title: Dental status as a predictor of mortality among nursing facility residents in eastern Iowa.
abstract: OBJECTIVE
  This study aimed to evaluate dental status (ie, number of teeth and presence of removable dental prostheses) as a predictor of all-cause mortality among nursing facility residents.
  
  
  BACKGROUND
  Edentulism has been associated with poorer health outcomes in geriatric populations.
  
  
  METHODS
  Between March 2006 and June 2008, oral health screening examinations were completed for 584 residents of 10 nursing facilities in four eastern Iowa counties. In September 2013, demographic, general and oral health information was obtained from the screening forms and linked with Iowa state death certificate data. The study outcome (time to death) was defined as the number of days between the screening examination and death. Univariate and bivariate distributions were assessed, and multivariable Cox proportional hazards regression models were generated to arrive at factors associated with time to death.
  
  
  RESULTS
  A total of 535 residents were eligible for data analysis. Age at screening ranged from 60-103 years (mean=85.2), 70% were female, and 33% were edentulous. By September 2013, 468 (87.5%) had died, with a median time to death among these individuals of 2.0 years. The final multivariable Cox model included data from 393 (73.4%) of the residents; statistically significant relationships were observed between time to death and dental status, age, sex, cooperativeness with care providers and renal disease.
  
  
  CONCLUSIONS
  Dental status remained strongly associated with time to death even after controlling for other important demographic and health-related factors.
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Caplan
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Tariq S
authors.initials: TS
authors.lastname: Ghazal
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Cowen
authors.affiliation: Department of Restorative Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA.
authors.forename: Deise C
authors.initials: DC
authors.lastname: Oliveira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007484:Iowa; D008297:Male; D009066:Mouth, Edentulous / Q000401:mortality; D009735:Nursing Homes; D009909:Oral Health; D016016:Proportional Hazards Models
keywords: aged; edentulous; institutionalisation; mortality, nursing homes; survival analysis