Japanese scientists examined how 13 oral health characteristics are associated with the risk of functional disability and death. An analysis of a sample of nearly 24,000 people revealed that virtually all 13 oral health indicators were associated with these risks, but masticatory function had the greatest impact on both the risk of death and the risk of disability. The article was published in The Lancet Healthy Longevity.
It is estimated that over 3.5 billion people worldwide suffer from oral diseases. Despite this, oral hygiene remains under-represented in clinical practice, leading the World Health Organization to set a goal of achieving universal oral health coverage by 2030.
In the context of global aging, maintaining oral hygiene in old age is crucial for maintaining health and longevity. Poor oral hygiene can lead to an increased risk of aspiration pneumonia and Alzheimer's disease. Furthermore, oral health problems are associated with declining physical function in older adults. However, there are very few large-scale, comprehensive studies examining the relationship between oral health and the most common adverse outcomes in old age—functional disability and death.
A research team led by Takafumi Abe of Shimane University used data obtained from oral examinations of elderly people over 75 years of age. They assessed 13 oral health characteristics: the number of remaining teeth, subjective chewing efficiency, objective chewing efficiency, periodontal tissue condition, functional swallowing disorder, tongue mobility, articulation, oral hygiene, the number of decayed teeth, maladjustment of upper and lower dentures, oral mucosal diseases, and dry mouth.
Between April 1, 2016, and March 31, 2022, 24,619 individuals underwent an oral health examination at least once. The mortality analysis included 22,747 individuals (9,722 men and 13,025 women, mean age 78.34 years). The final functional disability analysis included 21,881 individuals (9,175 men and 12,706 women, mean age 78.31 years). The primary analysis showed that all 13 oral health aspects studied were associated with the risk of death, and 11 of them (all except oral mucosal pathologies and dry mouth) were associated with the risk of functional disability.
Additional calculations and specific analyses revealed that the three aspects of oral health that most significantly influence functional impairment are objective chewing efficiency, periodontal tissue condition, and the number of remaining teeth. The association with mortality was most strongly influenced by objective chewing efficiency, the number of teeth, and subjective chewing efficiency.
According to the authors, chewing ability is an objective factor in oral health that particularly influences the risk of functional disability and death. This allows for preventive measures aimed directly at preventing and treating masticatory disorders.
We previously reported on the work of European scientists who found that the energy expenditure on chewing in humans is approximately five times less than that of non-human apes.
