Tooth loss rate and death in older adults.

Background: This study aimed to obtain a new indicator, tooth loss rate (TLR), to predict death and raise the awareness among older adults to prevent tooth loss in advance.

Methods: In this population-based study, data of participants older than 65 years were drawn from 3 cohorts enrolled in 2005, 2008, and 2011 from the Chinese Longitudinal Healthy Longevity Survey. The TLR was calculated for each participant by dividing the difference between the number of teeth at baseline and the first follow-up by the time difference between the surveys. The median is considered the boundary between rapid and slow TLR, with zero TLR as the reference group. Cox proportional hazards models were used to analyze the association between TLR and mortality and the influencing factors in older adults, adjusted for a range of covariates.

Results: TLR was an independent risk factor associated with higher mortality (adjusted hazard ratio [HR], 1.16 [95% CI, 1.11 to 1.21]). For people with tooth loss, the adjusted mortality risk was higher with rapid TLR (adjusted HR, 1.23 [95% CI, 0.94 to 1.62]) in comparison with slow TLR (adjusted HR, 1.02 [95% CI, 0.90 to 1.15]), accounting for potential confounding variables. The association between TLR and mortality risk was stronger for people 80 years and older, those who did not exercise regularly, and denture wearers compared with other variables.

Conclusions: Rapid TLR is associated with a higher risk of death in older adults, suggesting that TLR is one of the indicators that can predict mortality in older adults.

Practical implications: The evidence shows the need to prioritize older adults' oral health, especially regarding tooth loss, to boost oral care and foster good hygiene habits. This is important given the failure to meet the World Health Organization's 8020 Campaign goals and the high global TLR. Using TLR as a death predictor offers an easily observable risk factor.