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Tooth Loss: Prevalence, Risk Factors, and Impact on Quality of Life
Global Prevalence and Incidence of Tooth Loss
Global Trends in Tooth Loss (1990-2010)
The Global Burden of Disease 2010 Study provides comprehensive data on the prevalence and incidence of severe tooth loss worldwide. Between 1990 and 2010, the global age-standardized prevalence of edentate individuals decreased significantly from 4.4% to 2.4%, and the incidence rate dropped from 374 to 205 cases per 100,000 person-years. This decline was consistent across different regions and countries, with no significant differences observed between sexes in 2010. However, the prevalence of tooth loss increased with age, particularly around the seventh decade of life.
Tooth Loss in Europe
A review of tooth loss in Europe highlights a documented decline in edentulism, although significant geographical variations persist. The mean number of lost teeth increases with age, and many elderly individuals still require prosthodontic treatment. The incidence of tooth loss has decreased over recent decades, but institutionalized elderly people generally have poorer oral health compared to those living independently.
Risk Factors for Tooth Loss
Periodontitis and Systemic Health
Several studies have identified key predictors of tooth loss in periodontitis patients. Older age, non-compliance with dental care, diabetes, smoking, and genetic factors such as IL-1 polymorphism significantly increase the risk of tooth loss. Additionally, teeth with bone loss, high probing pocket depth, mobility, and molars with furcation involvement are more likely to be lost.
Socioeconomic and Behavioral Factors
A population-based cohort study in Brazil found that seeking dental services due to pain, previous tooth loss, and the presence of decayed teeth were significant risk factors for tooth loss. Socioeconomic factors, such as low income and limited access to dental care, also play a crucial role in the incidence of tooth loss.
Longitudinal Studies in the US
Longitudinal studies in the US have shown that the rate of tooth loss varies by population and sex. Significant predictors include the percentage of teeth with restorations, mean probing pocket depth, age, tobacco use, alcohol consumption, and the number of teeth present. These factors differ between populations and sexes, indicating the complexity of tooth loss predictors.
Impact of Tooth Loss on Quality of Life
Oral Health-Related Quality of Life (OHRQoL)
Tooth loss significantly impacts oral health-related quality of life (OHRQoL). Studies consistently show that tooth loss is associated with unfavorable OHRQoL scores, regardless of the instrument used or the study location. The number and position of missing teeth further influence the severity of the impact, with anterior tooth loss having a more significant effect on OHRQoL .
Psychological and Functional Impacts
The loss of teeth affects various dimensions of quality of life, including pain, psychological discomfort, and disability. Older individuals with fewer teeth report difficulties in eating, chewing, swallowing, and a reduced willingness to smile. These findings underscore the importance of maintaining oral health to preserve overall quality of life .
Conclusion
Tooth loss remains a significant public health issue, with its prevalence and incidence showing a declining trend globally. Various risk factors, including age, systemic health conditions, and socioeconomic status, contribute to tooth loss. The impact on quality of life is profound, affecting both psychological well-being and functional abilities. Efforts to prevent tooth loss should focus on addressing these risk factors and promoting comprehensive dental care.
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