{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:16:01Z","timestamp":1788869761942,"version":"build-2803163510"},"reference-count":35,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JDR Clinical &amp; Translational Research"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This cross-sectional observational study analyzed patterns of tooth loss across different population groups using National Health and Nutrition Examination Survey (NHANES) data from 2009 to 2018, aiming to identify the teeth most at risk and the key contributing factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data from 24,945 adults aged 20 y and older were analyzed. Tooth presence\/absence was modeled in relation to age, income, education, smoking history, and glycemic status. To improve robustness, missing covariate data were imputed using k-nearest neighbors, and survey weights were applied in regression analyses to account for NHANES\u2019s complex sampling design. A 2-step analytic approach was used: (1) survey-weighted quasi-Poisson regression estimated associations with total tooth count and (2) unweighted generalized estimating equations identified explanatory variables associated with individual tooth loss, accounting for intraoral clustering. Dental implants were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Tooth-level models suggested distinct intraoral and demographic patterns. Males retained more posterior teeth but lost more mandibular incisors than females did. Older adults (\u226560 y) exhibited markedly higher loss in mandibular anterior and premolar regions. High-income and high-education participants retained more teeth overall but were more likely to lack first premolars, likely reflecting orthodontic extractions. Smoking and diabetes were associated with anterior tooth loss, especially in visible, functionally important regions. Glycemic control showed a clear gradient, with low-normal HbA1c levels protective in posterior sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Tooth-level modeling suggested anatomically and socially patterned vulnerabilities often masked in whole-mouth analyses. Findings underscore the need for site-specific prevention strategies that address biological risk and structural inequity, advancing more equitable approaches to oral health care and policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Knowledge Transfer Statement:<\/jats:title>\n                    <jats:p>This study identified which specific teeth are most at risk of loss across age, health, and socioeconomic groups. Understanding these tooth-level patterns can help clinicians tailor preventive care to vulnerable patients, guide patient education, and inform public health strategies that target oral health disparities. These findings support more precise, equitable dental care to help people keep their natural teeth longer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23800844251384952","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T11:49:32Z","timestamp":1761133772000},"page":"465-475","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Mapping Tooth Loss at the Tooth Level: Associations with Demographic, Health, and Behavioral Factors"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2117-9295","authenticated-orcid":false,"given":"K.M.","family":"McCormick","sequence":"first","affiliation":[{"name":"Australian Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Mejia","sequence":"additional","affiliation":[{"name":"The University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Luzzi","sequence":"additional","affiliation":[{"name":"Australian Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9839-9280","authenticated-orcid":false,"given":"L.","family":"Jamieson","sequence":"additional","affiliation":[{"name":"Australian Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"crossref","unstructured":"Ahmadinia AR Rahebi D Mohammadi M Ghelichi-Ghojogh M Jafari A Esmaielzadeh F Rajabi A. 2022. Association between type 2 diabetes (T2D) and tooth loss: a systematic review and meta-analysis. BMC Endocr Disord. 