Journal List > J Korean Acad Oral Health > v.39(4) > 1057666

Shin and Kim: Association between the number of existing permanent teeth and health-related quality of life (EuroQol-5 Dimension) among adults: findings from the fifth Korea National Health and Nutrition Examination Surveys, 2012

Abstract

Objectives

The aim of this study was to evaluate whether the number of existing permanent teeth is associated with health-related quality of life by using EuroQol-5 Dimension (EuroQol-5D) in a representative sample of Korean adults.

Methods

A total of 5349 subjects who participated in the 2012 fifth Korea National Health and Nutrition Examination Survey (KNHANES) were examined. The dependent variable was EQ-5D index and independent variable was the number of existing permanent teeth. The health-related quality of life was assessed by using EQ-5D index. The number of existing permanent teeth was evaluated by dentists using World Health Organization Index. Demographic factors (age and gender), socioeconomic status (education, income), oral health behaviors (frequency of daily toothbrushing, and regular dental visit), health behaviors (cigarette smoking, drinking, regular physical activity), general health status (depression, stress, body mass index, hypertension, diabetes mellitus) were included as confounder in analysis. Multivariable linear regression model, stratified analysis and analysis of covariance were applied.

Results

After adjustment for various confounders, the number of existing permanent teeth was positively associated with EQ-5D index (P<0.001). This association was highlighted among 40-59 year-old males and over 60 year-old females.

Conclusions

Our data indicate that the number of existing permanent teeth was independently associated with EQ-5D index. Our results provided the substantially important evidence on the health and oral health promotion for Korean adults.

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Fig. 1.
Adjusted EQ-5D index according to the number of existing permanent teeth. Box and whisker plots denote the mean and standard error. All values of EQ-5D index were obtained from ANCOVA adjusted for age, sex, education, income, frequency of daily toothbrushing, regular dental check-up, smoking, alcohol drinking, physical activity, depression, stress, BMI, hypertension, diabetes mellitus. The letters a, b, c and d denote the differences between groups using post hoc multiple comparison tests by bonferroni. Values expressed unweighted N (%).
jkaoh-39-303f1.tif
Table 1.
Distribution of EQ-5D Levels according to demographic and socioeconomic status (N=5349)
Characteristics Category EQ-5D index
N Mean±SE P-value
Age (years) 20 to 39 1388 0.98 (0.002) <0 001*
40 to 59 1974 0.96 (0.003)
60 over 1987 0.88 (0.004)
Sex Male 2223 0.96 (0.002) <0 001
Female 3126 0.93 (0.002)
Education Primary school 1393 0.87 (0.006) <0 001*
Middle school 574 0.93 (0.005)
High school 1792 0.96 (0.003)
College 1590 0.98 (0.002)
Income I (lowest) 1310 0.93 (0.005) <0 001*
II 1344 0.95 (0.003)
III 1338 0.95 (0.003)
IV (highest) 1357 0.96 (0.003)
Number of existing permanent teeth 0 144 0.83 (0.020) <0 001*
1 to 9 317 0.85 (0.011)
10 to19 521 0.89 (0.008)
20 to 24 867 0.93 (0.005)
25 to 28 3500 0.96 (0.002)

Values expressed unweighted N (%).

* Obtained from ANOVA

Obtained from t-test. Bold values denote statistical significance at P<0.05.

Table 2.
Linear relationship between the nu mber of existing permanent teeth and EQ-5D index (N=5349)
Variables Model I Model II Model III Model IV
β SE Partial r P-value β SE Partial r P-value β SE Partial r P-value β SE Partial r P-value
Number of existing permanent teeth 0.002 0.000 0.100 <0.001 0.002 0.000 0.099 <0.001 0.002 0.000 0.090 <0.001 0.002 0.000 0.090 <0.001
Age (years) -0.001 0.000 -0.136 <0.001 -0.001 0.000 -0.135 <0.001 -0.001 0.000 -0.143 <0.001 -0.001 0.000 —0.119 <0.001
Sex -0.026 0.000 -0.110 <0.001 -0.027 0.003 -0.113 <0.001 -0.021 0.004 -0.069 <0.001 -0.022 0.004 —0.072 <0.001
Education 0.017 0.002 0.126 <0.001 0.016 0.002 0.116 <0.001 0.016 0.002 0.117 <0.001 0.015 0.002 0.114 <0.001
Income 0.007 0.001 0.063 <0.001 0.006 0.001 0.061 <0.001 0.005 0.001 0.049 <0.001 0.005 0.001 0.049 <0.001
Frequency of daily tooth-brushing 0.008 0.003 0.034 <0.001 0.006 0.00. 0.026 0.061 0.005 0.003 0.022 0.101
Regular dental check-up 0.004 0.004 0.014 0.298 0.003 0.004 0.013 0.352 0.003 0.004 0.012 0.382
Smoking status -0.006 0.003 -0.034 0.012 —0.006 0.003 —0.035 0.011
Alcohol consumption 0.007 0.002 0.061 <0.001 0.007 0.002 0.060 <0.001
Regular physical activity 0.006 0.002 0.038 0.006 0.006 0.002 0.038 0.006
Depression -0.110 0.010 -0.152 <0.001 —0.111 0.010 —0.153 <0.001
Stress 0.045 0.003 0.174 <0.001 0.045 0.003 —0.153 <0.001
Body mass index (kg/m2) —0.008 0.003 —0.038 0.006
Hypertension —0.011 0.004 —0.036 0.009
Diabetes mellitus —0.013 0.006 —0.032 0.019
Adjusted R2 0.171 0.172 0.223 0.227

Values expressed unweighted N (%).

Number of existing permanent teeth: Continuous variable (Range: 0-28).

All variables are ordinal variables transformed from categorical variables in Table 1. Bold values denote statistical significance at P<0.05

Table 3.
Age and sex stratified linear relationship between the number of existing permanent teeth (5-scale ordinal variable) and EQ-5D index (N=5349)
Stratum Subgroup N Adjusted R2 β SE Partial r P-value
Age 20-39 years 1388 0.126 ―0.001 0.001 ―0.013 0.634
40-59 years 1974 0.114 0.000 0.001 0.016 0.490
60 years 1987 0.159 0.002 0.000 0.103 <0.001
Sex Male 2223 0.167 0.001 0.000 0.078 <0.001
Female 3126 0.241 0.002 0.000 0.094 <0.001
Age and sex Male 20-39 years 570 0.532 ―0.002 0.001 ―0.063 0.136
40-59 years 809 0.097 0.002 0.001 0.116 0.001
60 years 844 0.108 0.001 0.001 0.079 0.023
Female 20-39 years 818 0.109 0.001 0.001 0.024 0.500
40-59 years 1165 0.110 ―0.001 0.001 ―0.046 0.115
60 years 1143 0.154 0.002 0.001 0.119 <0.001

Values expressed unweighted N (%). Number of existing permanent teeth: Continuous variable (range: 0-28). β coefficients are from multivariable linear regression model adjusted for age, sex, education, income, frequency of daily toothbrushing, regular denta check-up, smoking, alcohol drinking, physical activity, depression, stress, BMI, hypertension, diabetes mellitus except for stratum. Bold values denote higher association (partial r) than unstratified partial r of 0.090.

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