Tooth mortality in plantation workers and residents in Sri Lanka

Abstract The tooth mortality of 787 Sri Lanka tea plantation workers and residents aged between 15 and 85 yr was studied in terms of missing teeth as well as teeth requiring extraction for various reasons. The mean number of missing teeth per person was 6.7±9.0. A pattern relating actual tooth loss and tooth loss adjusted to lake account of teeth needing extraction was observed. Such adjustment increased the mean number of missing teeth per person by about two teeth in most age groups. The age specific pattern of tooth loss was calculated. There was an abrupt increase in tooth mortality at the ages 45–54. The age specific tooth mortality for the Sri Lankan group was consistently less than for people in several Western countries. These trends were also apparent in the mortality pattern of individual tooth types. Although there was a tendency for more women to be edentulous, a significantly higher proportion of women than men had a full complement of teeth.     

Progression of dental caries and tooth loss between the third and fourth decades of life: a birth cohort study

The majority of what is known of the experience of dental caries among adults is from cross-sectional studies, and there are surprisingly few population-level longitudinal studies of dental caries among adults. Dental examinations were conducted at age 26 and again at age 32 among participants in a longstanding prospective study of a birth cohort born in Dunedin (New Zealand) in 1972/1973. Some 901 individuals (88.8%) were dentally examined at both ages. The mean number of remaining teeth and tooth surfaces fell between 26 and 32, reflecting ongoing tooth loss. The overall prevalence of caries rose from 94.9 to 96.8%, while there were greater increases in the proportion with caries-associated tooth loss (from 10.8 to 22.8%). Caries experience was greatest in the molar teeth and upper premolars, and was lowest in the lower anterior teeth. The mean crude caries increment (CCI) was 5.0 surfaces (SD 6.6); 681 (75.5%) experienced 1+ CCI, and the mean CCI among those individuals was 6.6 surfaces (SD 6.9). Substantial dental caries and tooth loss experience occur as people move from the third into the fourth decade of life.     

Incidence of, and reasons for, tooth mortality among mentally retarded adults during a 10-year period

The aim of the study was to investigate the reasons for, and incidence of, tooth mortality over a 10-year period in mentally retarded adults receiving regular dental care. The number of teeth present in 115 individuals (mean age in 1984 was 41.0, range 19-83 years) was registered in 1984 and 1994. The reasons for tooth mortality, medication utilization, frequency of dental care visits and cooperation during dental treatment were registered and related to tooth loss. The average incidence of tooth mortality was 3.72 teeth during the 10-year period. The mean number of dental care visits per year was 6.6. Most of the 428 teeth (58%) were lost due to periodontal disease. The preventive dental care given was not sufficient to arrest oral diseases. The data indicate, however, that achievement of cooperation in dental care situations not only makes dental treatment possible, but also leads to a decreased incidence of tooth mortality.     

Socio-economic and behavioural risk factors for tooth loss from age 18 to 26 among participants in the Dunedin Multidisciplinary Health and Development Study

OBJECTIVE: To determine the risk factors associated with tooth loss between the ages of 18 and 26. METHODS: Dental examinations at ages 18 and 26 were conducted on Study members in the Dunedin Multidisciplinary Health and Development Study, and sociodemographic and dental service use data were collected using a self-report questionnaire. At age 15, an estimate of socio-economic status (SES) for each Study member had been obtained by classifying the occupation of the male parent. A case of tooth loss was defined as an individual who had lost one or more teeth (excluding third molars) due to caries between ages 18 and 26. Logistic regression and Poisson analysis were used to model the occurrence of tooth loss. RESULTS: Among the 821 study members who were examined at both ages, one or more teeth were lost because of caries by 85 (10.3%). After controlling for sex, SES and visiting pattern, baseline caries experience predicted subsequent tooth loss, with the odds increasing by 2.8 for every increase by 1 in the number of decayed surfaces present at age 18. Episodic dental visitors had 3.1 times the odds of their routine visiting counterparts of losing a tooth over the observation period. The number of teeth lost was, on average, 2.3 times higher among episodic dental visitors. CONCLUSIONS: Socio-economic inequalities in tooth loss appear to begin early in the life course, and are modified by individuals' SES and dental visiting patterns.     

