Oral health in relation to all-cause mortality: the IPC cohort study

Margaux Adolph, Christelle Darnaud, Frédérique Thomas, Bruno Pannier, Nicolas Danchin, G David Batty, Philippe Bouchard, Margaux Adolph, Christelle Darnaud, Frédérique Thomas, Bruno Pannier, Nicolas Danchin, G David Batty, Philippe Bouchard

Abstract

We evaluated the association between oral health and mortality. The study population comprised 76,188 subjects aged 16-89 years at recruitment. The mean follow-up time was 3.4 ± 2.4 years. Subjects with a personal medical history of cancer or cardiovascular disease and death by casualty were excluded from the analysis. A full-mouth clinical examination was performed in order to assess dental plaque, dental calculus and gingival inflammation. The number of teeth and functional masticatory units <5 were recorded. Causes of death were ascertained from death certificates. Mortality risk was evaluated using Cox regression model with propensity score calibrated for each oral exposure. All-cause mortality risk were raised with dental plaque, gingival inflammation, >10 missing teeth and functional masticatory units <5. All-cancer mortality was positively associated with dental plaque and gingival inflammation. Non-cardiovascular and non-cancer mortality were also positively associated with high dental plaque (HR = 3.30, [95% CI: 1.76-6.17]), high gingival inflammation (HR = 2.86, [95% CI: 1.71-4.79]), >10 missing teeth (HR = 2.31, [95% CI: 1.40-3.82]) and functional masticatory units <5 (HR = 2.40 [95% CI 1.55-3.73]). Moreover, when ≥3 oral diseases were cumulated in the model, the risk increased for all-cause mortality (HR = 3.39, [95% CI: 2.51-5.42]), all-cancer mortality (HR = 3.59, [95% CI: 1.23-10.05]) and non-cardiovascular and non-cancer mortality (HR = 4.71, [95% CI: 1.74-12.7]). The present study indicates a postive linear association between oral health and mortality.

Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1. Histogram representing Hazard Ratios (HR,…
Figure 1. Histogram representing Hazard Ratios (HR, 95% CI) for all-cause, all-cancer, and non CV and non cancer mortality depending on cumulative dental exposure (dental plaque, dental calculus, gingival inflammation, functional Masticatory Units 10) (Propensity score model).

