{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:08:41Z","timestamp":1788977321709,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T00:00:00Z","timestamp":1685923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013365","name":"West China Hospital, Sichuan University","doi-asserted-by":"publisher","award":["ZYJC21005"],"award-info":[{"award-number":["ZYJC21005"]}],"id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The available evidence on the connections between tooth loss, denture use, and mortality from all causes or specific causes among older adults is inconclusive. Therefore, we aimed to investigate the association between tooth loss, denture use, and all-cause and cause-specific mortality in older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 5,403 participants aged 65 and older were recruited in the 2014 Chinese Longitudinal Healthy Longevity Survey wave and followed up in the 2018 wave. Cox proportional hazard models were used to examine the association between the number of natural teeth, denture use, and all-cause and cause-specific mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a mean (SD) follow-up of 3.1 \u2009years (1.3), 2,126 deaths (39.3%) occurred. Individuals with 0 and 1\u20139 teeth had higher mortality due to all-cause, cardiovascular disease (CVD), cancer, and other causes (all <jats:italic>p<\/jats:italic>-trend &amp;lt;0.05) than those with 20+ teeth. At the same time, no association was found with respiratory disease mortality. Participants who used dentures had lower mortality due to all causes [hazard ratios (HR) 0.79, 95% confidence intervals (CI) 0.71\u20130.88], CVD (HR 0.80, 95% CI 0.64\u20131.00), respiratory disease (HR 0.66, 95% CI 0.48\u20130.92), and other causes (HR 0.77, 95% CI 0.68\u20130.88) than those without dentures. Joint analysis revealed that older adults with fewer natural teeth and no dentures had higher mortality. Additionally, interaction analyses showed that the effects of the number of natural teeth on all-cause mortality were more pronounced in older adults aged &amp;lt;80 \u2009years (<jats:italic>p<\/jats:italic>-value for interaction\u2009=\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Having fewer natural teeth, particularly less than 10 teeth, is linked to an increased risk of mortality from all causes, including CVD, cancer, and other causes, but not respiratory disease. The use of dentures would mitigate the adverse impact of tooth loss on all-cause and some cause-specific mortality.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1194054","type":"journal-article","created":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T05:22:48Z","timestamp":1685942568000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":38,"title":["Tooth loss, denture use, and all-cause and cause-specific mortality in older adults: a community cohort study"],"prefix":"10.3389","volume":"11","author":[{"given":"Miao","family":"Dai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quhong","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiping","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufang","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwei","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jirong","family":"Yue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,5]]},"reference":[{"key":"ref1","year":""},{"key":"ref2","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.arr.2011.03.003","article-title":"Aging with multimorbidity: a systematic review of the literature","volume":"10","author":"Marengoni","year":"2011","journal-title":"Ageing Res Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1177\/0022034518814829","article-title":"Tooth loss predicts myocardial infarction, heart failure, stroke, and death","volume":"98","author":"Lee","year":"2019","journal-title":"J Dent Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0195813","DOI":"10.1371\/journal.pone.0195813","article-title":"Tooth loss and pneumonia mortality: a cohort study of Japanese dentists","volume":"13","author":"Suma","year":"2018","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1177\/0022034520957233","article-title":"Tooth loss and dementia: a critical examination","volume":"100","author":"Thomson","year":"2021","journal-title":"J Dent Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"103221","DOI":"10.1016\/j.critrevonc.2021.103221","article-title":"Association of periodontitis and tooth loss with liver cancer: a systematic review","volume":"159","author":"Al-Maweri","year":"2021","journal-title":"Crit Rev Oncol Hematol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1654.e1","DOI":"10.1016\/j.jamda.2019.06.010","article-title":"Oral health, disability and physical function: results from studies of older people in the United Kingdom and United States of America","volume":"20","author":"Kotronia","year":"2019","journal-title":"J Am Med Dir Assoc"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1016\/j.clnu.2017.03.014","article-title":"Relationship of nutritional status and oral health in elderly: systematic review with meta-analysis","volume":"37","author":"Toniazzo","year":"2018","journal-title":"Clin Nutr"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1093\/gerona\/glaa096","article-title":"Poor