Premature gray hair development in the interbrow region owing to the loss of maxillary first molars in young mice.

The exact sites of premature hair graying and whether tooth loss causes this condition remain unknown. In this study, we aimed to explore the effect of reduced mastication on premature hair graying. Maxillary first molars were extracted from young mice, and the mice were observed for 3 months, along with non-extraction control group mice. After 3 months, gray hair emerged in the interbrow region of mice in the tooth extraction group but not in the control group. The expression of tyrosinase-related protein-2 (TRP-2) mRNA was lower in the interbrow tissues of young mice without maxillary molars than in those with maxillary molars. Tooth loss leads to interbrow gray hair growth, possibly because of weakened trigeminal nerve input, suggesting that reduced mastication causes premature graying. Thus, prompt prosthetic treatment after molar loss is highly recommended.

Dental health and lung cancer risk in the Golestan Cohort Study.

BACKGROUND: Poor oral health has been linked to various systemic diseases, including multiple cancer types, but studies of its association with lung cancer have been inconclusive. METHODS: We examined the relationship between dental status and lung cancer incidence and mortality in the Golestan Cohort Study, a large, prospective cohort of 50,045 adults in northeastern Iran. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between three dental health measures (i.e., number of missing teeth; the sum of decayed, missing, or filled teeth (DMFT); and toothbrushing frequency) and lung cancer incidence or mortality with adjustment for multiple potential confounders, including cigarette smoking and opium use. We created tertiles of the number of lost teeth/DMFT score in excess of the loess adjusted, age- and sex-specific predicted numbers, with subjects with the expected number of lost teeth/DMFT or fewer as the reference group. RESULTS: During a median follow-up of 14 years, there were 119 incident lung cancer cases and 98 lung cancer deaths. Higher DMFT scores were associated with a progressively increased risk of lung cancer (linear trend, p = 0.011). Compared with individuals with the expected DMFT score or less, the HRs were 1.27 (95% CI: 0.73, 2.22), 2.15 (95% CI: 1.34, 3.43), and 1.52 (95% CI: 0.81, 2.84) for the first to the third tertiles of DMFT, respectively. The highest tertile of tooth loss also had an increased risk of lung cancer, with a HR of 1.68 (95% CI: 1.04, 2.70) compared with subjects with the expected number of lost teeth or fewer (linear trend, p = 0.043). The results were similar for lung cancer mortality and did not change substantially when the analysis was restricted to never users of cigarettes or opium. We found no associations between toothbrushing frequency and lung cancer incidence or mortality. CONCLUSION: Poor dental health indicated by tooth loss or DMFT, but not lack of toothbrushing, was associated with increased lung cancer incidence and mortality in this rural Middle Eastern population.

Association of endogenous sex hormone levels with tooth loss due to periodontitis in men and post-menopausal women: The multi-ethnic study of atherosclerosis.

AIM: To investigate the association between endogenous sex hormone levels and history of tooth loss related to periodontitis in healthy middle-aged to older men and post-menopausal women. METHODS: This cross-sectional study included 5649 participants aged 45-84 (mean age, 63 ± 10 years) from the Multi-Ethnic Study of Atherosclerosis cohort who had sex hormone levels measured and answered a questionnaire regarding perceived periodontal status at exam 1. Multivariable logistic regression was used to examine the association of sex hormones (exposure) with history of tooth loss (outcome), stratified by sex. RESULTS: Among post-menopausal women, higher free testosterone (per 1SD) was associated with a greater prevalence of tooth loss [OR 1.49 (95% CI, 1.08-2.05)], whereas higher sex hormone binding globulin (SHBG) was associated with a lower prevalence of tooth loss [OR 0.74 (0.58-0.94)], after adjustment for cardiometabolic risk factors and reproductive factors. In men, higher free testosterone and lower SHBG were associated with a lower prevalent probability of tooth loss in unadjusted analysis, but these associations lost significance after covariate adjustment. CONCLUSION: A higher androgenic sex hormone profile in post-menopausal women (i.e., increased free testosterone, lower SHBG) was associated with an increased prevalence of tooth loss, after adjusting cardiometabolic risk factors. No such association was found in men. These findings suggest that sex hormones may influence or serve as a marker for periodontal health.

