Three-year Tooth Loss among Black and White Older Adults in North Carolina

Abstract

The distribution and determinants of tooth loss in older adults are poorly defined, especially in Blacks, who have been underrepresented in previous studies. This study investigated, epidemiologically, the distribution and predictors of tooth loss in elder Blacks and Whites by following a random sample of older adults in North Carolina for three years. It was hypothesized that Blacks would be at greater risk of tooth loss and would have different risk factors for tooth loss. Data from 263 Blacks and 228 Whites were collected by dental examinations and interviews conducted in the participants' homes. During the three-year follow-up, 53% of Blacks and 29% of Whites lost at least one tooth. Blacks lost 13% of their remaining teeth compared with 4% for Whites. Logistic regression models showed that factors related to tooth loss for Blacks were: more S. mutans in stimulated saliva, deeper periodontal pockets, more P. intermedia in subgingival plaque, high blood pressure, limited help from others, and few symptoms of depression. For Whites, significant factors were: more lactobacilli in stimulated saliva, history of current oral pain at baseline, more alcohol consumption, no history of past use of calcium or xerostomic medications, higher income, lower occupational prestige, and increased numbers of negative life events. This study showed that older Blacks were at greater risk of tooth loss than older Whites. For both races, factors such as oral bacteria, periodontal conditions, oral symptoms, and psychosocial and economic factors are related to increased risk of tooth loss.

Keywords

dental health survey human tooth loss geriatric epidemiology race.

Get full access to this article

View all access options for this article.

References

Agerholm DM , Sidi AD ( 1988). Reasons given for extraction of permanent teeth by general dental practitioners in England and Wales. Br Dent J 164:345-348.

Brown LJ , Meskin LH (1988). Sociodemographic differences in tooth loss patterns in US employed adults and seniors, 1985-86. Gerodontics 4:345-362.

Burt BA , Ismail AI , Morrison EC , Beltran ED (1990). Risk factors for tooth loss over a 28-year period . J Dent Res 69 :1126-1130.

Chauncey HH , Glass RL , Alman JE (1989). Dental caries. Principal cause of tooth extraction in a sample of US male adults. Caries Res 23:200-205.

Drake CW , Beck JD , Graves RC (1991). Dental treatment needs in an elderly population . J Public Health Dent 51:205-211.

Hand JS , Hunt RJ , Kohout FJ (1991). Five-year incidence of tooth loss in Iowans aged 65 and older. Community Dent Oral Epidemiol 19:48-51.

Jordan HV (1986). Cultural methods for the identification and quantitation of Streptococcus mutans and lactobacilli in oral samples. Oral Microbiol Immunol 1:23-30.

Koch GG , Beck JD ( 1992). Statistical methodologies useful for the analysis of data from risk-assessment studies. J Public Health Dent 52:146-67.

Loesche WJ , Giordano J. , Hujoel PP (1990). The utility of the BANA test for monitoring anaerobic infections due to spirochetes (Treponema denticola) in periodontal disease . J Dent Res 69:1696-1702.

10.

Miller AJ , Brunelle JA , Carlos JP , Brown, LJ , Loe H. (1987). Oral health in United States adults: National findings. The national survey of oral health in US employed adults and seniors: 1985-86. US Department of Health and Human Services, NIH Publication No. 87-2868. Bethesda, MD: National Institute of Dental Research.

11.

Niessen LC , Weyant RJ (1989). Causes of tooth loss in a veteran population. J Public Health Dent 49:19-23.

12.

Zambon JJ , Reynolds HS , Chen P. , Genco RJ (1985). Rapid identification of periodontal pathogens in subgingival dental plaque. Comparison of indirect immunofluorescence microscopy with bacterial culture for detection of Bacteroides gingivalis. J Periodontol 56(Suppl):32-40.