Risk factors for tooth loss over 3 years according to the number of pre-existing teeth: data from a rural cohort

Ga-Yeong Lee; Sang-Baek Koh; Nam-Hee Kim

doi:10.11149/jkaoh.2017.41.2.129

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Lee, Koh, and Kim: Risk factors for tooth loss over 3 years according to the number of pre-existing teeth: data from a rural cohort

Original Article

J Korean Acad Oral Health 2017;41(2):129-136.

Published online: 15 June 2017

DOI: https://doi.org/10.11149/jkaoh.2017.41.2.129

Risk factors for tooth loss over 3 years according to the number of pre-existing teeth: data from a rural cohort

Ga-Yeong Lee¹, Sang-Baek Koh², Nam-Hee Kim^3,

¹Department of Dental Hygiene, Graduate School, Yonsei University, Seoul, Korea

²Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

³Department of Dental Hygiene, Yonsei University Wonju College of Medicine, Wonju, Korea

Corresponding Author: Nam-Hee Kim Department of Dental Hygiene, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea Tel: +82-33-741-0391 Fax: +82-33-735-0391 E-mail: nami71@yonsei.ac.kr

Received 22 March 2017 Revised 17 May 2017 Accepted 24 May 2017

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The aim of this study was to identify the risk factors for tooth loss over three years, according to the number of pre-existing teeth, in middle and old aged people in a rural area.

Methods

This was a 3-year follow-up study including participants from KoGES-ARIRANG. Eight-hundred and fifty-five participants took part in both initial and follow-up oral examinations and surveys, conducted between 2010 and 2016. The number of existing teeth was determined through oral examination, and the subjects’ sociodemographic characteristics, subjective periodontal statuses, and oral health behaviors were identified through oral questionnaires via 1:1 interviews. Chi-square analysis was used to compare tooth loss in participants with less than 20 pre-existing teeth to tooth loss in those with 20 or more pre-existing teeth. Multivariate logistic regression analyses were used to identify risk factors for tooth loss.

Results

Four-hundred and thirty-nine (51.4%) subjects lost more than one tooth over three years. After adjusting for demographic characteristics, subjective periodontal statuses, and oral health behaviors in subjects with 20 or more pre-existing teeth, the odds for tooth loss were as follows: 2.11 (1.42-3.14) times higher in people aged over 65 years compared to less than 65 years, 1.59 (1.06-2.38) times higher in those with a low (below elementary school) compared to high educational level, and 2.01 (1.33-3.02) times higher in those with a severe compared to normal subjective periodontal status.

Conclusions

The risk of tooth loss was different in subjects with less than 20 pre-existing teeth compared to those with 20 or more pre-existing teeth. Therefore, the approach to prevent tooth loss should be different depending on the number of teeth present.

Keywords: Cohort study, Risk factor, The number of present teeth, Tooth loss

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Fig. 1.

Participants for cohort study.

Table 1.

The general characteristics of the subjects and the number of present teeth in baseline year

Variable	N (%)	The number of present teeth in baseline year
Variable	N (%)	Mean±SD	P-value
Total		21.02±3.95
Sex
Man	344 (40.2)	23.34±6.79	0.169*
Woman	511 (59.8)	23.78±6.45	0.169*
Age
65>	620 (72.5)	24.96±5.30	<0.001*
65≤	235 (27.5)	20.02±8.15	<0.001*
Education
High≤	421 (49.2)	25.38±5.22^ab	<0.001^†
Middle	165 (19.3)	22.84±7.05^bc
≤Elementary	269 (31.5)	21.29±7.38^ac
Self-reported periodontal health
Normal	525 (61.4)	23.43±6.87^a	<0.001^†
Moderate	152 (17.8)	25.28±4.93^b
Severe	176 (20.6)	22.64±6.79^ab
Daily tooth brush
3 times≤	303 (35.4)	23.80±6.59^ac	<0.001^†
2 times	448 (52.4)	23.94±6.22^bc
≤1 time	104 (12.2)	21.56±7.17^ab
Using interdental oral hygiene devices
Yes	237 (27.7)	26.72±2.20	<0.001*
No	618 (72.3)	22.41±7.29	<0.001*
Receiving dental scaling
Yes	244 (28.5)	25.76±7.14	<0.001*
No	611 (71.5)	22.74±4.27	<0.001*

*Mann-Whitney test was performed to compare mean of the number of tooth in baseline year.

^† Kruskal-Wallis test was performed to compare mean of the number of tooth in baseline year.

^a,b,c The same letter indicates significant difference at α=0.05.

Table 2.

Tooth loss according to present teeth in baseline year

Variable	Tooth loss^†			The number of tooth loss in 3 years*
Variable		No N (%)	Yes N (%)	P-value	Mean±SD	P-value
Present teeth in baseline year
<20 (N=159)	44 (27.7)	115 (72.3)	<0.001	3.11±3.31	<0.001
≥20 (N=696)	372 (53.4)	324 (46.5)	<0.001	1.46±2.72	<0.001

* Mann-Whitney test was performed to compare mean of the number of tooth in baseline year.

