title: Factors associated with having less than 20 natural teeth in rural adults: a cross-sectional study.
abstract: BACKGROUND
  Some systematic reviews have consistently indicated a positive link between Metabolic syndrome, impairedfasting glucose, all-cause or circulatory disease-related mortality, general health, periodontitis, and toothloss. This study was to examine the prevalence of number of remaining teeth <20 and associated risk factors among adults in a rural area of Taiwan.
  
  
  METHODS
  A community-based, cross-sectional study was conducted in southwestern coastal Taiwan in 2013; 6680 residents aged 20-64 years were studied. Oral hygiene, substance use, dietary habits, and metabolic syndrome were explored as potential risk factors for number of remaining teeth <20 using logistic regression analysis.
  
  
  RESULTS
  The mean number of remaining teeth was 24.6 (SD = 7.4), and 16.3 % (n = 1085) of the participants had number of remaining teeth <20. Men had significantly less frequent use of dental floss, unhealthy dietary habits, more substance use and metabolic syndrome than did women (p <0.001). However, women tended to have fewer teeth than men (p <0.001). After adjusting for potential confounders, older age (odds ratio [OR] = 4.56, 95 % confidence interval [CI]: 3.74-5.55), female (OR = 1.88, 95 % CI: 1.56-2.25), less education (OR = 2.40, 95 % CI: 1.90-3.02), infrequent use of dental floss (OR = 1.94, 95 % CI: 1.66-2.27), substance use (OR = 1.32, 95 % CI: 1.09-1.59), and number of metabolic syndrome components (OR = 1.10, 95 % CI: 1.04-1.16) were independently associated with a higher risk of number of remaining teeth <20.
  
  
  CONCLUSIONS
  Number of remaining teeth <20 was highly prevalent among rural adults. In addition to unmodifiable factors, infrequent use of dental floss, substance use, and metabolic syndrome were risk factors associated with tooth loss.
authors.affiliation: College of Nursing, Chang Gung University of Science and Technology, Taoyuan city, Taiwan, Republic of China. sjtsai@mail.cgust.edu.tw.
authors.forename: Su-Jen
authors.initials: SJ
authors.lastname: Tsai
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin County, Taiwan, Republic of China. mingshyan@gmail.com.
authors.forename: Ming-Shyan
authors.initials: MS
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin County, Taiwan, Republic of China. wendy0625@cgmh.org.tw.
authors.forename: Wen-Nan
authors.initials: WN
authors.lastname: Chiu
authors.affiliation: Nursing Department, Chang Gung University of Science and Technology, Taoyuan city, Taiwan, Republic of China. swjane@mail.cgust.edu.tw.
authors.forename: Su-Whi
authors.initials: SW
authors.lastname: Jane
authors.affiliation: Division of Dentistry, Chang Gung Memorial Hospital, Yunlin County, Taiwan, Republic of China. final1024@adm.cgmh.org.tw.
authors.forename: Liang-Tse
authors.initials: LT
authors.lastname: Tu
authors.affiliation: College of Nursing, Chang Gung University of Science and Technology, Taoyuan city, Taiwan, Republic of China. meiyen@mail.cgust.edu.tw.
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D009066:Mouth, Edentulous; D009910:Oral Hygiene; D012307:Risk Factors; D012424:Rural Population; D013624:Taiwan; D016388:Tooth Loss / Q000453:epidemiology*; D055815:Young Adult