title: Social determinants of denture/bridge use: Japan gerontological evaluation study project cross-sectional study in older Japanese.
abstract: BACKGROUND
  Studies suggest that using a denture/bridge may prevent disability in older people. However, not all older people with few remaining teeth use a denture/bridge. This cross-sectional study aimed to examine the social determinants which promote denture/bridge use among older Japanese.
  
  
  METHODS
  A total of 54,388 (25,630 males and 28,758 females) community-dwelling individuals aged 65 or over, living independently, able to perform daily activities, and with 19 or fewer teeth. The dependent variable was denture/bridge use. Socio-demographics, number of teeth, present illness, social participation, social support, and social networks were used as individual-level independent variables. Data for social capital were aggregated and used as local district (n = 561 for males, n = 562 for females) -level independent variables. Number of dentists working in hospitals/clinics per population and population density were used as municipality (n = 28) -level independent variables. Three-level multilevel Poisson regression analysis was performed for each sex.
  
  
  RESULTS
  High equivalent income, low number of teeth, present illness, and living in a municipality with high population density were significantly associated with denture/bridge use in both sexes in the fully adjusted models (p < 0.05). Denture/bridge use was significantly associated with high educational attainment in males and participating in social groups in females in the fully adjusted model (p < 0.05). No significant associations were observed between denture/bridge use and social capital.
  
  
  CONCLUSIONS
  Denture/bridge use was significantly associated with high economic status and present illness in both sexes, high educational attainment in males, and participation in social groups in females among community-dwelling older Japanese after adjusting for possible confounders.
authors.affiliation: Department of Dental Sociology, Kanagawa Dental University Graduate School of Dentistry, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan. yamamoto.tatsuo@kdu.ac.jp.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kondo
authors.forename: Jun
authors.initials: J
authors.lastname: Aida
authors.forename: Kayo
authors.initials: K
authors.lastname: Suzuki
authors.forename: Jimpei
authors.initials: J
authors.lastname: Misawa
authors.forename: Miyo
authors.initials: M
authors.lastname: Nakade
authors.forename: Shinya
authors.initials: S
authors.lastname: Fuchida
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hirata
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003817:Dentition; D003824:Denture, Complete / Q000706:statistics & numerical data*; D003829:Denture, Partial / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D057187:Independent Living; D007398:Interpersonal Relations; D007564:Japan; D008297:Male; D011156:Population Density; D011446:Prospective Studies; D012737:Sex Factors; D066270:Social Capital; D012923:Social Class; D064890:Social Determinants of Health; D012944:Social Support; D014504:Urban Health