Influence of mobility on the long-term risk of tooth extraction/loss in periodontitis patients. A systematic review and meta-analysis.

The aim of this systematic review (SR) was to assess whether tooth mobility (TM) increases the risk of tooth extraction/loss. The protocol was registered in PROSPERO database (CRD42023485425). The focused PECO questions were as follows: (1) "In patients with periodontitis, undergoing periodontal treatment, are teeth affected by mobility at higher risk of being extracted/lost compared to non-mobile teeth, with a minimum follow-up of 10 years?" and (2) "In these patients, does varying degrees of tooth mobility increase the risk of tooth extraction/loss, with a minimum follow-up of 10 years?". Results were reported according to PRISMA statement. Electronic and manual searches were conducted to identify longitudinal studies. The different assessments of tooth mobility were pooled into three groups: TM0: Undetectable tooth mobility, TM1: Horizontal/Mesio-distal mobility ≤1 mm, TM2: Horizontal/Mesio-distal mobility >1 mm or vertical tooth mobility. Tooth loss was the primary outcome. Various meta-analyses were conducted, including subgroup analyses considering different follow-up lengths and the timing of TM assessment, along with sensitivity analyses. A trial sequential analysis was also performed. Eleven studies were included (1883 patients). The mean follow-up range was 10-25 years. The weighted total of included teeth, based on the sample size, was 18 918, with a total of 1604 (8.47%) extracted/lost teeth. The overall rate of tooth extraction/loss increased with increasing mobility: TM0 was associated with a 5.85% rate (866/14822), TM1 with the 11.8% (384/3255), TM2 with the 40.3% (339/841). Mobile teeth (TM1/TM2) were at an increased risk for tooth extraction/loss, compared to TM0 (HR: 2.85; [95% CI 1.88-4.32]; p < .00001). TM1 had a higher risk than TM0 (HR: 1.96; [95% CI 1.09-3.53]; p < .00001). TM2 had a higher risk than TM1 (HR: 2.85; [95% CI 2.19-3.70]; p < .00001) and TM0 (HR: 7.12; [95% CI 3.27-15.51]; p < .00001). The results of the tests for subgroup differences were not significant. Sensitivity meta-analyses yielded consistent results with other meta-analyses. Within the limits of the quality of the studies included in the meta-analyses, mobile teeth were at higher risk of being extracted/lost in the long-term and higher degrees of TM significantly influenced clinicians' decision to extract a tooth. However, most teeth can be retained in the long-term and thus TM should not be considered a reason for extraction or a risk factor for tooth loss, regardless of the degree of TM.

A nomogram-based predictive model for tooth survival in Chinese patients with periodontitis: An 11-year retrospective cohort study.

AIM: To develop a nomogram-based predictive model of tooth survival by comprehensively analysing clinical and radiographic risk factors of tooth loss (TL). MATERIALS AND METHODS: In this study, 3447 teeth of 131 subjects who underwent non-surgical periodontal treatment were examined retrospectively within a mean follow-up period of 11.6 years. The association of risk factors including clinical and radiographic parameters with TL was assessed using univariate and multivariate Cox regression analyses. A nomogram-based predictive model was developed, and its validation and discriminatory ability were analysed. RESULTS: In all, 313 teeth were lost in 94 patients in this study (overall tooth loss [OTL] 9.08%; 0.21 teeth/patient/year). Male, heavy smoking, molar teeth, probing depth (PD), attachment loss (AL), tooth mobility and radiographic bone loss were significantly associated with TL (p < .05). A gradient effect of tooth mobility on TL increased from degree I to III versus none (p < .0001). The area under the curve (AUC) of the model was 0.865. Calibration curve and decision curve analysis demonstrated good performance and high net benefit, respectively. CONCLUSIONS: Adopting a specific nomogram could facilitate the prediction of tooth survival and the development of tailored treatment plans in Chinese patients with advanced periodontitis.