Changes in tooth mortality between 1990 and 2002 among adults in Västerbotten County, Sweden: influence of socioeconomic factors, general health, smoking, and dental care habits on tooth mortality

The objectives of the study were to analyse changes in tooth mortality among adults in V?sterbotten County, Sweden, between 1990 and 2002 and determine whether socioeconomic factors, general health, smoking, and dental care habits influenced tooth mortality. The study was based on samples drawn from the adult population in V?sterbotten County in 1990 and 2002. The studied age groups were 35-, 50-, and 65-year-olds. In 2002 75-year-olds were included. The surveys comprised a clinical examination and a questionnaire.The latter focused on oro-facial symptoms, socioeconomic factors, general health, smoking, and dental care habits. Complete data were obtained from 715 individuals in 1990 and from 768 individuals in 2002.Variables used to depict tooth mortality were edentulousness, occlusal supporting zones (Eichner index), and number of teeth. The prevalence of edentulousness in V?sterbotten County decreased from 12.7% in 1990 to 3.7% in 2002 (P < 0.001). The mean number of teeth increased in all age groups between 1990 and 2002, and so did the number of individuals with tooth contact in all occlusal supporting zones and no gaps between teeth. Low educational level, weak economic status, smoking, and irregular visits to the dental clinic were all significantly related to increased tooth mortality. Between 1990 and 2002 tooth mortality decreased significantly in the adult population of V?sterbotten County, Sweden. Cross-sectional analysis identified socioeconomic factors, smoking, and irregular use of dental care services as being related to tooth mortality in both 1990 and 2002.     

Patterns of and reasons for tooth extractions in general dental practice in Ontario, Canada

Abstract While substantial proportions of the population of Ontario, Canada continue to have teeth extracted, little is known about the reasons for this loss. In this survey of Ontario general dental practitioners. 128 dentists provided information on 6143 patients they saw during a reference week. Approximately one-in-seven of these patients had or were going to have one or more extractions as part of their current course of treatment. The mean number of extractions for patients having at least one tooth taken out was 2.3 (SD=2.5). Emergency patients were more likely than regular patients to have at least one extraction but, on average, had fewer teeth taken out. Orthodontic considerations were the main reason for tooth loss in childhood, caries continued to be an important cause of tooth loss at all ages and periodontal disease accounted for more teeth lost after 40 years of age than caries. This study differs from almost all others in finding that, overall, more permanent teeth were extracted because of periodontal disease than because of caries. The former accounted for 35.9% of teeth lost and the latter for 28.9%. While this may be due to methodological differences between this and other studies, it is consistent with epidemiological data on periodontal disease in the Ontario population and data showing that Ontarians receive little in the way of periodontal care.     

Socio-behavioral predictors of changes in dentition status: a prospective analysis of the 1942 Swedish birth cohort

Astrom AN, Ekback G, Ordell S, Unell L. Socio‐behavioral predictors of changes in dentition status: a prospective analysis of the 1942 Swedish birth cohort. Community Dent Oral Epidemiol 2011; 39: 300–310. © 2010 John Wiley & Sons A/S Abstract – Objectives: Using a prospective cohort design, this study assessed loss of natural teeth between ages 50 and 65. Guided by a conceptual framework grouping variables according to the life‐course stage at which they would be expected to operate, this study assessed the impacts of socio‐behavioral and disease‐related factors on tooth loss between ages 50 and 65. Methods: In 1992, all 50‐year‐olds in two counties of Sweden were invited to participate in a longitudinal questionnaire survey. Of the total population of 8888 subjects, 6346 responded (71.4%). Of the 6346 subjects who completed the 1992 questionnaire, 4143 (65%) completed postal follow‐ups at ages 55, 60 and 65. Results: For the total sample, the prevalence of having lost at least some teeth increased from 76% at age 50–85.5% at age 65. A total of 14% women and 13% men changed from having all teeth in 1992 to having tooth loss in 2007. Stepwise logistic regression analyses focused on predictors of tooth loss between 1992 and 2007. The following life‐stage predictors achieved or approached statistical significance with respect to overall tooth loss; country of birth and education (early life and young adult life stage), marital status, dental care avoidance because of high cost, smoking and reporting consistent pain (middle‐age and early‐old‐age life stage). Conclusion: Fewer substantial proportions of the 1942 cohort experienced tooth loss between ages 50 and 65. Tooth loss was highly prevalent from age 50 and increased moderately with increasing age. Oral disease‐related factors and socio‐behavioral characteristics such as refraining from dental care because of financial limitations, acting at earlier and later life‐course stages were major risk factors for having tooth loss. Early primary prevention of smoking and increased equitable access to dental care might improve tooth retention throughout the transition from middle age to early‐older age.     

