Leif Jansson1,2, Hero Kalkali1, Freha Mulk Niazi1,3. 1. a Department of Periodontology , Public Dental Service at Eastmaninstitutet, Stockholm County Council , Stockholm , Sweden. 2. b Division of Periodontology, Department of Dental Medicine , Karolinska Institutet , Huddinge , Sweden. 3. c Public Dental Service at Sollentuna , Stockholm County Council , Stockholm , Sweden.
Abstract
OBJECTIVE: To study the association between oral health and all-cause mortality rate over 44 years. In addition, the specific relations between oral health and death caused by cardiovascular disease (CVD), cancer or other reasons were investigated. MATERIALS AND METHODS: An epidemiological investigation studying the oral health of the population consisting of 1393 randomly selected subjects was performed in the County of Stockholm. The individuals were invited to a clinical examination, an interview and a radiographic examination. The incidence of mortality during the years 1970-2014 as well as the causes of death according to the death certificate were registered in 2015. Cox regression survival analysis was used for investigating the effect of several variables upon the time to the outcome of death. RESULTS: Forty-six percent of the subjects were still alive at the end of the year 2014. Cancers caused 27% of the deaths, while 22% died due to CVD. The mortality risk was positively and significantly correlated to oral health when compensated for age, sex, smoking and social status. In addition, the mortality risk caused by CVD, cancer or other reasons was significantly increased for those with poor oral health. CONCLUSIONS: Oral health was found to be a risk indicator of death caused by CVD and cancer as well as for all-cause mortality. Thus, the associations are unspecific. Harmful lifestyle factors impact dental health behavior as well as mortality risk. This might contribute to the association between oral health and mortality risk.
OBJECTIVE: To study the association between oral health and all-cause mortality rate over 44 years. In addition, the specific relations between oral health and death caused by cardiovascular disease (CVD), cancer or other reasons were investigated. MATERIALS AND METHODS: An epidemiological investigation studying the oral health of the population consisting of 1393 randomly selected subjects was performed in the County of Stockholm. The individuals were invited to a clinical examination, an interview and a radiographic examination. The incidence of mortality during the years 1970-2014 as well as the causes of death according to the death certificate were registered in 2015. Cox regression survival analysis was used for investigating the effect of several variables upon the time to the outcome of death. RESULTS: Forty-six percent of the subjects were still alive at the end of the year 2014. Cancers caused 27% of the deaths, while 22% died due to CVD. The mortality risk was positively and significantly correlated to oral health when compensated for age, sex, smoking and social status. In addition, the mortality risk caused by CVD, cancer or other reasons was significantly increased for those with poor oral health. CONCLUSIONS: Oral health was found to be a risk indicator of death caused by CVD and cancer as well as for all-cause mortality. Thus, the associations are unspecific. Harmful lifestyle factors impact dental health behavior as well as mortality risk. This might contribute to the association between oral health and mortality risk.
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