title: Is Social Network Diversity Associated with Tooth Loss among Older Japanese Adults?
abstract: BACKGROUND
  We sought to examine social network diversity as a potential determinant of oral health, considering size and contact frequency of the social network and oral health behaviors.
  
  
  METHODS
  Our cross-sectional study was based on data from the 2010 Japan Gerontological Evaluation Study. Data from 19,756 community-dwelling individuals aged 65 years or older were analyzed. We inquired about diversity of friendships based on seven types of friends. Ordered logistic regression models were developed to determine the association between the diversity of social networks and number of teeth (categorized as ≥20, 10-19, 1-9, and 0).
  
  
  RESULTS
  Of the participants, 54.1% were women (mean age, 73.9 years; standard deviation, 6.2). The proportion of respondents with ≥20 teeth was 34.1%. After adjusting for age, sex, socioeconomic status (income, education, and occupation), marital status, health status (diabetes and mental health), and size and contact frequency of the social network, an increase in the diversity of social networks was significantly associated with having more teeth (odds ratio = 1.08; 95% confidence interval, 1.04-1.11). Even adjusted for oral health behaviors (smoking, curative/preventive dental care access, use of dental floss/fluoride toothpaste), significant association was still observed (odds ratio = 1.05 (95% confidence interval, 1.02-1.08)).
  
  
  CONCLUSIONS
  Social connectedness among people from diverse backgrounds may increase information channels and promote the diffusion of oral health behaviors and prevent tooth loss.
authors.affiliation: Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.
authors.forename: Jun
authors.identifier: http://orcid.org/0000-0002-8405-9872
authors.initials: J
authors.lastname: Aida
authors.affiliation: Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.|Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kondo
authors.affiliation: Division of Dental Sociology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.|Department of Social Welfare, Nihon Fukushi University, Mihama, Japan.
authors.forename: Masashige
authors.initials: M
authors.lastname: Saito
authors.affiliation: Division of Oral Health Sciences, Department of Health Sciences, School of Health and Social Services, Saitama Prefectural University, Koshigaya, Japan.
authors.forename: Kanade
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Policy Studies, Aichi Gakuin University, Nisshin, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Osaka
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D012944:Social Support; D016388:Tooth Loss / Q000453:epidemiology*