22(1):100. https:\/\/doi.org\/10.1186\/s12902-022-01012-8.","DOI":"10.1186\/s12902-022-01012-8"},{"key":"e_1_3_4_3_1","doi-asserted-by":"crossref","unstructured":"Alvarenga MOP Ferreira RdO Magno MB Fagundes NCF Maia LC Lima RR. 2019. Masticatory dysfunction by extensive tooth loss as a risk factor for cognitive deficit: a systematic review and meta-analysis. Front Physiol. 10:832. https:\/\/doi.org\/10.3389\/fphys.2019.00832.","DOI":"10.3389\/fphys.2019.00832"},{"key":"e_1_3_4_4_1","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee; 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes\u20142024. Diabetes Care 1 January 2024; 47 (Supplement_1): S20\u2013S42. https:\/\/doi.org\/10.2337\/dc24-S002","DOI":"10.2337\/dc24-S002"},{"key":"e_1_3_4_5_1","doi-asserted-by":"crossref","unstructured":"Barman PK Koh TJ. 2020. Macrophage dysregulation and impaired skin wound healing in diabetes. Front Cell Dev Biol. 8:528. https:\/\/doi.org\/10.3389\/fcell.2020.00528.","DOI":"10.3389\/fcell.2020.00528"},{"key":"e_1_3_4_6_1","unstructured":"Centers for Disease Control and Prevention. 2024. Oral health surveillance report: dental caries tooth retention and edentulism United States 2017\u2013March 2020. Washington (DC): U.S. Department of Health and Human Services."},{"key":"e_1_3_4_7_1","doi-asserted-by":"crossref","unstructured":"Costantinides F Castronovo G Vettori E Frattini C Artero ML Bevilacqua L Berton F Nicolin V Di Lenarda R. 2018. Dental care for patients with end-stage renal disease and undergoing hemodialysis. Int J Dent. 2018:9610892. https:\/\/doi.org\/10.1155\/2018\/9610892.","DOI":"10.1155\/2018\/9610892"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12447"},{"key":"e_1_3_4_9_1","article-title":"srvyr: \u2018dplyr\u2019-like syntax for summary statistics of survey data","author":"Ellis GF","year":"2023","unstructured":"Ellis GF, Schneider B. 2023. srvyr: \u2018dplyr\u2019-like syntax for summary statistics of survey data. R Package version 1.2.0.","journal-title":"R Package version 1.2.0"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.1214\/088342306000000691"},{"key":"e_1_3_4_11_1","doi-asserted-by":"crossref","unstructured":"Gerritsen AE Allen PF Witter DJ Bronkhorst EM Creugers NH. 2010. Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes. 8:126. https:\/\/doi.org\/10.1186\/1477-7525-8-126.","DOI":"10.1186\/1477-7525-8-126"},{"key":"e_1_3_4_12_1","doi-asserted-by":"crossref","unstructured":"Gottschalk MG Domschke K Schiele MA. 2020. Epigenetics underlying susceptibility and resilience relating to daily life stress work stress and socioeconomic status. Front Psychiatry. 11:163. https:\/\/doi.org\/10.3389\/fpsyt.2020.00163.","DOI":"10.3389\/fpsyt.2020.00163"},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v015.i02"},{"key":"e_1_3_4_14_1","doi-asserted-by":"crossref","unstructured":"Hanioka T Ojima M Tanaka K Matsuo K Sato F Tanaka H. 2011. Causal assessment of smoking and tooth loss: a systematic review of observational studies. BMC Public Health. 11:221. https:\/\/doi.org\/10.1186\/1471-2458-11-221.","DOI":"10.1186\/1471-2458-11-221"},{"key":"e_1_3_4_15_1","doi-asserted-by":"crossref","unstructured":"Hao Y Yuan Z Zhu Y Li S Gou J Dong S Niu L. 2024. Association between tooth loss and depression mediated by lifestyle and inflammation- a cross-sectional investigation. BMC Public Health. 24(1):2627. https:\/\/doi.org\/10.1186\/s12889-024-20065-z.","DOI":"10.1186\/s12889-024-20065-z"},{"key":"e_1_3_4_16_1","doi-asserted-by":"crossref","unstructured":"Kaurani P Kakodkar P Bhowmick A Samra RK Bansal V. 2024. Association of tooth loss and nutritional status in adults: an overview of systematic reviews. BMC Oral Health. 24(1):838. https:\/\/doi.org\/10.1186\/s12903-024-04602-1.","DOI":"10.1186\/s12903-024-04602-1"},{"key":"e_1_3_4_17_1","unstructured":"Kochhar R Fry R Rohal M. 2015. The american middle class is losing ground: No longer the majority and falling behind financially. Online: Pew Research Centre."