Tooth loss during supportive periodontal care: A prospective study.

AIM: To assess periodontal stability and the association between tooth- and patient-related factors and tooth loss during supportive periodontal care (SPC). MATERIALS AND METHODS: A prospective observational study was carried out on previously treated periodontitis patients followed up for 5 years in SPC. The risk profile (low, moderate, high) of each patient based on periodontal risk assessment (PRA) scoring at baseline was evaluated, and tooth loss rates were analysed. RESULTS: Two hundred patients were included in the study, and 143 had 5-year follow-up data available for analysis. The overall annual tooth loss per patient was 0.07 ± 0.14 teeth/patient/year. Older age, smoking, staging and grading were associated with increased tooth loss rates. Most patients whose teeth were extracted belonged to the PRA high-risk group. Both PRA and a tooth prognosis system used at baseline showed high negative predictive value but low positive predictive value for tooth loss during SPC. CONCLUSIONS: Overall, the tooth loss rate of periodontitis patients in this prospective cohort study under SPC in private practice was low. Both tooth-based and patient-based prognostic systems can identify high-risk cases, but their positive predictive value should be improved.

Serum lipoprotein subfractions are associated with the periodontal status: Results from the population-based cohort SHIP-TREND.

AIM: To investigate the medium-term associations of serum protein subfractions derived from proton nuclear magnetic resonance (1 H-NMR) spectroscopy with periodontitis and tooth loss. MATERIALS AND METHODS: A total of 3031 participants of the cohort Study of Health in Pomerania (SHIP-TREND) were included. In addition to conventional serum testing, serum lipoprotein contents and subfractions were analysed by 1 H-NMR spectroscopy. Confounder-adjusted associations of lipoprotein variables with periodontitis and the number of missing teeth variables were analysed using mixed-effects models with random intercepts for time across individuals, accounting for multiple testing. RESULTS: While only spurious associations between lipoprotein levels from conventional blood tests were found-that is, triglycerides were associated with mean clinical attachment level (CAL) and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio with the number of missing teeth - several associations emerged from serum lipoprotein subfractions derived from 1 H-NMR analysis. Specifically, elevated LDL triglycerides were associated with higher levels of mean probing depth (PD), mean CALs, and increased odds of having <20 teeth. HDL-4 cholesterol levels were inversely associated with mean PD. Systemic inflammation (C-reactive protein) might mediate the effects of LDL and HDL triglyceride contents on periodontitis severity. CONCLUSIONS: Several associations between serum lipoprotein subfractions and periodontitis were observed. As the underlying biochemical mechanisms remain unclear, further research is needed.

Association of tooth location, occlusal support and chewing ability with cognitive decline and incident dementia.

AIM: Emerging evidence suggests association of tooth loss with impaired cognition. However, the differential effects of anterior versus posterior tooth loss, occlusal support loss and chewing ability are not considered comprehensively. MATERIALS AND METHODS: We conducted cross-sectional (N = 4036) and longitudinal analyses (N = 2787) on data from Health 2000 and 2011 Surveys for associations of posterior occlusal support loss, anterior versus posterior tooth loss, and chewing ability with baseline cognition and 11-year cognitive decline. Additionally, 15-year incident dementia risk was investigated (N = 4073). RESULTS: After considering relevant confounders and potential reverse causality bias, posterior occlusal support loss significantly increased dementia risk across all categories indicative of posterior occlusal support loss (hazard ratios [HRs] between 1.99 and 2.89). Bilateral inadequate posterior occlusal support was associated with 11-year decline in overall cognition (odds ratio [OR] = 1.48:1.00-2.19), and unilateral inadequate posterior occlusal support with total immediate (OR = 1.62:1.14-2.30) and delayed recall decline (OR = 1.45:1.03-2.05). Moreover, posterior tooth loss was associated with dementia (HR = 2.23:1.27-3.91) and chewing ability with total immediate decline (OR = 1.80:1.04-3.13). CONCLUSIONS: Posterior tooth and occlusal support loss significantly increases dementia risk. The impact of posterior occlusal support loss appears to be dose-dependent, and this effect is distinct from that of dentures. Dental healthcare services should be particularly attentive to the state of posterior dentition. Further studies exploring possible mechanisms are warranted.