^† Chi-square test was performed to compare tooth loss according to the 20 present teeth.

Table 3.

Characteristic distribution of tooth loss according to 20 present teeth in baseline year

Variable	Present teeth < 20 (N=159)				Present teeth ≥20 (N=696)
	Tooth loss		X²	P-value	Tooth loss		X²	P-value
	No N (%)	Yes N (%)	X²	P-value	No N (%)	Yes N (%)	X²	P-value
Sex
Man	17 (24.3)	53 (75.7)	0.72	0.397	144 (52.6)	130 (47.4)	0.15	0.703
Woman	27 (30.3)	62 (69.7)	0.72	0.397	228 (54.0)	194 (46.0)	0.15	0.703
Age
65>	17 (23.9)	54 (76.1)	0.89	0.345	318 (57.9)	231 (42.1)	20.92	<0.001
65≤	27 (30.7)	61 (69.3)	0.89	0.345	54 (36.7)	93 (63.3)	20.92	<0.001
Education
High≤	8 (19.5)	33 (80.5)			229 (60.3)	151 (39.7)		<0.001
Middle	13 (39.4)	20 (60.6)	3.65	0.162	66 (50.0)	66 (50.0)	17.68
≤Elementary	23 (27.1)	62 (72.9)			77 (41.8)	107 (58.2)
Self-reported periodontal health
Normal	29 (28.2)	74 (71.8)			236 (55.9)	186 (44.1)
Moderate	5 (29.4)	12 (70.6)	0.12	0.943	82 (60.7)	53 (39.3)	15.93	<0.001
Severe	10 (25.6)	29 (74.4)			53 (38.7)	84 (61.3)
Daily tooth brush
3 times≤	14 (27.5)	37 (72.5)			143 (56.7)	109 (43.3)
2 times	24 (30.8)	54 (69.2)	1.26	0.533	198 (53.5)	172 (46.5)	5.07	0.079
≤1 time	6 (20.0)	24 (80.0)			31 (41.9)	43 (58.1)
Using interdental oral hygiene devices
Yes	1 (25.0)	3 (75.0)		0.693^†	142 (60.9)	91 (39.1)	7.91	0.005
No	43 (27.7)	112 (72.3)		0.693^†	230 (49.7)	233 (50.0)	7.91	0.005
Receiving dental scaling
Yes	5 (27.8)	13 (72.2)		0.594^†	127 (56.2)	99 (43.8)	1.02	0.314
No	39 (27.7)	102 (72.3)		0.594^†	245 (52.1)	225 (47.9)	1.02	0.314

*Chi-square test was performed to compare tooth loss according to the 20 present teeth.

^† P-value determined by Fisher’s exact test.

Table 4.

Factors affecting tooth loss (1≤) according to the 20 present teeth in baseline year

Variable	Present teeth <20 (N=159)		Present teeth ≥20 (N=696)
Variable	Crude model	Adjusted model^†	Crude model	Adjusted model^†
Sex
Man	1	1	1	1
Woman	0.74 (0.36-1.50)	0.64 (0.27-1.51)	0.94 (0.70-1.28)	1.09 (0.78-1.53)
Age
65>	1	1	1	1
65≤	0.71 (0.35-1.45)	0.61 (0.28-1.31)	2.37 (1.63-3.45)**	2.11 (1.42-3.14)**
Education
High≤	1	1	1	1
Middle	0.37 (0.13-1.06)	0.36 (0.12-1.07)	1.52 (1.02-2.26)*	1.42 (0.93-2.15)
≤Elementary	0.65 (0.26-1.62)	0.78 (0.29-2.12)	2.11 (1.47-3.01)**	1.59 (1.06-2.38)*
Self-reported periodontal health
Normal	1	1	1	1
Moderate	0.94 (0.30-2.91)	0.84 (0.25-2.81)	0.82 (0.55-1.22)	0.87 (0.58-1.31)
Severe	1.14 (0.49-2.63)	1.28 (0.53-3.12)	2.01 (1.36-2.98)*	2.01 (1.33-3.02)*
Daily tooth brush
3 times≤	1	1	1	1
2 times	0.85 (0.39-1.86)	0.80 (0.35-1.83)	1.14 (0.83-1.57)	1.05 (0.75-1.48)
≤1 time	1.51 (0.51-4.48)	1.25 (0.39-4.03)	1.82 (1.08-3.08)*	1.22 (0.68-2.21)
Using interdental oral hygiene devices
Yes	1	1	1	1
No	0.87 (0.09-8.58)	1.41 (0.13-15.26)	1.58 (1.15-2.18)*	1.27 (0.89-1.82)
Receiving dental scaling
Yes	1	1	1	1
No	1.01 (0.34-3.01)	1.17 (0.36-3.77)	1.18 (0.86-1.62)	1.07 (0.75-1.51)

*P-value<0.05. **P-value<0.001.

^† Adjusted for sex, age, education, self-reported periodontal health, daily tooth brush, using interdental oral hygiene devices, receiving dental scaling.

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