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Poor Oral Health Correlates with Increased Mortality Risk in Older People

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Posted 30 August 2021 - 07:06 PM

It is suggested that inflammation in the gums spreads to cause inflammation in the heart and brain, raising the risk of cardiovascular disease and dementia. There is a good deal of evidence for this spread of inflammation to exist, the question is whether or not it contributes to age-related disease to a significant degree in comparison to other mechanisms present in the aging body. Epidemiological data such as that reported in today's open access paper shows meaningful correlations between poor oral health and raised risk of mortality, but it is only a matter of correlation. It might also be compared with other studies, such as an analysis that suggested only a small effect on risk of dementia due to gum disease.

Another possibility, when looking at large effect sizes such as those observed in the study below, is that people with poor oral health have poor oral health because they make bad lifestyle choices and fail to adequately maintain their health in a more general sense. Choose to live an unhealthy life and the gums will be far from the only part of the body to suffer as a consequence. As a further alternative, consider that those people with the worst burden of age-related damage, dysfunction, and chronic inflammation may well suffer worse oral health as one of the many outcomes. There, a raised mortality risk and a raised risk of gum disease stem from the same root causes.

Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA

Aging is characterized by an accumulation of chronic diseases and conditions, including poor oral health, which can influence quality of life and health. Oral health problems, including tooth loss, periodontal disease, and dry mouth, accumulate throughout adult life and worsen with increasing age3. Poor dental health is associated with high levels of inflammation, poor diet quality, and conditions such as disability, diabetes, and increased risk of cardiovascular disease (CVD) and pneumonia.

Furthermore, studies have suggested that poor oral health is associated with higher risk of mortality, including major causes of death such as CVD and respiratory diseases or infections. Tooth loss and periodontal disease have been reported to be associated with increased risks of all-cause, CVD, and respiratory mortality in community-dwelling middle-aged and older people. Furthermore, poor self-rated oral health was found to be associated with increased risk of all-cause mortality in a population of middle-aged and older adults.

We used cohort data from the British Regional Health Study (BRHS) (N = 2147, 71-92 years), and the US Health, Aging, and Body Composition (HABC) Study (N = 3075, 71-80 years). Follow-up was 9 years (BRHS) and 15 years (HABC Study). Oral health comprised tooth loss, periodontal disease, dry mouth, and self-rated oral health. Cox regression was performed for all-cause mortality, competing risks for CVD mortality, and accelerated failure time models for respiratory mortality.

In the BRHS, tooth loss was associated with all-cause mortality (hazard ratio = 1.59). In the HABC Study, tooth loss, dry mouth, and having ≥ 3 oral problems were associated with all-cause mortality; periodontal disease was associated with increased CVD mortality (subdistribution hazard ratio = 1.49); tooth loss, and accumulation of oral problems were associated with high respiratory mortality (time ratio = 0.73). Findings suggest that poor oral health is associated with mortality.

View the full article at FightAging

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