Dental development, dental age and tooth counts

Emergence data on the 20 deciduous teeth and the first 29 permanent teeth were collected from 212 randomly selected urban Swedish children who were followed from birth to 18 years of age. The sex difference in the emergence of the deciduous teeth is less than one month, which is not statistically significant. Boys are consistently ahead of girls until the 17th deciduous tooth. From the 17th deciduous tooth on through most of the permanent dentition, girls are consistently ahead of boys. In the permanent dentition the sex difference ranges from 3 MO to 11 MO; these differences are statistically significant except for the 29th tooth. Reference data on dental age based on counts of 1-19 deciduous and 1-27 permanent teeth are tabulated and tooth emergence curves constructed. The tooth emergence curves can be used to express individual dental development in terms of standard deviation scores. Validity of dental age assessed by counts of permanent teeth is evaluated by a cross-sectional comparison with another sample of Swedish boys and girls. The mean difference between estimated age and chronological age is about one month in either sex. Precision of an individual estimate of dental development in terms of 95% confidence level (approximately equal to +/- 2 S.D.) varies from about +/- 4 months in the deciduous dentition to +/- 3 years in the permanent dentition. Assessment of dental development and dental age by means of tooth counts is a convenient and simple method, although it can only be applied at ages when emergence can be expected. It is especially useful in cross-sectional evaluations, as no serial data are required. In populations with a low incidence of caries the impact of such disturbing factors on emergence is correspondingly low, further increasing the validity of assessments of dental development based on tooth emergence.     

Periodontal conditions of adult regular dental care attendants

Abstract The purpose of the present study was to examine longitudinal alterations in the periodontal conditions of regular dental care attendants, 225 randomly selected patients (age 18–65 years) at 12 community dental clinics in the county of Värmland, Sweden, were subjected to a baseline clinical and radiographic examination in 1978 and to a re-examination in 1990. During the study period, all participants received preventive and therapeutic measures according to decisions made by the dentist on duty in the clinics. The examinations involved assessments of number of remaining teeth, plaque, gingivitis, probing pocket depth, loss of probing attachment and periodontal bone height. The results showed that during the 12 years of monitoring, an average of 0.4 teeth were lost, The % of tooth sites with gingivitis was lower in 1990 (4%) than in 1978 (15%), but no major changes were found for the mean probing pocket depth. The mean probing attachment loss during the 12 years amounted to 0.5 mm. The tooth site analysis revealed that buccal sites had experienced more loss of attachment than lingual and approximal surfaces. Whereas no differences were observed between age groups with respect to longitudinal loss of attachment at lingual and approximal tooth sites, the youngest age group demonstrated more pronounced loss at buccal surfaces than older subjects. The radiographic assessments of the alveolar bone height revealed a mean longitudinal loss amounting to 0.2–0.4 mm in the various age groups. The time-lag comparison revealed less tooth mortality, lower gingivitis scores, less probing attachment loss and less periodontal bone loss in 1990 than in 1978 for subjects of the age 30–53 years, whereas the data were similar for older subjects. The improvement was the result of less breakdown at lingual and approximal sites, whereas no difference was evident for buccal surfaces.     