},{"key":"e_1_3_4_18_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.81.9.1166"},{"key":"e_1_3_4_19_1","article-title":"survey: analysis of complex survey samples","author":"Lumley T.","year":"2023","unstructured":"Lumley T. 2023. survey: analysis of complex survey samples. R package version 4.3.","journal-title":"R package version 4.3"},{"key":"e_1_3_4_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345221120164"},{"key":"e_1_3_4_21_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1010076108"},{"key":"e_1_3_4_22_1","unstructured":"National Center for Education Statistics. 2011. Table 25. Median houselhold income by state: Selected years 1990 through 2010. In: Statistics DoE editor. Online: National Centre for Education Statistics."},{"issue":"1","key":"e_1_3_4_23_1","first-page":"5","article-title":"A review on predisposing and modifying factors of periodontal disease","volume":"5","author":"Noor E","year":"2015","unstructured":"Noor E, Al-Bayaty FH. 2015. A review on predisposing and modifying factors of periodontal disease. J Adv Med Res. 5(1):5-23.","journal-title":"J Adv Med Res"},{"key":"e_1_3_4_24_1","doi-asserted-by":"crossref","unstructured":"Papadaki E Anastassiadou V. 2012. Elderly complete denture wearers: a social approach to tooth loss. Gerodontology. 29(2):e721-e727. https:\/\/doi.org\/10.1111\/j.1741-2358.2011.00550.x.","DOI":"10.1111\/j.1741-2358.2011.00550.x"},{"key":"e_1_3_4_25_1","doi-asserted-by":"crossref","unstructured":"Parisius KGH Verhoeff MC Lobbezoo F Avivi-Arber L Duyck J Hirano H Iijima K Janssens B Kossioni A Lin CS et al. 2024. Towards an operational definition of oral frailty: a e-Delphi study. Arch Gerontol Geriatr. 117:105181. https:\/\/doi.org\/10.1016\/j.archger.2023.105181.","DOI":"10.1016\/j.archger.2023.105181"},{"key":"e_1_3_4_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31146-8"},{"key":"e_1_3_4_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12675"},{"key":"e_1_3_4_28_1","unstructured":"R Core Team. 2023. R: a language and environment for statistical computing. Vienna (Austria): R Foundation for Statistical Computing."},{"key":"e_1_3_4_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1996.10476908"},{"key":"e_1_3_4_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2006.00286.x"},{"key":"e_1_3_4_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBP.0000000000000491"},{"key":"e_1_3_4_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034519849557"},{"key":"e_1_3_4_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12108"},{"key":"e_1_3_4_34_1","doi-asserted-by":"crossref","unstructured":"Toan NK Ahn S-G. 2021. Aging-related metabolic dysfunction in the salivary gland: a review of the literature. Int J Mol Sci. 22(11):5835. https:\/\/doi.org\/10.3390\/ijms22115835.","DOI":"10.3390\/ijms22115835"},{"issue":"3","key":"e_1_3_4_35_1","first-page":"1","article-title":"mice: multivariate imputation by chained equations in R","volume":"45","author":"Van Buuren S","year":"2011","unstructured":"Van Buuren S, Groothuis-Oudshoorn K. 2011. mice: multivariate imputation by chained equations in R. J Stat Softw. 45(3):1-67.","journal-title":"J Stat Softw"},{"key":"e_1_3_4_36_1","volume-title":"Global strategy and action plan on oral health 2023-2030","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. 2024. Global strategy and action plan on oral health 2023-2030. Global strategy and action plan on oral health 2023-2030. Geneva: World Health Organization."}],"container-title":["JDR Clinical &amp; Translational Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23800844251384952","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23800844251384952","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23800844251384952","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T15:03:20Z","timestamp":1781535800000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23800844251384952"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,22]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/23800844251384952"],"URL":"https:\/\/doi.org\/10.1177\/23800844251384952","relation":{},"ISSN":["2380-0844","2380-0852"],"issn-type":[{"value":"2380-0844","type":"print"},{"value":"2380-0852","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,22]]}}}