone resorption at furcation area was measured at the first visit by periapical radiographs taken by professional doctors of medical imaging. The status of tooth loss after 5-year non-surgical periodontal treatment on mandibular molars with furcation involvement, and the factors that affected the tooth loss were analyzed. RESULTS (1) Non-surgical treatment was significantly effective on the changes of PD in the patients of chronic periodontitis with furcation involvement, while the presence of furcation involvement could affect the improvement of PD here. (2) PD at the furcation area, tooth mobility, vertical bone resorption, and bone resorption area were all significant risk factors of mandibular molar missing (P<0.001), and the same with FI=3 and FI=4 (P=0.017, P=0.007), while age (P=0.703), gender (P=0.243) and smoking history (P=0.895) were not related to the tooth loss in this study. (3) The risk of tooth loss in mandibular molars with FI≥3 were significantly higher than those with FI≤2, and the survival rate of the former was less than 50%. CONCLUSION The loss of mandibular molars with furcation involvement was related to the furcation involvement, meanwhile the degree of furcation involvement and bone resorption can significantly increase the risk of tooth loss.

Construction of a Biological Age Score to Predict Tooth Loss over 10 Years

The aim of the present study was to construct a biological age score reflecting one’s physiologic capability and aging condition with respect to tooth loss over 10 y. From the follow-up to the population-based Study of Health in Pomerania (i.e., SHIP-2), 2,049 participants were studied for their baseline biomarker measures 10 y before (i.e., in SHIP-0). Metabolic and periodontal data were regressed onto chronological age to construct a score designated as “biological age.” For either sex separately, the impact of this individualized score was used to predict tooth loss in the follow-up cohort in comparison with each participant’s chronological age. Outcome data after 10 y with respect to tooth loss, periodontitis, obesity, and inflammation were shown to be better for biologically younger subjects than as expected by their chronological age, whereas for the older subjects, data were worse. Especially for tooth loss, a striking increase was observed in subjects whose biological age at baseline appeared to be higher than their chronological age. Biological age produced significantly better tooth loss predictions than chronological age (P < 0.001). Areas under receiver operating characteristic curves for tooth loss of ≥3 teeth in men during follow-up were 0.811 and 0.745 for biological and chronological age, respectively. For women, these figures were 0.788 and 0.724. For total tooth loss, areas under the curve were 0.890 and 0.749 in men and 0.872 and 0.752 in women. Biological age combines various measures into a single score and allows identifying individuals at increased risk of tooth loss.

Oral hygiene status in relation to salivary estradiol hormone level among pre-menopausal and post-menopausal Iraqi women

Background: The menopause is physiological changes in women that give rise to adaptive changes at both systemic and oral level. During menopause, ovarian function declines and the production of sex steroid hormones reduces significantly affecting the oral tissues and periodontal structures leading to chronic inflammation of the gingiva, increased risk of tooth loss. Aim of study: The present study was designed to estimate the oral hygiene status in relation to salivary estradiol level among pre and post-menopausal women. Materials and Methods: Ninety women aged 48-52 years old, the control group consisted of 45 pre-menopausal women and the study group consisted of 45 post-menopause were examined for gingival index, plaque index and calculus index. Unstimulated saliva was collected from all women to analyze estradiol hormone level. Results: the mean rank of the gingival index, plaque index and calculus index were higher in post-menopause than that of pre-menopause group with lower level of salivary estradiol hormone (E2).These oral hygiene indices have a negative relation with estradiol (E2) hormone level in both test groups. Conclusion: Oral hygiene status affected by salivary estradiol hormone level in women. Oral hygiene status was worse among post-menopausal women and correlated negatively with salivary Estradiol hormone level.

Socioeconomic status and remaining teeth in Japan: results from the Toyama dementia survey

BackgroundThe prevalence of periodontal disease is increasing among elderly individuals in Japan. Reports on the risk factors for tooth loss have included socioeconomic status (SES); however, few studies have addressed the association between remaining teeth and SES by examining whether education and occupation have a synergistic effect on tooth loss. Accordingly, the present study evaluated the association of remaining teeth with the socioeconomic factors of educational and occupational histories in Japanese elderly individuals.MethodsThis retrospective case-control study used data from the Toyama Dementia Survey, Japan. Toyama Prefecture residents aged ≥65 years were randomly selected for the study (sampling rate, 0.5%), and 1303 residents agreed to participate (response rate, 84.8%). Structured interviews with participants and family members (or proxies, if necessary) were conducted. Participants’ lifestyle factors (e.g., smoking and alcohol consumption), medical history, and SES (educational and occupational history) as well as the presence or absence of remaining teeth were assessed. The association between SES and remaining teeth was examined using a logistic regression analysis.ResultsOverall, 275 cases with no remaining teeth and 898 controls with remaining teeth were identified. The odds ratio (OR) for complete tooth loss was higher among less educated participants (≤6 years) than among highly educated participants [age- and sex-adjusted OR, 3.29; 95% confidence interval (CI), 1.90–5.71]; furthermore, it was higher among participants with a blue-collar occupational history than among those with a white-collar occupational history (age- and sex-adjusted OR, 2.16; 95% CI, 1.52–3.06). After adjusting for employment history or educational attainment, the ORs for tooth loss were 2.79–3.07 among less educated participants and 1.89–1.93 among participants with a blue-collar occupational history. A current or former smoking habit and medical history of diabetes and osteoporosis increased the risk of tooth loss. The interaction term of a low level of education and a history of blue-collar occupation with tooth loss was not significant.ConclusionsIn Japan, a low SES is a risk factor for tooth loss. A low level of education is a more important predictor of tooth loss than a blue-collar occupation.