oral health and inflammatory, hemostatic, and cardiac biomarkers in older age: results from two studies in the UK and USA","volume":"76","author":"Kotronia","year":"2021","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1111\/jcpe.13557","article-title":"Associations of periodontal disease and tooth loss with all-cause and cause-specific mortality in the sister study","volume":"48","author":"Wu","year":"2021","journal-title":"J Clin Periodontol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.2147\/cia.S263947","article-title":"Alveolar bone loss, tooth loss and oral cancer mortality in older patients: a retrospective cohort study","volume":"15","author":"Qian","year":"2020","journal-title":"Clin Interv Aging"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"213","DOI":"10.2188\/jea.JE20180243","article-title":"Number of teeth and all-cause and cancer mortality in a Japanese community: the Takayama study","volume":"30","author":"Goto","year":"2020","journal-title":"J Epidemiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1111\/joor.12883","article-title":"Posterior occluding pairs of teeth or dentures and 1-year mortality in nursing home residents in Japan","volume":"47","author":"Dewake","year":"2020","journal-title":"J Oral Rehabil"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s12903-020-01084-9","article-title":"Number of natural teeth, denture use and mortality in Chinese elderly: a population-based prospective cohort study","volume":"20","author":"Yuan","year":"2020","journal-title":"BMC Oral Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"16452","DOI":"10.1038\/s41598-021-95865-z","article-title":"Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA","volume":"11","author":"Kotronia","year":"2021","journal-title":"Sci Rep"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1111\/cdoe.12095","article-title":"Associations of number of teeth with risks for all-cause mortality and cause-specific mortality in middle-aged and elderly men in the northern part of Japan: the Iwate-KENCO study","volume":"42","author":"Ando","year":"2014","journal-title":"Community Dent Oral Epidemiol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1186\/1471-2458-10-386","article-title":"Relationship between tooth loss and mortality in 80-year-old Japanese community-dwelling subjects","volume":"10","author":"Ansai","year":"2010","journal-title":"BMC Public Health"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1111\/j.1741-2358.2006.00134.x","article-title":"Relationship between survival rates and numbers of natural teeth in an elderly Japanese population","volume":"23","author":"Morita","year":"2006","journal-title":"Gerodontology"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"930023","DOI":"10.3389\/fnut.2022.930023","article-title":"Effects of dental implants and nutrition on elderly edentulous subjects: protocol for a factorial randomized clinical trial","volume":"9","author":"Qian","year":"2022","journal-title":"Front Nutr"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1111\/jgs.12225","article-title":"Tooth loss and mortality in elderly Japanese adults: effect of oral care","volume":"61","author":"Hayasaka","year":"2013","journal-title":"J Am Geriatr Soc"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1080\/17538963.2013.764677","article-title":"Towards deeper research and better policy for healthy aging --using the unique data of Chinese longitudinal healthy longevity survey","volume":"5","author":"Zeng","year":"2012","journal-title":"China Economic J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e17","DOI":"10.1016\/s2542-5196(18)30264-x","article-title":"Residential greenness and mortality in oldest-old women and men in China: a longitudinal cohort study","volume":"3","author":"Ji","year":"2019","journal-title":"Lancet Planet Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"105620","DOI":"10.1016\/j.envint.2020.105620","article-title":"Association between biomass fuel use and risk of hypertension among Chinese older people: a cohort study","volume":"138","author":"Deng","year":"2020","journal-title":"Environ Int"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An introduction to propensity score methods for reducing the effects of confounding in observational studies","volume":"46","author":"Austin","year":"2011","journal-title":"Multivar Behav Res"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2028","DOI":"10.1093\/ije\/dyx056","article-title":"Oral health and mortality in the Golestan cohort study","volume":"46","author":"Vogtmann","year":"2017","journal-title":"Int J Epidemiol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1177\/0022034511414423","article-title":"\u4e0e\u764c\u75c7\u65e0\u5173Oral health and cancer, cardiovascular, and respiratory mortality of Japanese","volume":"90","author":"Aida","year":"2011","journal-title":"J Dent Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1111\/iej.13458","article-title":"Association between dental factors and mortality","volume":"54","author":"Liljestrand","year":"2021","journal-title":"Int Endod J"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1111\/ggi.13911","article-title":"Number of functional teeth more strongly predicts all-cause