Good dental care reduces mortality risk in elderly
medwireNews: Elderly individuals with tooth loss could lower their risk for mortality if they practice good oral hygiene, report researchers.
A study of over 20,000 individuals showed that oral hygiene habits such as tooth brushing, regular dental visits, and use of dentures were inversely associated with mortality risk in individuals with only 10 to 19 teeth remaining. In those with even fewer teeth (0 to 9), however, only visits to the dentist improved their mortality risk.
"An important concern for older people with missing teeth is whether there is a way to decrease the excess risk of associated mortality," say Kazuki Hayasaka (Tohoku
University, Sendai, Japan) and colleagues. One of the major causes of tooth loss is periodontal disease, which has previously shown associations with coronary heart disease, stroke, and pneumonia, they explain.
For the present study, the researchers obtained baseline data in 2006 on number of remaining teeth and oral care status for 21,730 individuals aged 65 years or older living in the Ohsaki city in northeastern Japan. The cohort was then followed up over a 4-year period for mortality using data from the Residential Registry of Ohsaki city.
As reported in the Journal of the American Geriatrics Society, 2362 (10.9%) participants died over the 4-year follow-up period.
Compared with participants with a moderate amount of teeth (≥20), those with only half their teeth (10-19) were at a 16% increased risk for mortality, after adjustment for age, gender, education level, smoking, alcohol drinking, body mass index, time spent walking daily, medical history, psychological distress, and energy and protein intake. And those with only a few or no teeth (0-9) were at a 31% increased risk for mortality.
However, among participants with only half versus a moderate amount of teeth, the risk for mortality was significantly reduced in those who brushed their teeth two times per day or more, visited the dentist at least once a year, or used dentures, at hazard ratios (HRs) of 1.03, 1.02, and 1.11, respectively. However, among those with 0 to 9 teeth, the risk for mortality was only significantly reduced among individuals who visited the dentist at least once a year, at an HR of 1.09.
The researchers also found that among individuals with 0-19 teeth, the adjusted HR for mortality among those who practiced all three types of oral care compared with those who practiced none was 0.54.
One possible pathway linking oral care to mortality is that "tooth brushing and dental visits may prevent death from pneumonia, especially aspiration pneumonia," suggests the team. Additionally, "oral hygiene reduces the chronic inflammation that periodontal disease causes, which increases the risk of coronary heart disease and stroke."
Hayasaka et al conclude: "Further observational studies should be conducted to confirm the effects of oral care on mortality of individuals with missing teeth."
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Sally Robertson, medwireNews Reporter