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Tooth Loss and Mortality in Elderly Japanese Adults: Effect of Oral Care


Address correspondence to Kazuki Hayasaka, Department of Public Health and Forensic Medicine, Division of Epidemiology, Tohoku University Graduate School of Medicine 2–1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980–8575, Japan. E-mail:



To assess whether oral care (tooth brushing, regular dental visits, and use of dentures) affects mortality in elderly individuals with tooth loss.


A 4-year prospective cohort study.


Ohsaki City, Japan.


Twenty-one thousand seven hundred thirty community-dwelling individuals aged 65 and older.


In a baseline survey in 2006, data were collected on number of remaining teeth and oral care status as measures of dental health. Data were also collected on age, sex, education level, smoking, alcohol drinking, time spent walking daily, medical history, psychological distress, and energy and protein intake as covariates. During the 4-year follow-up between 2006 and 2010, information on mortality was obtained from Ohsaki City government.


The multivariate-adjusted Cox proportional hazards model showed an inverse dose-response relationship between number of remaining teeth and mortality (P for trend <.001). In participants with 0 to 19 teeth, practicing oral care was inversely associated with mortality. The multivariate hazard ratio for mortality in participants who practiced all three types of oral care was 0.54 (95% confidence interval = 0.45–0.64), compared with participants who practiced none of the three.


Tooth brushing, regular dental visits, and use of dentures are inversely associated with mortality in elderly individuals with tooth loss.