Asthma, chronic obstructive pulmonary disease, tooth loss, and edentulism among adults in the United States

Dwibedi, Nilanjana; Wiener, R. Constance; Findley, Patricia A.; Shen, Chan; Sambamoorthi, Usha

doi:10.1016/j.adaj.2019.07.032

Cited by 15 publications

(10 citation statements)

References 42 publications

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“…As the major cause of tooth loss, periodontal disease was associated with several systemic diseases under the inflammatory mechanism (Kim and Amar, 2006;Linden et al, 2013;Genco and Sanz, 2020). Tooth loss has been associated with chronic diseases and conditions, such as diabetes (Kapp et al, 2007;Winning et al, 2017), cardiovascular disease (Okoro et al, 2005;Winning et al, 2020), stroke (Joshipura et al, 2003), cancer (Maisonneuve et al, 2017;Michaud et al, 2017), obesity (Österberg et al, 2010), depression (Okoro et al, 2012), memory impairment (Okamoto et al, 2015), arthritis (de Pablo et al, 2008), and respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) (Wang et al, 2009;Thomas et al, 2010;Bansal et al, 2013;Dwibedi et al, 2020). However, most of these studies have focused on an isolated chronic disease without controlling for other concurrent chronic diseases or multimorbidity.…”

Section: Introductionmentioning

confidence: 99%

Multiple Chronic Diseases Associated With Tooth Loss Among the US Adult Population

Zhang

Leveille²,

Shi³

2022

Front. Big Data

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BackgroundHalf of US adults aged 20–64 years have lost at least one permanent tooth; one in six adults aged 65 and over in the USA is edentulous. Tooth loss and edentulism interfere with nutritional intake and quality of life. Although selected chronic diseases (e.g., diabetes) have been identified as possible risk factors for tooth loss, data on multiple chronic diseases and on having two or more concurrent chronic diseases (multimorbidity) in relation to tooth loss are lacking. Therefore, this study aimed to assess the association between multiple chronic diseases, multimorbidity, and tooth loss in US adults.MethodsWe performed a secondary data analysis using the US 2012 Behavioral Risk Factor Surveillance System (BRFSS), a national cross-sectional telephone survey studying health conditions and health behaviors among US adults (≥18 years) who are non-institutionalized residents. Variables were derived from the BRFSS Standard Core Questionnaire. Descriptive analysis including means, standard deviations (SDs), and percentages was calculated. Sample weights were applied. The stepwise multinomial logistic regression method was used to examine the relationship between several chronic diseases and tooth loss. Separate multinomial logistic regression models were used to examine the relationship between multimorbidity and tooth loss among all adults aged more than 18 years, adults aged 18–64 years, and adults aged more than 65 years, respectively.ResultsAmong the samples (n = 471,107, mean age 55 years, 60% female), 55% reported losing no tooth loss, 30% reported losing one to five teeth, 10% reported losing six or more but not all teeth, and 5% reported losing all teeth. After adjusting for demographic characteristics, socioeconomic status, smoking, BMI, and dental care, chronic diseases that were associated with edentulism were chronic obstructive pulmonary disease (COPD) [adjusted risk ratio (adj. RR) 2.18, 95% confidence interval (CI) 2.08–2.29]; diabetes (adj. RR 1.49, 95% CI 1.44–1.56); arthritis (adj. RR 1.49, 95% CI 1.44–1.54); cardiovascular disease (adj. RR 1.38, 95% CI 1.30–1.45); stroke (adj. RR 1.31, 95% CI 1.24–1.40); kidney disease (adj. RR 1.16, 95% CI 1.08–1.25); cancer (adj. RR 1.05, 95% CI 1.01–1.11); and asthma (adj. RR 1.07, 95% CI 1.02–1.12). For those who reported losing six or more teeth, the association remained significant for all the chronic diseases mentioned, albeit the magnitude of association appeared to be comparative or smaller. In addition, adults with multimorbidity were more likely to have tooth loss (loss of one to five teeth: adj. RR 1.17, 95% CI 1.14–1.19; loss of six or more teeth: adj. RR 1.78, 95% CI 1.73–1.82; edentulous: adj. RR 2.03, 95% CI 1.96–2.10).ConclusionsMultiple chronic diseases were associated with edentulism and tooth loss. People with multimorbidity are more likely to be edentulous than those with one or no chronic disease. The findings from this study will help to identify populations at increased risk for oral problems and nutritional deficits, thus the assessment of oral health should be evaluated further as an important component of chronic illness care.