mortality than number of present teeth in Japanese older adults","volume":"20","author":"Maekawa","year":"2020","journal-title":"Geriatr Gerontol Int"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1093\/annonc\/mdw224","article-title":"The role of oral hygiene in head and neck cancer: results from international head and neck Cancer epidemiology (INHANCE) consortium","volume":"27","author":"Hashim","year":"2016","journal-title":"Ann Oncol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1016\/j.jdent.2014.08.012","article-title":"Tooth loss and its association with dietary intake and diet quality in American adults","volume":"42","author":"Zhu","year":"2014","journal-title":"J Dent"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1038\/oby.2011.218","article-title":"Total tooth loss and systemic correlates of inflammation: role of obesity","volume":"20","author":"Meisel","year":"2012","journal-title":"Obesity"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1016\/s0895-4356(03)00086-6","article-title":"Total tooth loss and prevalent cardiovascular disease in men and women: possible roles of citrus fruit consumption, vitamin C, and inflammatory and thrombotic variables","volume":"56","author":"Lowe","year":"2003","journal-title":"J Clin Epidemiol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1002\/jper.21-0433","article-title":"Association between tooth loss, chronic conditions, and common risk factors: results from the 2019 Brazilian health survey","volume":"93","author":"de Medeiros","year":"2022","journal-title":"J Periodontol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1111\/jgs.14777","article-title":"Oral health and incident depressive symptoms: JAGES project longitudinal study in older Japanese","volume":"65","author":"Yamamoto","year":"2017","journal-title":"J Am Geriatr Soc"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1111\/ger.12016","article-title":"Association between functional tooth units and chewing ability in older adults: a systematic review","volume":"31","author":"Naka","year":"2014","journal-title":"Gerodontology"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1016\/j.jdent.2015.05.008","article-title":"Effects of removable dental prostheses on masticatory performance of subjects with shortened dental arches: a systematic review","volume":"43","author":"Liang","year":"2015","journal-title":"J Dent"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/cdoe.12000","article-title":"Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities","volume":"41","author":"Furuta","year":"2013","journal-title":"Community Dent Oral Epidemiol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1111\/j.1600-0757.1993.tb00224.x","article-title":"Periodontal diseases and tooth loss","volume":"2","author":"Oliver","year":"2000","journal-title":"Periodontology"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s12903-020-01072-z","article-title":"Oral health status and associated lifestyle behaviors in a sample of Iranian adults: an exploratory household survey","volume":"20","author":"Jahangiry","year":"2020","journal-title":"BMC Oral Health"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1177\/0022034515598961","article-title":"Smoking, smoking cessation, and risk of tooth loss: the EPIC-Potsdam study","volume":"94","author":"Dietrich","year":"2015","journal-title":"J Dent Res"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/j.adaj.2021.11.008","article-title":"Tooth loss and uncontrolled diabetes among US adults","volume":"153","author":"Vu","year":"2022","journal-title":"J Am Dent Assoc"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.maturitas.2015.07.016","article-title":"Tooth loss and bone mineral density in postmenopausal south Korean women: the 2008\u20132010 Korea National Health and Nutrition Examination Survey","volume":"82","author":"Jang","year":"2015","journal-title":"Maturitas"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s12966-017-0465-3","article-title":"Physical activity levels objectively measured among older adults: a population-based study in a southern city of Brazil","volume":"14","author":"Ramires","year":"2017","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1136\/jech-2020-214545","article-title":"Associations between vision, hearing and tooth loss and social interactions: the JAGES cross-sectional study","volume":"75","author":"Igarashi","year":"2021","journal-title":"J Epidemiol Community Health"}],"updated-by":[{"DOI":"10.3389\/fpubh.2023.1360927","type":"corrigendum","label":"Corrigendum","source":"publisher","updated":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T00:00:00Z","timestamp":1704758400000}}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1194054\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T13:18:13Z","timestamp":1704806293000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1194054\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,5]]},"references-count":44,"alternative-id":["10.3389\/fpubh.2023.1194054"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1194054","relation":{"corrigendum":[{"id-type":"doi","id":"10.3389\/fpubh.2023.1360927","asserted-by":"object"}]},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,5]]},"article-number":"1194054"}}