Tooth loss among middle-aged adults in the Northern Finland Birth Cohort 1966:associations with tobacco smoking and diabetes

• Main Author: Similä, T. (Toni)
• Other Authors: Nieminen, P. (Pentti), Lappalainen, O. (Olli-Pekka)
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Oulun yliopisto 2020
• Subjects: cohort study; diabetes; epidemiology; middle-aged adults; regression models; self report; smoking; tobacco; tooth loss; validity; aikuiset; epidemiologia; hampaat; itseraportointi; keski-ikäiset; kohorttitutkimus; menetys; regressioanalyysi; tupakka; tupakointi; validiteetti; Northern Finland
• Online Access: http://urn.fi/urn:isbn:9789526226033

Abstract Oral and general health are linked to each other, and both are contributed by many sociodemographic and behavioral factors. Information on tooth loss, as a simple indicator of oral health of an individual, can easily be collected through self-report for research purposes in population studies. This cross-sectional study was conducted among the 46-year-old members of the Northern Finland Birth Cohort 1966 (N = 10,321), providing a comprehensive and representative sample of middle-aged Finns. First, it was explored if smoking (history), as a harmful health behavior, associated with tooth loss. In addition, the duration of smoking history and the presumed benefits of cessation on tooth loss were investigated. The validity of self-report as a substitute for clinically determined number of teeth was also evaluated. Finally, the usefulness of number of teeth as an indicator of impaired glucose metabolism (prediabetes and diabetes) was tested. Tooth loss, as the outcome, was assessed by clinically measured (N = 1,946) and/or self-reported (N = 5,950) number of teeth. Questionnaires inquired about socioeconomic and behavioral factors, with smoking as the exposure of interest. Impaired glucose metabolism was determined through different sources, with oral glucose tolerance test as the primary screening tool. Negative binomial and logistic regression models served to statistically explore the associations while controlling for relevant confounders. Intraclass correlation coefficient and Bland-Altman plot were the primary tools for validation analysis. Smoking had an exposure-dependent association with tooth loss, mainly among males. It also seemed that those males who had stopped smoking started to gradually reclaim the aptitude for tooth retention. Self-reported number of teeth was in good agreement with the corresponding clinical measure in this study population. A reduced number of teeth associated with impaired glucose metabolism, mainly among females. The findings of this study advocate the importance of ...