Consequences of success: do more teeth translate into more disease and utilization?
OBJECTIVE
Increased tooth retention coupled with increased numbers of older adults means that the actual number of teeth at risk to dental disease will increase sharply. Whether this increase in the number of teeth will translate into more disease and utilization in unknown. The purpose of this study was to test this "more teeth, therefore more dental disease" theory using cross-sectional data.


METHODS
In-home personal interview and oral examination data were obtained on a probability sample of elders aged 70 years and older living in the six New England states using the Medicare beneficiary list as a sampling frame. Data on dental utilization, number of teeth, dental caries, and periodontal disease were included in the current analysis.


RESULTS
Analysis of variance on subjects with 1-10 (Group 1), 11-24 (Group 2), and 25-32 (Group 3) teeth show that the extent of bleeding on probing, pocket depth, and loss of attachment all increase as numbers of teeth increase. Similarly, a greater number of restored coronal and root surfaces were found in Group 3 relative to the other two groups. Mean numbers of decayed and filled coronal surfaces were 8.4 in Group 1.33.0 in Group 2, and 50.3 in Group 3. In contrast, unrestored coronal and root surface were significantly higher in Group 1 (mean root DS = 1.3) than Group 3 (mean root DS = 0.3). Utilization patterns of those with successful aging dentitions (Group 3) show that they are visiting dentists more frequently than the compromised group (Group 1).


CONCLUSIONS
These cross-sectional data obtained from a probability sample of New England elders show that subjects who retained higher numbers of teeth have more periodontal disease and dental caries experience, and visit the dentist more frequently.
Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA. joshi@warren.med.harvard.edu
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Joshi
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Douglass
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Feldman
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Mitchell
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Jette
D000368:Aged; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D004245:DMF Index; D016321:Dental Care for Aged / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000453:epidemiology; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D003817:Dentition; D005260:Female; D005884:Gingival Hemorrhage / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009511:New England / Q000453:epidemiology; D017622:Periodontal Attachment Loss / Q000453:epidemiology; D010510:Periodontal Diseases / Q000453:epidemiology; D010514:Periodontal Pocket / Q000453:epidemiology; D010808:Physical Examination; D011336:Probability; D012307:Risk Factors; D017213:Root Caries / Q000453:epidemiology; D019228:Tooth Crown; D014076:Tooth Diseases / Q000453:epidemiology*; D014092:Tooth Root