Predictors for tooth loss in periodontitis patients: Systematic review and meta-analysis.

A range of predictors for tooth loss in periodontitis patients have been reported. We performed a systematic review and meta-analysis to assess the consistency and magnitude of any association between a total of 12 predictors and tooth loss. Medline/Embase/Central were searched for longitudinal studies investigating the association between predictors and tooth loss in periodontitis patients. Random-effects meta-analysis was performed, and study quality assessed. Twenty studies (15,422 patients, mean follow-up: 12years) were included. The mean annual tooth loss/patient was 0.12 (min./max: 0.01/0.36). Older patients (n=8 studies; OR: 1.05, 95% CI: 1.03-1.08/year), non-compliant ones (n=11; 1.51, 1.06-2.16), diabetics (n=7; 1.80, 1.26-2.57), those with IL-1-polymorphism (n=3; 1.80; 1.29-2.52) and smokers (n=15; 1.98, 1.58-2.48) had a significantly higher risk of tooth loss. Teeth with bone loss (n=3; 1.04, 1.03-1.05/%), high probing pocket depth (n=6; 3.19, 1.70-5.98), mobility (n=4; 3.71, 1.65-8.38) and molars (n=4; 4.22, 2.12-8.39), especially with furcation involvement (n=5; 2.68, 1.75-4.08) also showed higher risks. Gender (n=16; 0.95, 0.86-1.05) and endodontic affection (n=3; 3.62, 0.99-13.2) were not significantly associated with tooth loss. Older, non-compliant, smoking or diabetic patients, and teeth with bone loss, high probing pocket depth, mobility, or molars, especially with furcation involvement showed higher risks of tooth loss.

Effort-reward imbalance at work and tooth loss: a cross-sectional study from the J-SHINE project.

Oral diseases produce enormous productivity loss. However, epidemiological evidence of work stress and tooth loss is scarce. The aim of this study was to examine the association of work stress, according to effort–reward imbalance (ERI), with tooth loss. We conducted a cross-sectional study using data obtained between 2010 and 2011 in Japan. This study included 1,195 employees aged 25–50 years old (response rate=32%). The dependent variable was self-reported tooth loss (having or not). The independent variable was a dichotomized ERI ratio (>1.4 and ≤1.4). Age, sex, sociodemographic variables, work-related factors, and health-related variables were adjusted. Psychological distress was used as a potential mediator. We also examined an additive interaction between support from supervisors and ERI. The median age was 37, and 48% were women. After adjusting for the covariates, ERI was still associated with tooth loss (prevalence ratio=1.20 [95% confidence interval=1.01, 1.42] from Poisson regression models with a robust error variance). Psychological distress partially explained the association, and support from supervisors significantly attenuated the association. In conclusion, high ERI ratio was still associated with an increased risk of tooth loss among working adults.

PRS41 CO-OCCURRING ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS ASSOCIATED WITH POOR ORAL HEALTH AMONG ADULTS IN THE UNITED STATES

Individuals with asthma and Chronic obstructive pulmonary disease (COPD) may be at higher risk for tooth loss compared to those with neither asthma nor COPD due to medications for these conditions and other aspects of the diseases that may be a barrier to routine dental care visits. The objective of this study was to determine the association of asthma and/or COPD and tooth loss among US adults. A cross-sectional design was employed using 2016 Behavioral Risk Factor Surveillance System (N=387,217). We categorized number of missing permanent teeth into 4 groups: asthma only (N=38,817); COPD only (N = 19,819); asthma and COPD (N=13,494); and no asthma, no COPD (N=315,087). Our primary outcome was number of missing teeth categories (none, 1-6, 6-not all, and all teeth missing). We employed multinomial logistic regressions to study the association between asthma and COPD and tooth loss categories. One in 20 adults reported all missing teeth. Adults with asthma and COPD had higher odds of poor oral health (missing>=6 teeth, all) compared to no asthma, no COPD (AOR=2.04; 95%CI=1.85-2.26). Dental visits mediated the relationship between asthma and COPD and oral health. Adults with asthma and COPD had poor oral health compared to those with neither asthma nor COPD. Adults with asthma and COPD may need to maintain routine dental visits to reduce risk of tooth loss. Findings from our study can be useful for planning and developing health promotion and disease prevention programs for oral health.

The effect of diabetes on tooth loss caused by periodontal disease: A nationwide population-based cohort study in South Korea.

Our purpose was to compare the risk of tooth loss caused by periodontal disease between diabetic and nondiabetic individuals and to estimate the relative risk of tooth loss according to the severity and control of diabetes. We selected 10,215 individuals who were diagnosed as diabetics in the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) database in 2003 and the same number of individuals who had never been diagnosed with diabetes during the period covered by the NHIS-NSC (2002-2013) with propensity score matching. Diabetic individuals were divided into two groups according to the treatment modality. We counted the number of teeth lost in each group to determine the difference in the risk of tooth loss among groups and used the Cox proportional hazards model to calculate hazard ratios (HRs) of tooth loss caused by periodontitis. Diabetic individuals had a higher risk of tooth loss than nondiabetic individuals (HR=1.298, 95% confidence interval [CI]: 1.233≤HR≤1.366; P<0.01). The severer the degree of diabetes, the higher the risk of tooth loss. As the number of dental visits increased, the risk of tooth loss declined (HR=0.998, 95% CI: 0.996≤ HR≤0.999; P<0.01). Within the limits of this retrospective cohort study, the risk of tooth loss among diabetic individuals was higher than that among nondiabetic individuals. The risk of tooth loss declined with increasing numbers of dental visits and increased with the severity of diabetes.