Prevalence of and Changes in Tooth Loss Among Adults Aged ≥50 Years with Selected Chronic Conditions — United States, 1999–2004 and 2011–2016

Abstract

Extensive tooth loss can lead to poor diet resulting in weight loss or obesity (1). It can also detract from physical appearance and impede speech, factors that can restrict social contact, inhibit intimacy, and lower self-esteem (1). Chronic medical conditions and oral conditions share common risk factors (2). Persons with chronic conditions are more likely to have untreated dental disease, which can result in tooth loss. Three measures of tooth loss during 1999-2004 and 2011-2016 were estimated by comparing data from the National Health and Nutrition Examination Survey (NHANES) for each period among adults aged ≥50 years with selected chronic conditions.* The three measures were 1) edentulism (having no teeth); 2) severe tooth loss (having eight or fewer teeth) (3); and 3) lacking functional dentition (having <20 teeth out of 28, which is considered a full set for the purpose of NHANES assessments) (4). During 2011-2016, prevalences of edentulism and severe tooth loss were ≥50% higher among adults with fair or poor general health, rheumatoid arthritis, asthma, diabetes, emphysema, heart disease, liver condition, or stroke than among those with those adults without the chronic condition. Lack of functional dentition was also more prevalent among adults with chronic conditions than among persons without these conditions. Tooth loss is preventable with self-care and routine dental visits (1). To encourage these behaviors, public health professionals can educate the public about the association between having a chronic condition and tooth loss, and primary care providers can educate their patients about the importance of healthy behaviors and screen and refer them for needed dental care. Data obtained from CDC's NHANES, a multistage probability sample designed to assess the health and nutritional * Data from three 2-year cycles of NHANES were combined for each period status of the noninstitutionalized U.S. population through participant interviews and physical examinations, † were analyzed for all adults aged ≥50 years and those with selected chronic conditions; the analysis was limited to adults who completed a dental examination as part of NHANES. Prevalences of the three categories of tooth loss (edentulism and severe tooth loss [determined by the Global Burden of Disease to cause major difficulty in eating meat, fruits, and vegetables (3)] and lacking functional dentition), using the World Health Organization criteria (4) during 2011-2016 were estimated. Lack of functional dentition provides the most actionable information among the three measures because it detects symptomatic tooth loss in the earliest stage. Chronic conditions were self-reported except for uncontrolled diabetes, obesity, and the number of teeth lost, which were clinically assessed. Estimated prevalence † https://www.cdc.gov/nchs/nhanes.htm.