Natural history of periodontal disease in man

Abstract This paper describes the initiation, rate of progress of periodontal disease and consequent tooth loss in a population never exposed to any programs or incidents relative to prevention and treatment of dental diseases. The group consisted of 480 male laborers at two tea plantations in Sri Lanka. The study design and baseline data have been published. At the initial examination in 1970, the age of the participants ranged between 14 and 31 years. Subsequent examinations occurred in 1971, 1973, 1977, 1982 and 1985. Thus, the study covers the age range 14–46 years. Throughout the study, the clinical indices were scored by the same two examiners, both well-trained and experienced periodontitis. Intra-examiner reproducibility for each index was tested at baseline and repeated periodically during the study. The data for each examination were computerized and updated on an ongoing basis. At the last examination in 1985, there were 161 individuals who had participated in the first survey. This population did not perform any conventional oral hygiene measures and consequently displayed quite uniformly large aggregates of plaque, calculus and stain on their teeth. Virtually all gingival units exhibited inflammation. Based on interproximal loss of attachment and tooth mortality rates, three subpopulations were identified: (1) individuals (～8%) with rapid progression of periodontal disease (RP), those (～81%) with moderate progression (MP), and a group (～11 %) who exhibited no progression (NP) of periodontal disease beyond gingivitis. At 35 years of age, the mean loss of attachment in the RP group was ～9 mm, the MP group had ～4 mm and the NP group had less than 1 mm loss of attachment. At the age of 45 years, the mean loss of attachment in the RP group was ～13 mm and the MP group ～7 mm. The annual rate of destruction in the RP group varied between 0.1 and 1.0 mm, in the MP group between 0.05 and 0.5 mm, and in the NP group between 0.05 and 0.09 mm. Since this population was virtually caries free, essentially all missing teeth were lost due to periodontal disease. In the RP group, tooth loss already occurred at 20 years of age and increased throughout the next 25 years. At 35 years of age, 12 teeth had been lost, at 40 years of age 20 teeth were missing and at 45 all teeth were lost. In the MP groups, tooth mortality started after 30 years of age and increased throughout the decade. At 45 years of age, the mean loss of teeth in this group was 7 teeth. The NP group essentially showed no tooth loss.     

Tooth loss as related to dental caries and periodontal breakdown in adult Tanzanians

A total of 170 adults aged 30-69 yr from the Zanzibar and Pemba Islands (Tanzania) were examined for tooth loss, dental caries and loss of periodontal attachment. The cause of tooth loss was recorded from information given by the examinee to a Kiswahili-English interpreter. Dental caries were recorded according to the depth of the lesion, i.e. involving enamel, dentin or pulp, respectively. Loss of attachment was measured as the distance in mm from the CEJ to the bottom of the pocket. The most severely affected surface determined the state of the tooth. The mean number of teeth present ranged from 29.5 in the youngest to 23.9 in the oldest age group. The mean number of teeth missing due to dental caries ranged between 2.1 and 7.0 teeth, and exceeded by far tooth loss due to periodontal breakdown which was only observed in the two oldest age groups. In all age groups the molars were the teeth most frequently missing and also the teeth most frequently affected by dental caries. Although a substantial number of the teeth in the older age groups demonstrated an extensive loss of attachment only a few teeth, mainly mandibular incisors, were lost due to periodontal breakdown within the age range examined.     

Dental and periodontal health in a Swiss population-based sample of older adults: a cross-sectional study

In this cross-sectional study, the prevalences of tooth loss, prosthetic dental restorations, and probing pocket depths (PPD) ≥4 mm, and their relationship to sociodemographic factors, were investigated in older Swiss adults. There were up to 1,673 participants aged ≥55 yr in the fourth survey of the Swiss Cohort Study on Air Pollution And Lung And Heart Disease In Adults (SAPALDIA4). Missing teeth, prosthetic dental restorations, and PPD ≥4 mm were recorded in clinical examinations conducted by field workers and compared with self-reported information from questionnaires. Examination data showed that participants were missing five teeth on average, 74.8% had a prosthetic dental restoration, and 21.1% had PPD of ≥4 mm. The mean number of missing teeth and the prevalences of tooth loss, fixed dental prostheses, and removable dental prostheses were associated with age, education level, smoking status, and time since last visit to a dentist. Comparison of data obtained by field workers and that from self-reports show a high level of agreement for the number of missing teeth and the prevalence of removable dental prostheses, but a lower level of agreement for self-reports of fixed dental prostheses and periodontitis.     