Association between dietary patterns and periodontal disease: The OsteoPerio cohort study.

AIM: To examine the association of dietary patterns with periodontal disease (PD) and its progression over 5 years. MATERIALS AND METHODS: Analyses involved 1197 post-menopausal women from the OsteoPerio cohort. Dietary patterns assessed include Healthy Eating Index-2015 (HEI), Alternative HEI (AHEI), Dietary Approaches to Stop Hypertension (DASH) and alternate Mediterranean Diet (aMed) at baseline (the average of two food frequency questionnaires administered between 1993 and 2001). At baseline and the 5-year follow-up, periodontal assessments evaluated alveolar crestal height (ACH), probing pocket depth (PPD), clinical attachment loss (CAL), percentage of gingival sites bleeding on probing (%BOP) and missing teeth due to PD. Linear and logistic regression were used to examine the associations. RESULTS: Cross-sectionally, HEI and aMed were associated with smaller CAL and %BOP; along with DASH, they were associated with a decreased odds of teeth missing due to PD. AHEI and aMed were associated with a decreased odds of severe PD. Prospectively, AHEI was associated with greater ACH progression. This association was attenuated to the null after loss of ACH was imputed for teeth lost due to PD over follow-up, or after excluding participants with diabetes, osteoporosis, hypertension or heart disease at baseline. CONCLUSIONS: Better adherence to healthy dietary patterns was associated with better PD measures cross-sectionally but greater progression of ACH over 5 years. The latter might be explained by incident tooth loss due to PD and pre-existing comorbidities.

Interdental cleaning aids are beneficial for oral health at 7-year follow-up: Results from the Study of Health in Pomerania (SHIP-TREND).

AIM: To estimate association between the use of interdental cleaning aids (IDAs) and type on 7-year follow-up levels of interdental plaque, interdental gingival inflammation, interdental periodontitis severity, the number of interdental sound surfaces and the number of missing teeth in a population-based cohort study. MATERIALS AND METHODS: We used 7-year follow-up data of 2224 participants from the Study of Health in Pomerania (SHIP-TREND). We applied generalized linear and ordinal logistic models, adjusting for confounding and selection bias using inverse probability treatment weighting and multiple imputation. RESULTS: Flossers were 32% less likely to have higher interdental plaque (iPlaque) levels than non-users of IDAs (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.50-0.94); flossing resulted in 5% lower means of iPlaque. Effects on interdental bleeding on probing (iBOP), mean interdental probing depths and mean interdental clinical attachment levels were direction-consistent but statistically non-significant. Interdental brushing was associated with lower follow-up levels for interdental plaque (OR = 0.73; 95% CI: 0.57-0.93) and iBOP (OR = 0.69; 95% CI: 0.53-0.89). IDAs were more effective in reducing iPlaque in participants with periodontitis, whereas iBOP reduction was more pronounced in participants with no or mild periodontitis. The analyses did not suggest that the use of IDAs affected caries. Finally, applying change score analyses, flossing reduced tooth loss incidence (incidence rate ratio [IRR] = 0.71) compared with non-users of IDAs. CONCLUSIONS: Recommending flossing and interdental brushing in dental practices represents an approach to the prevention of gingivitis and consequently periodontitis.

Survival time analysis of remaining teeth following replacement of unilateral free-end missing teeth: A comparison between fixed implant-supported prostheses and removable partial dentures.

