Association between periodontal disease and tooth loss and mortality in an elderly Chinese population
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ORIGINAL ARTICLE
Association between periodontal disease and tooth loss and mortality in an elderly Chinese population Lei Qi1,2,3 · Yifeng Qian1,2,3 · Fangxing Zhu1,2,3 · Ningning Cao1,2,3 · Haixia Lu2,3 · Lei Zhang1,2,3 Received: 8 September 2019 / Accepted: 11 December 2019 © Springer Nature Switzerland AG 2020
Abstract Background Poor oral health is a risk indicator of poor quality of life and mortality. However, whether these associations remain potent in elderly subjects after adequately considering the confounding factors is not yet clearly elucidated. The present study aimed to investigate the associations between periodontal disease and tooth loss and total mortality and cardiovascular disease (CVD) outcomes in the elderly > 75 years old. Methods A total of 1385 individuals, receiving periodontal treatment in Shanghai, participated in this retrospective study. Data on oral status were obtained from radiographs to calculate the proportion of residual bone. The information about mortality was collected from the Shanghai Municipal Center for Disease Control and Prevention (SCDC). Univariate Cox proportional hazards model, multivariable-adjusted model, and competing risk hazard model were used to analyze the association between periodontal disease or tooth loss and mortality. Results Those with severe periodontitis were associated with higher risk of total mortality than healthy individuals [hazard ratio (HR) = 1.48, 95% confidence interval (95% CI) 1.11–1.98]. Further, missing teeth increased the risk of total mortality (HR = 1.02, 95% CI 1.01–1.03). However, no significant difference was detected in the association between periodontitis or tooth loss and CVD mortality. In competing risk hazard model, an increased risk was observed for other-cause mortality, not CVD mortality, in those with severe periodontitis and missing teeth. Conclusion Periodontal diseases and tooth loss were the potential predictors of total mortality even after adjustment for confounding factors. However, these were not independent indicators for CVD mortality. Keywords Periodontal disease · Tooth loss · Cardiovascular disease · Totality
Introduction Lei Qi and Yifeng Qian contributed equally to this article. * Haixia Lu [email protected] * Lei Zhang [email protected] 1
Department of Oral and Cranio‑maxillofacial Surgery, Ninth People’s Hospital Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
2
National Clinical Research Center for Oral Diseases, Ninth People’s Hospital Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai 200011, China
3
Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
The chance of getting poor oral health and getting one or more chronic systemic disorders does increase with age [1–5]. It has been estimated that the number of elderly individuals > 60 years old will reach 1200 million by 2025, the majority of th
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