Factors Associated with Tooth Loss in Postmenopausal Women: A Community-Based Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design, Sample, and Setting
2.2. Measurements
- Demographic characteristics included age, years of education, and three self-reported chronic diseases (diabetes mellitus, hypertension, and hyperlipidemia).
- Bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry at the collaborating hospitals. Participants with a T-score <−1.0 were classified as having osteopenia, and a T-score <−2.5 indicated osteoporosis, as recommended by WHO guidelines [24].
- Number of remaining teeth (NRT) was calculated by the trained research assistants based on the natural and filled teeth in the mouth. Removable dentures and residual roots without a crown were excluded. Participants were divided into two categories, namely “NRT <20” and “NRT ≥20”.
- Oral health related behaviors were measured by personal habits including oral hygiene, substance use, and eating behaviors. Firstly, oral hygiene was evaluated by three questions: “Do you use dental floss daily?”, “Do you undergo dental checkups or tooth scaling regularly (every 6–12 months can be covered by the National Health Insurance)?”, and “Do you brush your teeth after meals?” Answers were categorized as infrequent (“never/seldom”) versus frequent (“usually/always”). Secondly, tobacco and alcohol use were classified as “never used” versus “currently or formerly used”. Thirdly, eating behaviors were examined with two questions: “Does your diet include five food groups per day, namely grains, vegetables, milk, meat, and fruits?”, and “Do you drink at least 1500 mL of water every day? The answers “never or sometimes” were classified as inadequate, whilst “usually or always” were coded as adequate.
2.3. Procedure and Ethical Considerations
2.4. Statistical Analyses
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Disclosure
References
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Variable | n (%) | Mean ± SD |
---|---|---|
Age, years | 65.4 ± 7.6 | |
≥65 | 321 (52.6) | |
Education level, years | 3.1 ± 4.3 | |
≤9 | 564 (92.5) | |
Chronic diseases | ||
Hypertension | 284 (46.6) | |
Diabetes mellitus | 287 (47.0) | |
Hyperlipidemia | 127 (20.8) | |
BMD T-score | −1.6 ± 1.1 | |
BMD status | ||
Normal | 187 (30.7) | |
Osteopenia | 297 (48.7) | |
Osteoporosis | 126 (20.7) | |
Oral health related behaviors | ||
Tooth brushing after meal (infrequent) | 402 (65.9) | |
Dental flossing (infrequent) | 483 (79.2) | |
Tooth scaling (infrequent) | 488 (80.0) | |
Inadequate nutrition | 164 (26.9) | |
Inadequate water intake | 326 (53.4) | |
Cigarette smoking | 12 (2.0) | |
Alcohol drinking | 36 (5.9) | |
Number of remaining teeth (NRT) | 17.6 ± 10.4 | |
Group of NRT | ||
0 | 85 (13.9) | |
1–19 | 183 (30.0) | |
≥20 | 342 (56.1) |
Variable | NRT ≥20 (n = 342) | NRT <20 (n = 268) | p |
---|---|---|---|
Age, years (Mean ± SD) | 63.3 ± 7.4 | 68.0 ± 6.9 | <0.001 |
≥65 | 140 (40.9) | 181 (67.5) | <0.001 |
Education years (Mean ± SD) | 4.0 ± 0.2 | 2.0 ± 3.6 | <0.001 |
≤9 | 306 (89.5) | 258 (96.3) | 0.002 |
Chronic diseases | |||
Hypertension | 150 (43.9) | 134 (50.0) | 0.131 |
Diabetes mellitus | 147 (40.3) | 140 (52.2) | 0.023 |
Hyperlipidemia | 72 (21.1) | 55 (20.5) | 0.873 |
BMD T-score (Mean ± SD) | −1.4 ± 1.1 | −1.7 ± 1.2 | <0.001 |
BMD status | 0.006 | ||
Normal | 117 (34.2) | 70 (26.1) | |
Osteopenia | 169 (49.4) | 128 (47.8) | |
Osteoporosis | 56 (16.4) | 70 (26.1) | |
Oral health related behaviors | |||
Tooth scaling infrequent | 246 (71.9) | 242 (90.3) | <0.001 |
Using dental floss infrequent | 244 (71.3) | 239 (89.2) | <0.001 |
Cigarette smoking * | 11 (3.2) | 1 (0.4) | 0.012 |
Alcohol drinking | 22 (6.4) | 14 (5.2) | 0.529 |
Inadequate nutrition | 82 (24.0) | 82 (30.6) | 0.134 |
Inadequate water intake | 176 (51.5) | 150 (56.0) | 0.268 |
Explanatory Variables | Model 1 | Model 2 | Model 3 |
---|---|---|---|
OR (95% CI) | OR (95% CI) | OR (95% CI) | |
Hypertension | 1.28 (0.93–1.76) | § | § |
Diabetes mellitus | 1.45 (1.05–2.00) * | § | § |
Hyperlipidemia | 0.97 (0.65–1.44) | § | § |
BMD status | |||
Normal ¶ | – | – | – |
Osteopenia | 1.27 (0.87–1.84) | § | § |
Osteoporosis | 2.09 (1.32–3.31) * | § | § |
Oral health related behaviors | |||
Tooth scaling infrequent | 3.63 (2.27–5.80) * | 3.11 (1.92–5.06) * | 2.78 (1.70–4.56) * |
Dental flossing infrequent | 3.31 (2.11–5.20) * | 2.38 (1.49–3.82) * | 2.01 (1.24–3.26) * |
Cigarette smoking | 0.11 (0.01–0.88) * | § | § |
Alcohol drinking | 0.80 (0.40–1.60) | § | § |
Inadequate nutrition | 1.40 (0.98–2.00) | 1.53(1.04–2.24) * | § |
Inadequate water intake | 1.20 (0.87–1.65) | § | § |
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Pan, M.-Y.; Hsieh, T.-C.; Chen, P.-H.; Chen, M.-Y. Factors Associated with Tooth Loss in Postmenopausal Women: A Community-Based Cross-Sectional Study. Int. J. Environ. Res. Public Health 2019, 16, 3945. https://doi.org/10.3390/ijerph16203945
Pan M-Y, Hsieh T-C, Chen P-H, Chen M-Y. Factors Associated with Tooth Loss in Postmenopausal Women: A Community-Based Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2019; 16(20):3945. https://doi.org/10.3390/ijerph16203945
Chicago/Turabian StylePan, Mei-Yu, Tsung-Cheng Hsieh, Po-Han Chen, and Mei-Yen Chen. 2019. "Factors Associated with Tooth Loss in Postmenopausal Women: A Community-Based Cross-Sectional Study" International Journal of Environmental Research and Public Health 16, no. 20: 3945. https://doi.org/10.3390/ijerph16203945