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Section: Introductionmentioning

confidence: 99%

Multiple Chronic Diseases Associated With Tooth Loss Among the US Adult Population

Zhang

Leveille²,

Shi³

2022

Front. Big Data

View full text Add to dashboard Cite

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“…On the other hand, metabolic diseases can increase susceptibility to dental caries and missing teeth due to dysregulated inflammation and immune functions. In patients with missing teeth, systemic inflammation and immune dysfunctions can also increase susceptibility to cancer, respiratory diseases, such as asthma and chronic obstructive pulmonary disease, and digestive diseases, such as liver diseases (34)(35)(36).…”

Section: Discussionmentioning

confidence: 99%

Is the Number of Missing Teeth Associated With Mortality? A Longitudinal Study Using a National Health Screening Cohort

et al. 2022

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This study aimed to estimate the risk of mortality related to the number of missing teeth in a South Korean population. The ≥ 40-year-old population of the Korean National Health Insurance Service-Health Screening Cohort 2002–2003 was analyzed. Participants were selected from a total of 220,189 participants and included in groups of 0 teeth lost, 1–2 teeth lost, and ≥ 3 teeth lost. Among the total population, 17,211 participants were included in no missing teeth, 1–2 missing teeth, and ≥ 3 missing teeth and were randomly matched 1:1:1 for age and sex. Mortality from specific causes and all-cause mortality were compared among the groups. The hazard ratio (HR) of the number of missing teeth for all-cause mortality or each cause of mortality was analyzed using Cox proportional hazard models. According to the cause of death, the HRs for metabolic disease, digestive disease, and trauma were greater in the group with ≥ 3 missing teeth than in the no missing teeth group. The group with ≥ 3 missing teeth indicated a 1.19-fold higher HR for all-cause mortality than the no missing teeth group [95% confidence intervals (95% CIs) = 1.12–1.27, P < 0.001]. The group with 1- 2 missing teeth did not show a higher HR for all-cause mortality. In the group with 1–2 missing teeth, the HRs for mortality from mental disease and digestive disease were higher than those in the no missing teeth group. The group with 1–2 missing teeth did not show a higher HR for all-cause mortality. The number of missing teeth was linked with a higher risk of mortality. For specific causes of mortality, mortality from metabolic disease, digestive disease, and trauma was higher in the participants with the number of missing teeth.

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“…Specifically, a population-based study revealed that persons diagnosed with asthma were significantly less likely to receive dental care than the general population. 19 This study attempted to address this phenomenon by analyzing reported cases of newly diagnosed asthma within 2 years of the NHANES survey, when data were collected regarding the dental filling status of persons. As a result, it is assumed that more long-term trends in differential dental care among persons diagnosed with asthma versus the general population would be minimized.…”

Section: Discussionmentioning

confidence: 99%

Reported asthma and dental amalgam exposure among adults in the United States: An assessment of the National Health and Nutrition Examination Survey

Geier¹,

Geier²

2021

SAGE Open Medicine

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Objective: Mercury (Hg)-based amalgam is a dental restorative material in common use. This hypothesis-testing study evaluated the relationship between dental amalgam exposure and the risk of reported asthma diagnoses in American adults. Methods: A total of 97,861,577 weighted-persons with one or more dental amalgam surfaces (exposed group) and 31,716,558 weighted-persons with one or more other dental surfaces (no dental amalgams, unexposed group) were examined in the 2015–2016 National Health and Nutrition Examination Survey. All persons were 20–80 years old and with known reported asthma status (only newly diagnosed asthma cases were examined). Survey logistic regression and survey frequency modeling in SAS were employed to evaluate the relative incidence rate of reported asthma diagnoses among those in the exposed group compared to the unexposed group. Covariates of gender, race, socioeconomic status, educational status, country of birth, and tobacco exposure were considered. Results: Survey logistic modeling revealed a significantly increased incidence rate of reported asthma in the exposed group as compared to the unexposed group in unadjusted (4.46-fold) and adjusted (4.84-fold) models. A dose–response relationship was observed for the risk of reported asthma per dental amalgam filling surface in unadjusted (1.073) and adjusted (1.076) models. Survey frequency modeling revealed that the frequency of reported asthma (per 10,000 weighted-person years) was 3.66-fold significantly increased in the exposed group (2.06) as compared to the unexposed group (0.56). Conclusion: Increased dental amalgam exposure was associated with an increased risk of reported asthma diagnoses in American adults, but future studies should further evaluate this relationship.

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Asthma, chronic obstructive pulmonary disease, tooth loss, and edentulism among adults in the United States

Cited by 15 publications

References 42 publications

Multiple Chronic Diseases Associated With Tooth Loss Among the US Adult Population

Multiple Chronic Diseases Associated With Tooth Loss Among the US Adult Population

Is the Number of Missing Teeth Associated With Mortality? A Longitudinal Study Using a National Health Screening Cohort

Reported asthma and dental amalgam exposure among adults in the United States: An assessment of the National Health and Nutrition Examination Survey

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