Association among dental visit behavior,oral health,and all-cause mortality:A population-based cohort study

ZHU Yi-na; XU Ke-hui; WAN Mei-chen; JIA Shuai-lin; LI Jing; MA Sai; NIU Li-na

doi:10.15956/j.cnki.chin.j.conserv.dent.2025.02.006

Abstract：AIM:The association between oral health and various systemic diseases has been extensively investigated.However,little is known whether dental visit mitigates the oral health-related risk for mortality.METHODS:A total of 36 174 participants from the US National Health and Nutrition Examination Survey were followed up from 1999 to 2004 and 2011 to 2018.Oral health was evaluated according to the status of periodontitis,dental caries,and tooth loss,respectively.Dental visit behavior was defined as the time interval of last dental visit.Cox proportional hazards models were used to estimate the hazard ratios and 95%confidence intervals of the mortality risk.Mediation analyses were used to examine the mediation role of dental visit behavior in the association between poor oral health and mortality.RESULTS:Overall,30%of the population had mild to severe periodontitis,38.9%had at least 15 teeth with dental caries,21.2%had at least 15 teeth lost,and more than 50%of the population had their last dental visit within 1 year.After the mean follow-up period of 9.03 years,6 012 deaths were identified.Poor oral health was associated with a higher risk for all-cause mortality.Last dental visit within 1 year was associated with a reduced risk for all-cause mortality.The benefit of good dental visit behavior was seen in participants with different oral health conditions.Mediation analysis found that dental visit behavior mediated the associations between periodontitis,dental caries,tooth loss,and all-cause mortality.Mediation of dental visit behavior was most notable in participants over 60 years of age,and was not apparent in participants younger than 60.Similar results were identified when cardiovascular diseases mortality or cancer mortality was considered.CONCLUSION:Promotion of good dental visit behavior has valuable public health significance in preventing oral health-related risk for systemic health.Other practical measures should be explored to reduce the risk for impaired overall health in young population with severe oral diseases.