Tooth loss and associated risk indicators in an adult urban population from south Brazil

The aim of the present study was to assess the prevalence, extent, and risk indicators of tooth loss in a representative adult, urban population in the Brazilian state of Rio Grande do Sul. A sample of 974 subjects (ages 30 to 103 years, mean 48.7, SD 13.4) representative of the metropolitan area of Porto Alegre, Brazil was selected by a multi-stage probability cluster sampling strategy. In all, 94% of the subjects had experienced tooth loss. The mean tooth loss was 11.2 teeth, and varied between 5.5 and 20.2 teeth in the 30-39 and 60 + years age groups, respectively. The multivariable analysis, adjusted for age, showed that subjects who had lost 7-13 or > or = 14 teeth were more likely to be females (odds ratio (OR) = 1.4, 2.4), of low (OR = 2.8, 5.1) or middle socio-economic status (OR = 2.3, 3.4), and heavy smokers (OR= 2.0, 2.3) than those with 6 or fewer missing teeth. Furthermore, loss of > or = 14 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR= 5.7), and loss of 7-13 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR = 2.4) and having 15-30% or > 30% decayed-filled teeth (OR = 2.7 and 4.1). In conclusion, tooth loss is highly prevalent in this urban Brazilian population. Gender, socio-economic status, cigarette smoking, caries experience, and attachment loss are important risk indicators. A reduction in the population's tooth loss may be achieved by the implementation of community programs for the prevention and treatment of dental caries and periodontal diseases.     

Lifestyle and psychosocial factors associated with tooth loss in Mexican adolescents and young adults

OBJECTIVE: The aim of the present study was to examine: (1) the prevalence of tooth loss in persons living in community dwellings and (2) the strength of the association identified between tooth loss experience and the psychosocial factors of lifestyle, stress, and anxiety. MATERIAL AND METHODS: A cross-sectional study was carried out in a convenience sample where data were collected by means of self-administered questionnaires of lifestyle and psychosocial factors (stress and anxiety) and a clinical examination. A total of 516 subjects aged 14-30 years of age were included in the study. Subjects had a visual dental examination. Prevalence and mean of tooth loss were calculated excluding third molars, and their related factors were adjusted in a binary logistic regression. RESULTS: Mean age of participants was 17.4+/-3.0 years; 45.5% were men. The prevalence of tooth loss (when at least one tooth was lost) was 20.5%. Among the 516 persons, a total of 201 teeth were lost with a mean tooth loss 0.39+/-0.95 overall. Mean tooth loss in subjects with at least one missing tooth was 1.90+/-1.26 teeth. Results adjusted by anxiety in the multivariate logistic regression model showed tooth loss was associated with lifestyle (OR=1.95, 95% CI=1.17 - 3.24), age (OR=2.65, 95% CI=1.64 - 4.26), and Angle's malocclusion II and III (OR=2.86; 95% CI=1.67 - 4.90). A slight association toward tooth loss was observed (p<0.10) in the sex and stress variables. CONCLUSIONS: Lifestyle and tooth loss have a substantial association. According to age group, these results suggest tooth loss is an oral health problem in the study population.     

Tooth mortality in smokers and nonsmokers in a selected population in Sana'a, Yemen

Background and Objective:  Tobacco smoking has been shown to be a major risk factor for tooth loss. The present study was designed to examine tooth mortality and the patterns of tooth loss in smokers and nonsmokers over a wide age range in a selected population from Sana'a, Yemen.
Material and Methods:  A total of 2506 persons between the ages of 15 and 64 years were examined, and every permanent tooth was assessed. Missing teeth included both extracted and missing teeth. Individuals currently smoking one or more boxes of cigarettes (20 cigarettes) a day for 5 years were considered as smokers, whereas individuals with no smoking history were considered as nonsmokers.
Results:  Smokers had a higher mean tooth loss than nonsmokers. The difference was statistically significant at p  < 0.001. Mean tooth loss was significantly higher in smokers across all age groups, except for those in the 45–54 years age group. Smokers had a significantly higher mean upper tooth loss than nonsmokers. Tooth loss decreased from the incisors to the canines and then increased, with peak loss in the first molars.
Conclusion:  Tooth loss among smokers is significantly higher than among nonsmokers. The central incisors, lateral incisors and first molars were the most commonly missing teeth in smokers, compared with nonsmokers.     

