title: Social stratification and tooth loss among middle-aged and older Americans from 1988 to 2004.
abstract: OBJECTIVE
  Tooth retention has improved over the past few decades, but it is not known whether these trends have been observed across all demographic/socioeconomic subgroups. We examined number of missing teeth among dentate individuals (n = 9,113) as well as edentulism and systematically modeled their trends over time by using clinical examination data.
  
  
  METHODS
  We investigated the association between social stratification and trends in tooth retention among adults ages 50+ from 1988 to 2004, using four waves of the National Health and Nutrition Examination Surveys (NHANES) (n = 11,812).
  
  
  RESULTS
  The prevalence of edentulism declined from 24.6% in NHANES III (1988-1994) to 17.4% in 2003-2004, and the mean number of missing teeth declined from 8.19 to 6.50. Older participants, Blacks, the less educated and those with lower income were higher on both edentulism and number missing teeth. Both edentulism and number of missing teeth declined over time, but their patterns varied. For edentulism, age and socioeconomic related disparities decreased over time due to more decline among older and low-income participants. For missing teeth, there was less decrement among older and low-income participants, resulting in increased age and socioeconomic related disparities.
  
  
  CONCLUSIONS
  Our study found disparities in trends of tooth loss across demographic/socioeconomic strata. Findings suggest that racial/ethnic disparities are partially explained by socioeconomic status. Interventions designed to improve oral health for older adults, particularly those with low levels of income, need special attention.
authors: School of Nursing, Duke University, Durham, NC, USA; Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA; Global Health Institute, Duke University, Durham, NC, USA.
authors: Bei
authors: B
authors: Wu
authors: Celia
authors: C
authors: Hybels
authors: Jersey
authors: J
authors: Liang
authors: Lawrence
authors: L
authors: Landerman
authors: Brenda
authors: B
authors: Plassman
mesh_terms: D000368:Aged; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class; D016388:Tooth Loss / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: edentulism; middle-aged; older adults; tooth loss; trends