BACKGROUND: A dentition of at least 20 teeth is associated with sufficient masticatory efficiency and is a stated health goal of the World Health Organisation. We examined whether subjects with missing, unreplaced teeth had an increased mortality risk. METHODS: We used data prospectively collected from those participants in the population-based Study of Health in Pomerania who had fewer than 20 remaining teeth, resulting in a sample of 1803 participants with a median age of 64 years. Of those, 188 subjects had 9 or more unreplaced teeth. During a median follow-up period of 9.9 years, 362 subjects died, 128 of whom of cardiovascular causes. RESULTS: We found that having 9 or more unreplaced teeth was related to all-cause mortality (rate ratio 1.53, 95% CI: 1.11-2.10; adjusted for variables according to causal diagrams: remaining teeth, age, sex, education, income, marital status, partnership, and oral health behaviour) and cardiovascular mortality (rate ratio 1.94, 95% CI: 1.15-3.25). When adjusting not only for the variables according to causal diagrams but also for smoking, alcohol consumption, physical activity, obesity, hypertension, diabetes, and dyslipidemia, the rate ratio was 1.43 (95% CI: 1.05-1.96) for all-cause mortality and 1.88 (95% CI: 1.10-3.21) for cardiovascular mortality. CONCLUSIONS: A reduced, unrestored dentition is associated with increased mortality risk. Thus, clinicians and dietitians have a responsibility to consider individual chewing ability in nutritional recommendations.
BACKGROUND: A dentition of at least 20 teeth is associated with sufficient masticatory efficiency and is a stated health goal of the World Health Organisation. We examined whether subjects with missing, unreplaced teeth had an increased mortality risk. METHODS: We used data prospectively collected from those participants in the population-based Study of Health in Pomerania who had fewer than 20 remaining teeth, resulting in a sample of 1803 participants with a median age of 64 years. Of those, 188 subjects had 9 or more unreplaced teeth. During a median follow-up period of 9.9 years, 362 subjects died, 128 of whom of cardiovascular causes. RESULTS: We found that having 9 or more unreplaced teeth was related to all-cause mortality (rate ratio 1.53, 95% CI: 1.11-2.10; adjusted for variables according to causal diagrams: remaining teeth, age, sex, education, income, marital status, partnership, and oral health behaviour) and cardiovascular mortality (rate ratio 1.94, 95% CI: 1.15-3.25). When adjusting not only for the variables according to causal diagrams but also for smoking, alcohol consumption, physical activity, obesity, hypertension, diabetes, and dyslipidemia, the rate ratio was 1.43 (95% CI: 1.05-1.96) for all-cause mortality and 1.88 (95% CI: 1.10-3.21) for cardiovascular mortality. CONCLUSIONS: A reduced, unrestored dentition is associated with increased mortality risk. Thus, clinicians and dietitians have a responsibility to consider individual chewing ability in nutritional recommendations.
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Authors: Hans J Grabe; Heinrich Assel; Thomas Bahls; Marcus Dörr; Karlhans Endlich; Nicole Endlich; Pia Erdmann; Ralf Ewert; Stephan B Felix; Beate Fiene; Tobias Fischer; Steffen Flessa; Nele Friedrich; Mariacarla Gadebusch-Bondio; Manuela Gesell Salazar; Elke Hammer; Robin Haring; Christoph Havemann; Michael Hecker; Wolfgang Hoffmann; Birte Holtfreter; Tim Kacprowski; Kathleen Klein; Thomas Kocher; Holger Kock; Janina Krafczyk; Jana Kuhn; Martin Langanke; Uwe Lendeckel; Markus M Lerch; Wolfgang Lieb; Roberto Lorbeer; Julia Mayerle; Konrad Meissner; Henriette Meyer zu Schwabedissen; Matthias Nauck; Konrad Ott; Wolfgang Rathmann; Rainer Rettig; Claudia Richardt; Karen Saljé; Ulf Schminke; Andrea Schulz; Matthias Schwab; Werner Siegmund; Sylvia Stracke; Karsten Suhre; Marius Ueffing; Saskia Ungerer; Uwe Völker; Henry Völzke; Henri Wallaschofski; Vivian Werner; Marek T Zygmunt; Heyo K Kroemer Journal: J Transl Med Date: 2014-05-23 Impact factor: 5.531