Oral Health Status of a Federal Prison Population

The purpose of this study was to describe the prevalence of decayed, missing, and filled teeth among federal male prisoners (aged 21-75) in the US Penitentiary. Leavenworth, Kansas, and to assess the impact of age, race, number of years incarcerated, and number of visits to the prison dentist on these parameters of oral health. Inmates (n = 191) were randomly selected and represented 16.4 percent of the prison population (N = 1,161). Two calibrated examiners collected caries and tooth loss data using NIDR criteria. No radiographs were taken. Results showed a mean DMFT of 12.9 for inmates aged 20-34, 16.4 for inmates aged 35- 44, and 22.1 for inmates aged 45 and older. Whites had significantly fewer decayed teeth (P less than .05) than black inmates for ages 20-34. The number of missing teeth increased significantly (P less than .01) with inmate age. Proportion edentulous (both arches) was 5.2 percent for ages 35 to 44, 17.3 percent for ages 45-54, and 45.5 percent for ages 55 to 75. Cross tabulations and chi-square analyses showed that inmates incarcerated less than two years had a significantly (P less than .001) lower utilization rate of dental services, and that inmates who made greater use of available dental services had fewer decayed teeth than those with lower utilization rates.     

Dental caries prevalence in early Polynesians from the Hawaiian Islands

We examined the skeletal remains of 1338 early Hawaiians (preserved in the Bishop Museum, Honolulu) to determine total caries and root surface caries prevalence. Specimens from seven islands were represented in the collection. Estimation of age at death was made by a combination of dental developmental staging for younger individuals and occlusal attrition and/or alveolar bone loss in adults. Museum records were also consulted for age estimation of adults which was primarily based on osteological criteria. The material was divided into six age groups. Predentate infants and edentulous adults were not included. A total of 19,425 teeth was examined. Caries lesions were observed in 462 individuals (34.5%) and 1895 teeth (9.8%). Coronal caries lesions in children and adolescents tended to be small and not particularly destructive of tooth structure. Root surface lesions in young adults were also small but increased progressively in size in the older groups, resulting in pulp exposure and coronal amputation. Although coronal caries was apparently not a significant dental health problem in children and young adults (compared with contemporary Hawaiians), root surface caries was an increasingly important source of tooth morbidity and tooth mortality in the older population groups. This age-related caries pattern was similar for all of the islands.     

Fractured and avulsed permanent incisors in Finnish children. A retrospective study.

The frequency of traumatic injuries to permanent incisors was studied in a sample of 1614 children from the city of Lahti in Southern Finland. The children, 801 girls and 813 boys, ranged in age from 6 to 16 years. Injuries to hard dental tissues and exarticulations of teeth were recorded. The prevalence of injuries was 19.8%--14.6% in girls and 25.0% in boys. A rapid growth in the prevalence rates was found at the ages of 9--11 years, at which the estimated mean annual incidence was about 5% in girls and 7% in boys. In 78.4% of the children with injured incisors, one tooth only was injured. The teeth most commonly injured were the upper central incisors, 81.7%; and the most frequent type of injury was an uncomplicated crown fracture, 90.5%.     

Tooth loss in a young population from south Brazil

OBJECTIVES: To assess the prevalence, extent, and risk indicators of tooth loss in a representative young urban population from south Brazil. METHODS: A representative sample was drawn using a multi-stage probability cluster sampling strategy, and consisted of 612 subjects 14-29 years of age in the metropolitan area of Porto Alegre, Brazil. A clinical examination was carried out by 4 calibrated examiners in a mobile examination center. RESULTS: The prevalence of tooth loss was 44.8%, 26%, and 60%, and the mean tooth loss was 1.4, 0.6, and 2.4 teeth in the age groups 14-29, 14-19 and 25-29 years, respectively. First molars were the most frequently missing teeth, and the mandibular incisors and canines were the least missing teeth. Tooth loss increased sharply with age, and was similar in males and females. Having > or =4 missing teeth was significantly associated with low socioeconomic status and heavy smoking, and was significantly more likely in persons who had > or =2 teeth with caries/fillings and/or > or =5 mm attachment loss. CONCLUSION: Tooth loss is a dental health concern in this young Brazilian population. Community-based oral diseases prevention programs targeting groups having these risk factors should be implemented to reduce tooth loss.