title: Cumulative lead exposure and tooth loss in men: the normative aging study.
abstract: BACKGROUND
  Individuals previously exposed to lead remain at risk because of endogenous release of lead stored in their skeletal compartments. However, it is not known if long-term cumulative lead exposure is a risk factor for tooth loss.
  
  
  OBJECTIVE
  We examined the association of bone lead concentrations with loss of natural teeth.
  
  
  METHODS
  We examined 333 men enrolled in the Veterans Affairs Normative Aging Study. We used a validated K-shell X-ray fluorescence (KXRF) method to measure lead concentrations in the tibial midshaft and patella. A dentist recorded the number of teeth remaining, and tooth loss was categorized as 0, 1-8 or > or = 9 missing teeth. We used proportional odds models to estimate the association of bone lead biomarkers with tooth loss, adjusting for age, smoking, diabetes, and other putative confounders.
  
  
  RESULTS
  Participants with > or = 9 missing teeth had significantly higher bone lead concentrations than those who had not experienced tooth loss. In multivariable-adjusted analyses, men in the highest tertile of tibia lead (> 23 microg/g) and patella lead (> 36 microg/g) had approximately three times the odds of having experienced an elevated degree of tooth loss (> or = 9 vs. 0-8 missing teeth or > or = 1 vs. 0 missing teeth) as those in the lowest tertile [prevalence odds ratio (OR) = 3.03; 95% confidence interval (CI), 1.60-5.76 and OR = 2.41; 95% CI, 1.30-4.49, respectively]. Associations between bone lead biomarkers and tooth loss were similar in magnitude to the increased odds observed in participants who were current smokers.
  
  
  CONCLUSIONS
  Long-term cumulative lead exposure is associated with increased odds of tooth loss.
authors.affiliation: Environmental and Occupational Medicine and Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA. marora@hsph.harvard.edu
authors.forename: Manish
authors.initials: M
authors.lastname: Arora
authors.forename: Jennifer
authors.initials: J
authors.lastname: Weuve
authors.forename: Marc G
authors.initials: MG
authors.lastname: Weisskopf
authors.forename: David
authors.initials: D
authors.lastname: Sparrow
authors.forename: Huiling
authors.initials: H
authors.lastname: Nie
authors.forename: Raul I
authors.initials: RI
authors.lastname: Garcia
authors.forename: Howard
authors.initials: H
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D004781:Environmental Exposure; D006801:Humans; D007854:Lead / Q000097:blood* / Q000378:metabolism / Q000633:toxicity; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016388:Tooth Loss / Q000097:blood* / Q000209:etiology* / Q000378:metabolism; D055815:Young Adult
chemical_list: D007854:Lead