Intake of dairy calcium and tooth loss among adult Danish men and women.

OBJECTIVE: To investigate whether gender differences in tooth loss are influenced by caries risk and sources of dietary calcium intake. METHODS: This was a cohort study that included 432 Danish adults (30-60 y old) with information on dietary calcium intake in 1982 and 1983 and tooth loss from 1987 and 1988 through 1993 and 1994. Total calcium intake, estimated by a 7-d food record or a a diet history interview, was divided into dairy and non-dairy forms of calcium. RESULTS: In men, a 10-fold increase in dairy calcium intake was significantly associated with a decreased risk of tooth loss (incidence-rate ratio 0.32, 95% confidence interval 0.15-0.68) even after an adjustment for tooth count in 1987 and 1988, age, education, and civil status (model 1), smoking, alcohol consumption, sucrose intake, and use of vitamin and/or mineral supplements (model 2), time since last dental visit and the presence of oral dryness (model 3), and a high Lactobacillus count (model 4). In women, dairy calcium was not statistically associated with tooth loss in the crude and adjusted models (models 1 to 3). However, the association became highly significant once the Lactobacillus count was included in model 4 (incidence-rate ratio 0.25, 95% confidence interval 0.09-0.73). Non-dairy calcium was not associated with tooth loss in men and women in the fully adjusted models. CONCLUSION: Dietary calcium intake, particularly calcium from dairy products, seems to protect against loss of teeth in adult men and women. The previous gender differences found in the relation between calcium intake and tooth loss may be the result of differences in the caries risk between genders.

Reduction of tooth loss associated with periodontal treatment.

Comparing tooth loss for populations comprising subjects with periodontal disease has been limited by broad and different definitions of disease severity. Numeric scores for periodontal disease severity and risk were used to enhance the precision of comparing tooth loss for two populations. Both populations received routine dental care, but only one received comprehensive periodontal treatment. The analysis provides evidence that adding periodontal treatment to routine dental care is associated with less tooth loss and more patients who do not lose any teeth. Furthermore, it may be possible to nearly eliminate tooth loss associated with periodontal disease.

Osteoporosis and the risk of tooth loss.

Osteoporosis and osteopenia may influence periodontal disease and tooth loss. Although many studies suggest that in elderly men and women, maintenance of normal bone mineral density is associated with improved tooth retention, the evidence is still inconclusive. Hormone replacement therapy and calcium and vitamin D supplements that are used to prevent or treat osteoporosis appear to have beneficial effects on tooth retention as well. Future prospective studies, including randomized clinical trials, are needed to confirm these findings.

Calcium and vitamin D supplements reduce tooth loss in the elderly.

PURPOSE: Oral bone and tooth loss are correlated with bone loss at nonoral sites. Calcium and vitamin D supplementation slow the rate of bone loss from various skeletal sites, but it is not known if intake of these nutrients affects oral bone and, in turn, tooth retention. SUBJECTS AND METHODS: Tooth loss was examined in 145 healthy subjects aged 65 years and older who completed a 3-year, randomized, placebo-controlled trial of the effect of calcium and vitamin D supplementation on bone loss from the hip, as well as a 2-year follow-up study after discontinuation of study supplements. Teeth were counted at 18 months and 5 years. A comprehensive oral examination at 5 years included assessment of caries, oral hygiene, and periodontal disease. The odds ratio (OR) and 95% confidence interval (CI) of tooth loss were estimated by stepwise multivariate logistic regression. Initial age (mean +/- SD) of subjects was 71 +/- 5 years, and the number of teeth remaining was 22 +/- 7. RESULTS: During the randomized trial, 11 of the 82 subjects (13%) taking supplements and 17 of the 63 subjects (27%) taking placebo lost one or more teeth (OR = 0.4; 95% CI: 0.2 to 0.9). During the 2-year follow-up period, 31 of the 77 subjects (40%) with total calcium intake of at least 1000 mg per day lost one or more teeth compared with 40 of the 68 subjects (59%) who consumed less (OR = 0.5; 95% CI: 0.2 to 0.9). CONCLUSION: These findings suggest that intake levels of calcium and vitamin D aimed at preventing osteoporosis have a beneficial effect on tooth retention.

Dental self-care among dentate adults: contrasting problem-oriented dental attenders and regular dental attenders.

Self-care behaviors are common and can act as substitutes for or supplements to formal health care services. We tested the hypothesis that problem-oriented dental attenders (POAs) report more dental self-care behaviors than do regular dental attenders (RAs), presumably as a substitute for professional care. The Florida Dental Care Study is a longitudinal cohort study of changes in oral health, in which we measured dental self-care behaviors related to three common dental problems: toothache pain, bleeding gums, and tooth loss. Despite using less dental care, POAs were less likely to report "conventional" methods as means to prevent the three dental problems; however, they were more likely to report that homemade remedies, topical medications, or mouthwashes were ways to prevent or treat these problems. POAs were also more likely to believe that "nothing can be done" to prevent these problems. Additionally, POAs had more negative dental attitudes, used less dental care during follow-up, had more dental disease, were the only persons who extracted at least one of their own teeth, and were more likely to use tobacco. With the exception of dental self-extractions, no single self-care belief or behavior distinguished POAs from RAs, nor were POAs likely to have different explanations for dental problems. Instead, the pattern was one of modest differences on a number of items. Although POAs use less dental care, they do not compensate by employing more "conventional" dental self-care behaviors, but report being more likely to employ "unconventional" behaviors. They also are more likely to believe that nothing can be done to prevent dental problems.