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. 2014 Dec;42(6):495-502.
doi: 10.1111/cdoe.12116. Epub 2014 Jun 27.

Social stratification and tooth loss among middle-aged and older Americans from 1988 to 2004

Bei Wu  1 , Celia Hybels, Jersey Liang, Lawrence Landerman, Brenda Plassman
Affiliations

Social stratification and tooth loss among middle-aged and older Americans from 1988 to 2004

Bei Wu et al. Community Dent Oral Epidemiol. 2014 Dec.

Abstract

Objectives: Tooth retention has improved over the past few decades, but it is not known whether these trends have been observed across all demographic/socioeconomic subgroups. We examined number of missing teeth among dentate individuals (n = 9,113) as well as edentulism and systematically modeled their trends over time by using clinical examination data.

Methods: We investigated the association between social stratification and trends in tooth retention among adults ages 50+ from 1988 to 2004, using four waves of the National Health and Nutrition Examination Surveys (NHANES) (n = 11,812).

Results: The prevalence of edentulism declined from 24.6% in NHANES III (1988-1994) to 17.4% in 2003-2004, and the mean number of missing teeth declined from 8.19 to 6.50. Older participants, Blacks, the less educated and those with lower income were higher on both edentulism and number missing teeth. Both edentulism and number of missing teeth declined over time, but their patterns varied. For edentulism, age and socioeconomic related disparities decreased over time due to more decline among older and low-income participants. For missing teeth, there was less decrement among older and low-income participants, resulting in increased age and socioeconomic related disparities.

Conclusions: Our study found disparities in trends of tooth loss across demographic/socioeconomic strata. Findings suggest that racial/ethnic disparities are partially explained by socioeconomic status. Interventions designed to improve oral health for older adults, particularly those with low levels of income, need special attention.

Keywords: edentulism; middle-aged; older adults; tooth loss; trends.

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Figures

Figure 1
Figure 1
Predicted Probability of Edentulism by Age Over Time
Figure 2
Figure 2
Predicted Probability of Edentulism by Poverty Level Over Time
Figure 3
Figure 3
Predicted Number of Missing Teeth by Age Over Time
Figure 4
Figure 4
Predicted Number of Missing Teeth by Race/Ethnicity Over Time
Figure 5
Figure 5
Predicted Number of Missing Teeth by Poverty Level Over Time
See this image and copyright information in PMC

References

    1. Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, et al. Trends in oral health status: United States, 1988–1994 and 1999–2004. Vital Health Stat. 2007;11(248):1–92. Epub 2007/07/19. - PubMed
    1. Cunha-Cruz J, Hujoel PP, Nadanovsky P. Secular trends in socio-economic disparities in edentulism: USA, 1972–2001. J Dent Res. 2007;86(2):131–6. Epub 2007/01/26. - PubMed
    1. Wu B, Liang J, Plassman BL, Remle C, Luo X. Edentulism trends among middle-aged and older adults in the United States: comparison of five racial/ethnic groups. Community dentistry and oral epidemiology. 2012;40(2):145–53. Epub 2011/10/07. - PMC - PubMed
    1. House JS, Lantz PM, Herd P. Continuity and change in the social stratification of aging and health over the life course: evidence from a nationally representative longitudinal study from 1986 to 2001/2002 (Americans’ Changing Lives Study) J Gerontol B Psychol Sci Soc Sci. 2005;60(Spec No 2):15–26. Epub 2005/10/28. - PubMed
    1. Zipf G, Chiappa M, Porter KS, et al. National Health and Nutrition Examination Survey: Plan and operations, 1999–2010. National Center for Health Statistics. Vital Health Stat. 2013;1(56) - PubMed

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