Correlation analysis between tooth loss and chronic pain in middle-aged and elderly populations

CHEN Dan; GUO Yue; WANG Hui; GUO Yan; HE Yong

doi:10.19749/j.cn.cjgd.1672-2973.2025.05.009

Abstract：Objective To analyze the correlation between dentition loss and chronic pain in middle-aged and elderly people in China,and to provide a reference for oral health care and and chronic pain control for patients with tooth loss.Methods Based on data from the China Health and Retirement Longitudinal Study conducted in 2015 and 2020,this study analyzed the incidence of chronic pain among 850 middle-aged and elderly individuals aged 45 years and older,stratified by their tooth loss status.Multivariate Logistic regression was used to analyze the association between factors related to dentition loss and chronic pain,and to explore the relationship between dentition loss and chronic pain in different subgroups.The relative contribution of multiple variables to chronic pain was evaluated using the XGBoost model,and the model was analyzed in detail through the SHAP(Shapley Additive Explanations)method.The mediating effect between dental loss and chronic pain was analyzed in terms of uric acid level,BMI and depression score.Results Among middle-aged and elderly individuals aged 45 years and older,the incidence of chronic pain was higher in those with complete tooth loss compared to those without complete tooth loss.The P values of the interaction between multiple related factors of dentition loss and chronic pain were all＞0.05,and the associated effects were not statistically significant.The ranking of the importance of SHAP features shows that dentition loss has a high contribution to the prediction of chronic pain.The absolute value of the average SHAP value is 0.0101.The SHAP dependence plot shows that the presence of dentition loss will increase the prediction probability of chronic pain.Uric acid levels showed a mediating role in dentition loss and chronic pain.The total effect was 0.076(95%CI:0.017-0.134,P=0.012),the direct effect was 0.07(95%CI:0.01-0.129,P=0.016),and the indirect effect was 0.006(95%CI:0.000-0.013,P=0.024),the mediating effect accounted for 7%of the total effect,and BMI and depression score did not reflect the mediating role.Conclusion There is a correlation between dentition loss and chronic pain.Patients with dentition loss have a higher probability of developing chronic pain than those without dentition loss.Uric acid shows a mediating effect between dentition loss and chronic pain.