Two-year incidence of tooth loss among South Australians aged 60+ years.
Tooth loss diminishes oral function and quality of life, and national health targets aim to reduce population levels of tooth loss.


OBJECTIVE
The purpose of this study was to determine tooth loss incidence and predictors of tooth loss among older adults in South Australia.


METHODS
Data were obtained from a cohort study of a stratified random sample of community-dwelling dentate people aged 60+ years. Interviews and oral examinations were conducted among 911 individuals at baseline and among 693 of them (76.1%) 2 years later. Incidence rates and relative risks were calculated for population subgroups and multivariate logistic regression was used to construct risk prediction models. A method was developed to calculate 95% confidence intervals (95% CI) for relative risks (RR) from logistic regression models using a Taylor series approximation.


RESULTS
Some 19.5% (95% CI = 15.4-23.6%) of people lost one or more teeth during the 2 years. Men, people with a recent extraction, people who brushed their teeth infrequently, smokers and people born outside Australia had significantly (P < 0.05) greater risk of tooth loss. Baseline clinical predictors of tooth loss included more missing teeth, retained roots, decayed root surfaces, periodontal pockets and periodontal recession. In a multivariate model that controlled for baseline clinical predictors, former smokers (RR = 2.55, 95% CI = 1.48-4.40) and current smokers (RR = 2.06, 95% CI = 0.92-4.62) had similarly elevated risks of tooth loss compared with non-smokers.


CONCLUSIONS
The findings from this population suggest that a history of smoking contributes to tooth loss through mechanisms in addition to clinical disease processes alone.
Slade
G D
GD
Department of Dental Ecology, University of North Carolina, Chapel Hill 27599-7450, USA.
Gansky
S A
SA
Spencer
A J
AJ
D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005889:Gingival Recession / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000502:physiology; D015999:Multivariate Analysis; D010514:Periodontal Pocket / Q000453:epidemiology; D010808:Physical Examination; D011788:Quality of Life; D012111:Residence Characteristics / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D017213:Root Caries / Q000453:epidemiology; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013021:South Australia / Q000453:epidemiology; D014076:Tooth Diseases / Q000453:epidemiology; D014081:Tooth Extraction / Q000706:statistics & numerical data; D016388:Tooth Loss / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D014092:Tooth Root / Q000473:pathology; D014099:Toothbrushing / Q000706:statistics & numerical data