Tooth retention, health, and quality of life in older adults: a scoping review

Abstract

Objective This scoping review describes the relationship between tooth retention, health, and quality of life in older adults. Methods Seven databases were searched for English language articles for subjects ≥ 65 y from 1981 to 2021. Exposure was tooth retention (≥ 20), and outcomes were general/systemic health and quality of life. Methodological quality was assessed using the Newcastle–Ottawa Scale and Cochrane Risk of Bias 2.0 tool. Results 140 articles were included, only four were randomized trials. Inter-rater agreement (κ) regarding study inclusion was 0.924. Most were assessed with low risk of bias (n = 103) and of good quality (n = 96). Most studies were conducted in Japan (n = 60) and Europe (n = 51) and only nine in the US. Tooth retention was referred to as “functional dentition” in 132 studies and “shortened dental arch” in 19 studies. Study outcomes were broadly synthesized as (1) cognitive decline/functional dependence, (2) health status/chronic diseases, (3) nutrition, and (4) quality of life. Discussion There is a positive relationship between tooth retention, overall health, and quality of life. Older adults retaining ≥ 20 teeth are less likely to experience poorer health. Having < 20 teeth increases the likelihood for functional dependence and onset of disability, and may affect successful ageing. This review supports the general finding that the more teeth older adults retain as they age, the less likely they are to have adverse health outcomes. However, significant knowledge gaps remain which can limit decision-making affecting successful ageing for many older adults. This review highlights the need to consider, as an important marker of oral health and function, the retention of a functional minimum of a natural dentition, rather than a simple numeric score of missing teeth.

Oral health for baby boomers: Past, present, and future

“…This is particularly true in trying to improve the standards of care for those who depend on others for help to manage their daily routines. 35…”

“…The importance of retaining a functional minimum number of occluding natural teeth (rather than solely a tooth count) has been emphasized in successful aging. This is particularly true in trying to improve the standards of care for those who depend on others for help to manage their daily routines 35 …”

Social participation and tooth loss, vision, and hearing impairments among older Brazilian adults

“…11 Besides its intrinsic function, the mouth plays a crucial role in face-to-face social interaction. Older adults with severe tooth loss are more likely to feel embarrassed, 12,13 avoid smiling, talking, and eating in public, 14,15 and become homebound, 16 which can reduce opportunities for social interactions. Although vision, hearing and tooth loss often occur together in older populations, they are commonly viewed separately in research and service provision.…”

The Absence of Dental Care in Medicare and Health Inequities

“…As older adults age, the more teeth they retain, the less likely they are to have adverse health outcomes. 5 During the past 25 years, our understanding of the association between oral health and overall health has significantly evolved. For several decades prior to the beginning of the 20th century, we generally believed that oral infection was mostly a localized concern (except with diabetes and periodontitis), and from a public perspective, good oral health was equated to having healthy teeth.…”

“…There is an important association between tooth retention and overall health. As older adults age, the more teeth they retain, the less likely they are to have adverse health outcomes …”