References

    1. Broadbent J. M., Thomson W. M., Boyens J. V. & Poulton R. Dental plaque and oral health during the first 32 years of life. J Am Dent Assoc 142, 415–426 (2011).
    1. Mariotti A. Dental plaque-induced gingival diseases. Ann Periodontol 4, 7–19, doi: 10.1902/annals.1999.4.1.7 (1999).
    1. Kassebaum N. J. et al.. Global burden of untreated caries: a systematic review and metaregression. J Dent Res 94, 650–658, doi: 10.1177/0022034515573272 (2015).
    1. Eke P. I. et al.. Update on Prevalence of Periodontitis in Adults in the United States: NHANES 2009 to 2012. J Periodontol 86, 611–622, doi: 10.1902/jop.2015.140520 (2015).
    1. Joshipura K. J. et al.. Poor oral health and coronary heart disease. J Dent Res 75, 1631–1636 (1996).
    1. DeStefano F., Anda R. F., Kahn H. S., Williamson D. F. & Russell C. M. Dental disease and risk of coronary heart disease and mortality. BMJ 306, 688–691 (1993).
    1. Soder B., Yakob M., Meurman J. H., Andersson L. C. & Soder P. O. The association of dental plaque with cancer mortality in Sweden. A longitudinal study. BMJ Open 2, doi: 10.1136/bmjopen-2012-001083 (2012).
    1. Hayasaka K. et al.. Tooth loss and mortality in elderly Japanese adults: effect of oral care. J Am Geriatr Soc 61, 815–820, doi: 10.1111/jgs.12225 (2013).
    1. Desvarieux M. et al.. Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Stroke 34, 2120–2125, doi: 10.1161/01.STR.0000085086.50957.22 (2003).
    1. de Oliveira C., Watt R. & Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey. BMJ 340, c2451, doi: 10.1136/bmj.c2451 (2010).
    1. Tomas I., Diz P., Tobias A., Scully C. & Donos N. Periodontal health status and bacteraemia from daily oral activities: systematic review/meta-analysis. J Clin Periodontol 39, 213–228, doi: 10.1111/j.1600-051X.2011.01784.x (2012).
    1. Kornman K. S., Page R. C. & Tonetti M. S. The host response to the microbial challenge in periodontitis: assembling the players. Periodontol 2000 14, 33–53 (1997).
    1. Klock K. S. & Haugejorden O. Primary reasons for extraction of permanent teeth in Norway: changes from 1968 to 1988. Community Dent Oral Epidemiol 19, 336–341 (1991).
    1. Walls A. W., Steele J. G., Sheiham A., Marcenes W. & Moynihan P. J. Oral health and nutrition in older people. J Public Health Dent 60, 304–307 (2000).
    1. Nowjack-Raymer R. E. & Sheiham A. Numbers of natural teeth, diet, and nutritional status in US adults. J Dent Res 86, 1171–1175 (2007).
    1. Sheiham A. et al.. The relationship among dental status, nutrient intake, and nutritional status in older people. J Dent Res 80, 408–413 (2001).
    1. Linden G. J. et al.. All-cause mortality and periodontitis in 60-70-year-old men: a prospective cohort study. J Clin Periodontol 39, 940–946, doi: 10.1111/j.1600-051X.2012.01923.x (2012).
    1. Hamalainen P., Meurman J. H., Keskinen M. & Heikkinen E. Relationship between dental health and 10-year mortality in a cohort of community-dwelling elderly people. Eur J Oral Sci 111, 291–296 (2003).
    1. Darnaud C., Thomas F., Pannier B., Danchin N. & Bouchard P. Oral Health and Blood Pressure: The IPC Cohort. Am J Hypertens 28, 1257–1261, doi: 10.1093/ajh/hpv025 (2015).
    1. Carra M. C. et al.. Sleep disorders and oral health: a cross-sectional study. Clin Oral Investig, doi: 10.1007/s00784-016-1851-y (2016).
    1. Silness J. & Loe H. Periodontal Disease in Pregnancy. Ii. Correlation between Oral Hygiene and Periodontal Condtion. Acta Odontol Scand 22, 121–135 (1964).
    1. Lobene R. R., Weatherford T., Ross N. M., Lamm R. A. & Menaker L. A modified gingival index for use in clinical trials. Clin Prev Dent 8, 3–6 (1986).
    1. Gotfredsen K. & Walls A. W. What dentition assures oral function? Clin Oral Implants Res 18 Suppl 3, 34–45, doi: 10.1111/j.1600-0501.2007.01436.x (2007).
    1. Menotti A., Puddu P. E., Maiani G. & Catasta G. Cardiovascular and other causes of death as a function of lifestyle habits in a quasi extinct middle-aged male population. A 50-year follow-up study. Int J Cardiol 210, 173–178, doi: 10.1016/j.ijcard.2016.02.115 (2016).
    1. Whitmore S. E. & Lamont R. J. Oral bacteria and cancer. PLoS Pathog 10, e1003933, doi: 10.1371/journal.ppat.1003933 (2014).
    1. Cabrera C. et al.. Can the relation between tooth loss and chronic disease be explained by socio-economic status? A 24-year follow-up from the population study of women in Gothenburg, Sweden. Eur J Epidemiol 20, 229–236 (2005).
    1. Tu Y. K. et al.. Associations between tooth loss and mortality patterns in the Glasgow Alumni Cohort. Heart 93, 1098–1103, doi: 10.1136/hrt.2006.097410 (2007).
    1. Abnet C. C. et al.. Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. Int J Epidemiol 34, 467–474, doi: 10.1093/ije/dyh375 (2005).
    1. Abnet C. C. et al.. Prospective study of tooth loss and incident esophageal and gastric cancers in China. Cancer Causes Control 12, 847–854 (2001).
    1. Aida J. et al.. Oral health and cancer, cardiovascular, and respiratory mortality of Japanese. J Dent Res 90, 1129–1135, doi: 10.1177/0022034511414423 (2011).
    1. Stolzenberg-Solomon R. Z. et al.. Tooth loss, pancreatic cancer, and Helicobacter pylori. Am J Clin Nutr 78, 176–181 (2003).
    1. Ansai T. et al.. Association between tooth loss and orodigestive cancer mortality in an 80-year-old community-dwelling Japanese population: a 12-year prospective study. BMC Public Health 13, 814, doi: 10.1186/1471-2458-13-814 (2013).

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