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Number of Teeth and Mortality Risk in the Baltimore Longitudinal Study of Aging

¹ Community Oral Health Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
² Post-Graduate Program in Community Health and Post-Graduate Program in Dentistry, Lutheran University of Brazil–Canoas, RS, Brazil.
³ Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.

Address correspondence to Dalva Maria Pereira Padilha, PhD, Dental School, UFRGS, R. Ramiro Barcelos, 2492. Porto Alegre, RS 90035-003, Brazil. E-mail: dalvapadilha{at}via-rs.net

Background. Findings from several studies suggested an association between oral health and several health outcomes including cardiovascular disease, aspiration pneumonia, malnutrition, poor quality of life, and mortality. Using data from the Baltimore Longitudinal Study of Aging (BLSA), we tested the hypothesis that number of teeth is indicative of mortality risk independent of other confounders.

Methods. Dentists conducted a standardized oral examination that included tooth count, tooth with coronal and cervical caries count, and gingival and periodontal index. Blood tests used in the analysis included fasting glucose, oral glucose tolerance test, serum low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol, triglycerides, and white blood cell counts. Physical activity, skin fold thickness, body mass index and chronic diseases were also evaluated.

Results. Of the 500 BLSA participants evaluated, 198 died an average of 130 (±75) months postdental evaluation, and 302 survivors were followed for a mean of 185 (±90) months. Based on multivariate Cox regression models, being edentulous or having than 20 teeth was independently associated with mortality.

Conclusion. The results of this study support the notion that number of teeth is a significant and independent risk indicator for early mortality. These findings suggest that the improvement of oral health may have a positive impact on general health and may delay mortality.

Key Words: Aged • Mortality • Cohort studies • Tooth loss