Radiographic oral findings and death risk in the elderly

Soikkonen, Kari (1999-11-16)
 
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Soikkonen, Kari
University of Oulu
16.11.1999
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Academic Dissertation to presented with the assent of the Faculty of Medicine, University of Oulu, for public discussion in the Auditorium 1 of the Institute of Dentistry (Aapistie 3), on January 7th, 2000, at 12 noon.
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Abstract

Radiographic oral and maxillofacial findings were recorded in a cohort of 293 home living elderly, in Helsinki, Finland, derived from a random sample of 8035 subjects, born in 1904, 1909, and 1912, who participated in the Helsinki Ageing Study. They were 76, 81, and 86 years old at the commencement of the radiographic study. The relationships of potentially infectious findings with increased all-cause mortality over four years were studied. During the four-year follow-up, 18.5% of the subjects died.

Of the 124 edentulous subjects, 17% had condylar findings, 13% radiopaque intraosseous findings, 9% retained roots, 6% maxillary sinus findings, 4% impacted teeth and 3% radiolucent findings. Edentulous women had more arthrotic condylar findings than men.

The mean number of teeth in the 169 dentate subjects was 13.9, 15.5 in men and 13.2 in women. Carious teeth were found in 75%, radiolucent findings in 41%, teeth with vertical infrabony pockets in 51%, furcation lesions in 28%, calculus in 40%, and condylar findings in 25%. Periodontal attachment loss was slight in 18%, moderate in 31%, and advanced in 46%. 21% of the teeth had been endodontically treated. Periapical lesions were found in 17% of these teeth, and in 4% of the other teeth. 75% of the rootfillings were inadequate, exhibiting periapical lesions twice as often as the adequate ones. Men had more carious teeth, periapical lesions and furcation lesions than women, indicating better oral hygiene and/or utilisation of dental services in women.

Compared with the previous studies carried out in Finland, slightly more teeth and less tooth-associated pathology were found in the present subjects. In contemporary Scandinavian studies, only a slightly better oral health status in the elderly has been reported.

During the four-year follow-up, mortality was higher in the subjects with moderate to advanced infrabony pockets, OR 2.2, 1.0–4.7. In the previous studies, similar associations have been found in larger study cohorts including younger subjects. Our results indicate that oral foci may be more dangerous for the elderly than it has been previously thought, as the subjects who died had poorer dental health than those who survived.

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