title: Multidimensional risk assessment for tooth loss in a geriatric population with diverse medical and dental backgrounds.
abstract: OBJECTIVE
  To introduce a multidimensional approach to assess risk of tooth loss for older adults with diverse medical and dental backgrounds.
  
  
  METHODS
  Retrospective longitudinal study.
  
  
  METHODS
  Community-based geriatric dental clinic in Minnesota.
  
  
  METHODS
  Four hundred ninety-one older adults who presented to the studied clinic as new patients between October 1999 and December 2006, remained dentate after finishing the initial treatment plan, and returned for care at least once thereafter were selected as participants.
  
  
  METHODS
  All existing dental conditions were treated before enrollment. Comprehensive dental care was continually provided for all participants during follow-up.
  
  
  METHODS
  Demographic information, together with medical, dental, functional, and cognitive assessment at arrival, was abstracted from dental records. Logistic, Cox, Poisson, and negative-binomial regressions were developed to assess risk of tooth loss from four dimensions: likelihood of tooth loss, time to first tooth loss, and frequency and rate of tooth loss per person-year.
  
  
  RESULTS
  Although the traditional single-dimensional risk assessment approach indicated that number of teeth being carious or retaining roots at arrival was the only contributing factor for tooth loss in older adults, the multidimensional approach found that risk factors of tooth loss differed when assessed from different perspectives. While likelihood of tooth loss and time to first tooth loss were associated only with dental factors, both dental and nondental factors were associated with frequency and rate of tooth loss.
  
  
  CONCLUSIONS
  A single-dimensional risk assessment approach focusing on likelihood of tooth loss alone fails to provide a comprehensive risk profile for older adults. A multidimensional approach should be considered during assessment and treatment planning.
authors.affiliation: Department of Dental Ecology, University of North Carolina, Chapel Hill, North Carolina 27599, USA. xi_chen@dentistry.unc.edu
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Jennifer J J
authors.initials: JJ
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003753:Dental Health Surveys; D003792:Dental Records / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006801:Humans; D016013:Likelihood Functions; D008134:Long-Term Care / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data; D016388:Tooth Loss / Q000453:epidemiology* / Q000209:etiology