OBJECTIVES: This retrospective study aimed to investigate the differences in tooth loss rate between fixed implant-supported prostheses (FISPs) and removable partial dentures (RPDs) in cases of unilateral free-end missing teeth. MATERIALS AND METHODS: The data of 324 patients who underwent treatment with FISPs or RPDs for unilateral free-end missing teeth and satisfied the applicable criteria, were evaluated (47 in the FISPs group and 277 in the RPDs group). After propensity score (PS) matching, which was used to extract patients with similar background factors related to prosthetic selection at baseline, survival time analyses were performed with tooth loss as the endpoint. The adjusted variables were age, sex, number of restored teeth, periodontal status, and the practicing dentist's experience in years. The remaining teeth were classified into subcategories in relation to the missing molars. RESULTS: Overall, 58 patients (29 in each group) selected by PS matching were evaluated in the final analysis. The total number of lost teeth was 35 (FISPs group: n = 10; RPDs group: n = 25). The mean (±SD) period to tooth loss and the 10-year survival rates in the FISPs and RPDs groups were 51.6 (±30.1) months and 42.3 (±29.7) months, 70.5% and 16.4%, respectively. The log-rank test showed that significantly longer survival time in FISPs compared with RPDs. CONCLUSIONS: After adjustments for confounding factors using PS matching, replacing unilateral free-end missing teeth with FISPs may exhibit a lower tooth loss rate in adjacent and contralateral teeth compared to replacing with RPDs.

Females have lower salivary flow than males, before and after radiation therapy for head/neck cancer.

OBJECTIVE: To compare salivary flow rates between females and males, before and after radiation therapy (RT) for head and neck cancer (HNC). METHODS: Prospective observational multicenter cohort study (OraRad). Stimulated whole salivary flow was measured before RT and at 6 and 18 months after RT. RESULTS: Mean (95% confidence interval) salivary flow in g/min before RT was 0.81 (0.71, 0.90) in females (n = 107) and 1.20 (1.15, 1.25) in males (n = 391) (p < 0.001); at 6 months was 0.34 (0.24, 0.44) in females and 0.50 (0.44, 0.55) in males (p = 0.01); at 18 months was 0.49 (0.38, 0.59) in females and 0.70 (0.64, 0.75) in males (p < 0.001). Median nadir salivary flow after RT was 0.22 in females and 0.35 in males (p < 0.001). A lower nadir salivary flow in females, but not males, was associated with an increased risk for tooth failure (p = 0.02). CONCLUSIONS: Females with HNC have lower stimulated whole salivary flow than males, before and after RT. Low salivary flow after RT may be a risk factor for tooth failure among females. The lower pre-RT salivary flow rates in females, combined with prior literature in other populations, indicates that, in general, females have lower stimulated salivary flow than males.

Association of Sleep Duration with Tooth Loss and Periodontitis: Insights from the National Health and Nutrition Examination Surveys (2005-2020).

OBJECTIVE: Sleep disorders such as insomnia, apnea, and restless leg syndrome can negatively affect a person's overall health and may cause hypertension, heart failure, and coronary heart disease. Likewise, periodontitis, a gum disease, can lead to both physical and psychological health issues, exerting a considerable effect on one's overall well-being-periodontitis stands as a primary cause of tooth loss. Nevertheless, there has been insufficient research on the correlation between the amount of sleep individuals get and the occurrence of periodontitis/tooth loss among Americans. Therefore, this study aimed to assess the influence of sleep length on periodontitis in the American population. METHODS: Periodontitis severity was classified (none, mild, moderate, and severe) using American Periodontal Association criteria. Sleep duration was assessed by self-reported data and categorized into three groups (deficient, adequate, and excessive). Tooth loss was assessed by the oral examination. To establish a connection between the duration of sleep and periodontitis/tooth loss, a weighted multivariable logistic regression analysis was employed. A GAM analysis and smooth curve fitting assessment were conducted to identify non-linear relationships. Subgroup, interaction, and mediation analyses were also performed. RESULTS: The prevalence of tooth loss was significantly high, affecting 96.4% of the individuals, whereas 46.6% of the study sample experienced moderate to severe periodontitis. The average age of participants was 52.7 years. After adjusting for potential confounding factors, the analysis of weighted multivariable logistic regression revealed a significant association between sleep insufficiency and moderate/severe periodontitis (OR 1.15, 95% CI 1.01-1.30, P = 0.0298), as well as tooth loss (OR 1.16, 95% CI 1.01-1.33, P = 0.0371). Additionally, the research showed a correlation between the length of sleep and periodontitis that followed a U-shaped pattern. In addition, the analysis of mediation revealed that high blood pressure explained 7.0% (95% CI 4.0% to 12.9%; P < 0.0001) of the link between the amount of sleep and the likelihood of losing teeth. CONCLUSION: Sleep duration was independently correlated with moderate/severe periodontitis/tooth loss and had a non-linear relationship.

