title: Patterns of tooth loss in older adults with and without dementia: a retrospective study based on a Minnesota cohort.
abstract: OBJECTIVE
  To study tooth loss patterns in older adults with dementia.
  
  
  METHODS
  Retrospective longitudinal study.
  
  
  METHODS
  A community-based geriatric dental clinic in Minnesota.
  
  
  METHODS
  Four hundred ninety-one older adults who presented to the study clinic as new patients during the study period, remained dentate after finishing the initial treatment plan, and returned for care at least once thereafter were retrospectively selected. One hundred nineteen elderly people with International Classification of Diseases, Ninth Revision, codes 290.x, 294.1, or 331.2 or a plain-text diagnosis of dementia, Alzheimer's disease, or chronic brain syndrome in the medical history were considered having dementia.
  
  
  METHODS
  All existing dental conditions were treated before enrollment. Dental treatment was continually provided for all participants during follow-up.
  
  
  METHODS
  Tooth loss patterns, including time to first tooth loss, number of tooth loss events, and number of teeth lost per patient-year were estimated and compared for participants with and without dementia using Cox, Poisson, and negative-binomial regressions.
  
  
  RESULTS
  Participants with dementia arrived with an average of 18 and those without dementia with an average of 20 teeth; 27% of remaining teeth in the group with dementia were decayed or retained roots, higher than in the group without dementia (P<.001). Patterns of tooth loss did not significantly differ between the two groups; 11% of participants in both groups had lost teeth by 12 months of follow-up. By 48 months, 31% of participants without dementia and 37% of participants with dementia had lost at least one tooth (P=.50). On average, 15% of participants in both groups lost at least one tooth each year. Mean numbers of teeth lost in 5 years were 1.21 for participants with dementia and 1.01 for participants without dementia (P=.89).
  
  
  CONCLUSIONS
  Based on data available in a community-based geriatric dental clinic, dementia was not associated with tooth loss. Although their oral health was poor at arrival, participants with dementia maintained their dentition as well as participants without dementia when dental treatment was provided.
authors.affiliation: Department of Dental Ecology, University of North Carolina School of Dentistry, Chapel Hill, North Carolina 27599, USA. xi_chen@dentistry.unc.edu
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Shuman
authors.forename: James S
authors.initials: JS
authors.lastname: Hodges
authors.forename: Laël C
authors.initials: LC
authors.lastname: Gatewood
authors.forename: Jia
authors.initials: J
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016010:Binomial Distribution; D015331:Cohort Studies; D004245:DMF Index; D003704:Dementia / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D016012:Poisson Distribution; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016388:Tooth Loss / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy