Late-Life Depression and Risk of Tooth Loss

American Geriatrics Society (AGS) 2014 Annual Meeting

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An increasing number of older adults are being admitted into long-term care facilities with more of their natural teeth intact. As such, reducing the risk of tooth loss and its subsequent complications has become a goal of care. Although many strategies for providing oral care focus on the mechanical removal of plaque, little is known about how mental health may affect dentition. A new study that was presented during the American Geriatrics Society 2014 Annual Scientific Meeting investigated the association between depression, dentition, and overall dental care among older adults.

Deborah L. Huang, MD, MS, division of general internal medicine, University of Washington, Seattle, and Mijung Park, PhD, MSN, MPH, RN, Health and Community Systems, School of Nursing, University of Pittsburgh, PA, conducted a cross-sectional study of a nationally representative sample of adults aged 65 years and older from the 2012 Behavioral Risk Factor Surveillance System to determine the relationships between depressive disorder and permanent tooth loss due to caries or periodontal disease and dental care utilization. The researchers compared older adults with self-reported depressive disorder diagnosis to older adults without prior depressive disorder diagnosis. Approximately 13.5% of older adults (more than 150,000) in the United States reported a prior diagnosis of depressive disorder (mean age, 72.2 years; 66.6% female).

The results of descriptive, bivariate, and multivariable logistic regression analyses showed the following trends:

• A greater proportion of older adults with depressive disorder had permanent tooth loss compared with older adults without depressive disorder (79.7% vs 73.7%, respectively; P<.001).
• A greater proportion of older adults with depressive disorder had edentulism  compared with older adults without depressive disorder (18.9% vs 15.8%, respectively; P<.001).
• Fewer older adults with depressive disorder visited a dentist than older adults without depressive disorder (61.4% vs 66.5%, respectively; P<.001).
• Self-reported depressive disorder was associated with increased odds of permanent tooth loss (odds ratio=1.18; 95% confidence interval 1.09-1.28; P<.001)
• Self-reported depressive disorder was not significantly associated with a visit to the dentist in the past year or edentulism.

Based on these results, the authors of the study concluded that older adults who report depressive disorder are at increased risk of tooth loss, but not necessarily that they are less likely to utilize dental care. “Further studies are needed to clarify how depression affects oral health in older adults,” they wrote.

–Allison Musante, ELS