Knowledge, attitudes, and practice related to tooth loss and dentures among patients with dental arch deficiencies.

BACKGROUND: Tooth loss is a common problem that affects many people worldwide. Exploring knowledge, attitude, and practice (KAP) among patients can identify barriers and challenges in following recommended practices, providing valuable insights for dental healthcare providers, policymakers, and researchers. This study aimed to explore the KAP of patients with dental arch deficiencies regarding tooth loss and dentures. METHODS: This web-based, cross-sectional study was conducted among patients with dental arch deficiencies using a self-designed questionnaire. RESULT: 3166 valid questionnaires were included. Participants' mean KAP scores were 6.84 ± 2.27 (possible range: 0 ~ 12), 39.4 ± 3.72 (possible range: 9 ~ 45), and 27.7 ± 4.36 (possible range: 8 ~ 40), respectively. Multivariable logistic regression analysis showed that knowledge (OR = 1.383), employed (OR = 1.805), family history (OR = 2.158), and treatment (OR = 1.683) were independently associated with attitude. Moreover, knowledge (OR = 1.239), attitude (OR = 1.250), female (OR = 0.619), age (OR = 0.967), college/bachelor (OR = 0.373), and master and above degree (OR = 0.418), employed (OR = 0.554) or student (OR = 0.434), with 10,001-20,000 Yuan household income per month (OR = 0.492), have been married (OR = 0.609), smoking (OR = 0.595), drinking (OR = 0.397), disease duration (OR = 0.972), with family history (OR = 1.676), and with treatment (OR = 3.492) were independently associated with practice (all P < 0.05). CONCLUSION: Patients with dental arch deficiencies have insufficient knowledge, positive attitudes, and moderate practice toward tooth loss and dentures, which might be affected by multiple demographic factors.

Social participation, subjective well-being, and cognitive function as serial mediators between tooth loss and functional limitations in older Chinese adults.

BACKGROUND: Although tooth loss appears to be related to functional limitations, the mechanisms that underpin this relationship are unknown. We sought to address this knowledge gap by examining a multiple mediation hypothesis whereby tooth loss is predicted to indirectly affect functional limitations through social participation, subjective well-being, and cognitive function. METHODS: This study included 7,629 Chinese adults from the 2017/2018 Chinese Longitudinal Healthy Longevity Survey wave. The serial mediation effects were examined using Model 6 in the Hayes' PROCESS macro for SPSS. RESULTS: Tooth loss was significantly related to functional limitations. There was a direct (ß = - 0.0308; 95% CI, - 0.0131 to - 0.0036) and indirect (ß = - 0.0068; 95% CI, - 0.0096 to - 0.0041) association between tooth loss and instrumental activities of daily living (IADL) limitations, but only an indirect correlation with activities of daily living (ADL) limitations (ß = - 0.0188; 95% CI, - 0.0259 to - 0.0121). Social participation, subjective well-being, and cognitive function serially mediated the relationship between tooth loss and ADL/IADL limitations. CONCLUSION: The association between tooth loss and functional limitations is serially mediated by social participation, subjective well-being, and cognitive function. Our findings underscore the necessity of considering psychological and social factors as integrated healthcare approaches for the functional health of older adults.

The association between objective and subjective oral health conditions and the presence of anorexia of aging among Japanese older Adults1.

Anorexia of aging is a risk factor for malnutrition among older adults. This study aimed to evaluate the association between objective and subjective oral health and anorexia among independent older adults. This cross-sectional study targeted independent older adults aged ≥65 years who participated in the Japan Gerontological Evaluation Study conducted in 2022. The outcome variable was the presence of anorexia, as assessed by the Simplified Nutritional Appetite Questionnaire. Exposure variables were dental status (≥20 teeth, 10-19 teeth with/without dentures, and 0-9 teeth with/without dentures) as objective oral health and oral health-related quality of life measured by five items of the short version of the Oral Impacts on Daily Performances (OIDP) (eating, speaking, smiling, emotional stability, and enjoying with others) as subjective oral health. We fitted the Poisson regression model, including possible confounders, and estimated prevalence ratios (PRs) and 95% confidence intervals. Among 19,787 participants (mean age: 74.6 years [1SD = 6.2], male: 48.5%), 9.0% were classified as having anorexia. After adjusting possible confounders, those with ≤19 teeth had a higher proportion of experiencing anorexia compared to those with ≥20 teeth; however, the association was less pronounced among those with dentures (0-9 teeth with dentures: PR = 1.48 [1.31-1.68], and 0-9 teeth without dentures: PR = 2.08 [1.65-2.63]). Even after adjusting for dental status, each item of OIDP was significantly associated with the presence of anorexia (all p < 0.05). The results showed that both objective and subjective poor oral health were significantly associated with a higher probability of developing anorexia of aging. Therefore, improving both objective and subjective oral health through appropriate dental care could contribute to maintaining appetite in later life.

A prospective association between social isolation and cognitive performance among older adults in Europe: the role of loneliness and poor oral health.

OBJECTIVES: The relationship between social isolation, loneliness, and tooth loss and cognition in older people is poorly understood. We examine how social isolation and cognitive performance are associated prospectively among older adults, as well as how tooth loss and loneliness are related to this association. METHODS: Using data from 26,168 participants aged ≥50 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we explored the association between social isolation, loneliness, tooth loss and cognition. We used bootstrapping with resampling strategies for testing a moderated mediating model. RESULTS: Higher social isolation was associated with poorer cognitive performance (B = -0.20, 95% CI = -0.03, -0.01; R2 =0.60), an association mediated by the respondent's number of missing teeth (B = -0.001, 95% CI = -0.002, -0.001). Higher levels of social isolation were associated with a greater number of missing teeth, and a higher number of missing teeth was linked with poorer cognition. We also found that loneliness moderated the relationship between social isolation and both the number of missing teeth (B = -0.11, p = 0.047) and cognitive performance. CONCLUSION: In later life, social isolation and loneliness are associated with shoddy oral health and poor cognitive status. Clinicians and policymakers should be aware of both the association between social isolation and feelings of loneliness on dentition and oral health and their relationship to the cognitive status of older adults.

Is tooth loss associated with oral health-related quality of life among young men? Findings from southern Brazil.

OBJECTIVE: To determine the association between tooth loss and oral health-related quality of life (OHRQoL) among young men from southern Brazil. METHODS: Cross-sectional study of 518 young men aged 18-19 years enlisted for mandatory military service in the Brazilian Army in two cities of southern Brazil in 2019-2021. Participants were clinically examined regarding gingivitis, dental caries experience (caries lesions, missing and filled surfaces), and malocclusion. A questionnaire collected socioeconomic information and the Oral Health Impact Profile 14 (OHIP-14). The outcome was OHRQoL, modeled as a discrete variable. The main explanatory variable was tooth loss due to caries (0 or ≥1). Negative binomial regression analysis was used; rate ratios (RR) and 95% confidence intervals (CI) were estimated. RESULTS: Tooth loss prevalence was 22.2%. Associations were detected between tooth loss and OHRQoL in the physical pain and handicap domains. Individuals with at least one missing tooth had 17% higher OHIP-14 scores in the physical pain domain (adjusted RR=1.17; 95%CI=1.01, 1.35) and 49% higher in the handicap domain (adjusted RR=1.49; 95%CI=1.03, 2.15) than those with no tooth loss. CONCLUSIONS: Tooth loss was negatively associated with OHRQoL among 18-19-year-old Brazilian Army conscripts, and this association was related to physical pain and handicap domains.

Association between cognitive rumination and periodontal disease, tooth loss and oral health-related quality of life in a rural Southern Brazil population.

OBJECTIVES: Rumination is a maladaptive emotion regulation strategy. It has been associated with several psychological disorders and physical problems. This cross-sectional study aimed to evaluate whether cognitive rumination is associated with periodontal disease (PD), tooth loss (TL), and oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: A population-based sample from a rural area in southern Brazil was evaluated. Calibrated examiners carried out a complete periodontal examination at six sites-per-tooth. Rumination and Reflection (RRQ) and Oral Health Impact Profile (OHIP-14) questionnaires were administered. Regression modeling was used to assess the prevalence ratio (PR) between rumination and PD and to estimate the rate ratio (RR) between rumination and TL and rumination and OHIP. RESULTS: Severe periodontitis prevalence of 33% was observed in the sample. In the Poisson-adjusted model (n = 587), individuals who ruminate more have 27% more periodontal disease (PR: 1.27, 95%CI:1.02 - 1.60). Regarding TL and OHIP, negative binomial regression (n = 672) showed an association with rumination, but it was not significant (RR 1.14, 95%CI 0.99 - 1.31) and (RR 1.20, 95%CI 0.98 - 1.48), respectively. CONCLUSIONS: Cognitive rumination was independently associated with periodontal disease in individuals living in a rural area. Borderline non-significant estimates were observed regarding TL and OHRQoL. More research using different populations and focusing on individual's responses to psychological stress may confirm these results. CLINICAL RELEVANCE: Emotional regulation is crucial to deal with stress, anxiety, and depression. Since psychopathologies are among the most prevalent diseases in the world, it is critical to understand the role of these issues in dental outcomes.

Factors associated with furcation involvement and fixed prostheses: A cross-sectional study.

OBJECTIVE: The study aims to explore the relationship between horizontal and vertical furcation involvement (FI) in teeth with or without a single unit fixed prosthesis (FP). MATERIALS AND METHODS: Adult subjects presenting to the periodontics department requiring cone beam computed tomography (CBCT) analysis were recruited for this study. 79 patients, with a total of 200 teeth, were split into two groups based on the presence or absence of FP within the same patient. Our analysis considered patient-level factors like smoking, diabetes, and periodontal severity and tooth-level factors including root trunk length (RTL), probing depth (PD), periodontal supracrestal tissue height (STH), supracrestal tissue attachment (STH-PD), interproximal bone distance (IPBD) to the cementoenamel junction (CEJ) (control) or crown margin (Test), and the distance from the furcation to the CEJ (control) or crown margin (Test). Subsequently, we developed a predictive model for FI. RESULTS: The presence of a prosthesis had a significant association with FI, with an odds ratio (OR) of 12.8 (p < 0.001). Other factors significantly correlated with FI were periodontitis (OR = 10.9; p = 0.006), buccal furcation site (OR = 5.70; p < 0.001), and PD (OR = 1.90; p = 0.027). FP placement increased IPBD by 1.08 mm (p < 0.001). The predictive model built for FI demonstrated a sensitivity of 92.9% and a specificity of 66.7%. CONCLUSIONS: Fixed prosthesis significantly influenced FI only in periodontitis patients. Factors such as periodontitis Stage, probing depth, and buccal site contribute to FI. The high sensitivity of the predictive model highlights the importance of considering these correlations during treatment planning. CLINICAL RELEVANCE: Comprehending FI factors is vital for devising customised treatment plans to halt disease progression and enhance outcomes of periodontal regenerative therapies.