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Objective: To investigate the effects of tooth loss on gait stability in a healthy elderly population., Methods: A case-control study was conducted among healthy and prosthetically well-restored seniors over the age of 65 years. The test group comprised 24 edentulous participants who were restored with complete dentures in the upper jaw and an overdenture fixed on two implants in the lower jaw. The control group comprised 25 dentate participants who either still had their natural teeth or were restored with conventional fixed partial dentures. Gait stability was evaluated by measuring the parameters 'gait velocity' and 'cycle-time variability' during self-selected normal walking speed and under dual-task performance conditions. Measurements were conducted using the GAITRite(®) electronic walkway system., Results: Dentated and fixed restored participants (the control group) had a significantly higher gait velocity compared with denture wearers (the test group) under both normal walking (p = 0.03) and dual-task performance conditions (p = 0.01). In each test condition, among edentulous participants, gait velocity did not significantly differ according to whether the participant wore their dentures., Conclusion: The present results suggest that tooth loss in healthy seniors is associated with lower gait velocity and therefore may have a negative impact on gait stability., (© 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.)

Background: Patients with dementia have poorer oral health and fewer teeth than their peers without cognitive impairment., Objective: The hypothesis of this study is that the number of natural teeth and the chewing efficiency are associated with cognitive functioning., Methods: This cross-sectional study included 29 patients diagnosed with dementia aged 75 years or older and 22 controls who were either cognitively normal (n = 19) or with mild cognitive impairment (n = 3). Neuropsychological, nutritional and dental assessments were performed. The chewing efficiency was evaluated with a two-colour mixing test., Results: Demented patients and controls presented with a mean of 4.9 and 6.5 teeth, respectively (n.s.). The number of natural teeth was not associated with dementia (p = 0.553). Same results were found for age (p = 0.746) and sex (p = 0.901). The chewing efficiency by visual inspection proved worse in participants with dementia than in the controls (p < 0.011) and explained 9.3% of the variance in the diagnosis of dementia. Neither dental state nor chewing efficiency was related to the nutritional state., Conclusion: Chewing efficiency seems stronger associated with cognitive impairment than the number of teeth. Hence, in a more holistic approach for the geriatric assessment, the dental examination may be complemented by a chewing efficiency test., (© 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.)

Objectives: To systematically review the current evidence on the relationship between dentition status and chewing ability in older adults, as the latter was subjectively perceived by questionnaires., Background: Tooth loss is associated with functional impairment regarding chewing ability, depending on the number and the location of the remaining teeth., Methods: A search of the English literature was undertaken using the appropriate electronic databases and keywords in order to answer the question of this review. Independent extraction of the related articles was carried out by two authors using predefined eligibility criteria., Results: Full-text analysis was performed for 51 articles of possible relevance. Finally, data were extracted from 18 studies, published in 20 articles that met the inclusion criteria., Conclusions: Although there was a conflict between the studies relevant to the number of functional tooth units needed to maintain adequate oral function, it was revealed that chewing ability was closely related to the number and distribution of teeth remaining. Treatment plan should focus on the preservation of the strategic parts of the dental arch that are critical for adequate oral function. Long-term prospective studies, comprising well-defined criteria, clinical variables, methods and utilising comprehensive questionnaires, should be preferred to obtain a clearer picture on the association between masticatory ability and functional tooth units., (© 2012 The Gerodontology Society and John Wiley & Sons A/S.)

Background: There are still no data available on the relationship between postural stability and occlusal status among the elderly., Objectives: To examine relationships between postural stability and occlusal status through a cohort study among elderly Japanese., Method: Oral examination, occlusal status, postural stability and a questionnaire were conducted and given to 87 community-dwelling Japanese at enrolment., Results: The average occlusal pressure of the female group was statistically higher than the male group while average occlusal pressure and postural stability length were lesser in the group with more remaining teeth. Postural stability area and number of remaining teeth showed statistically significant correlations. Postural stability length was lesser in the group with strong occlusal force. Furthermore, the number of decayed teeth was fewer in the good hygiene group., Conclusions: This study identified a close relationship between occlusal status and postural stability of Japanese older individuals. Occlusal hypofunction was observed more in those with occlusal problems, and a decrease in their occlusal functions resulted in postural instability., (© 2011 The Gerodontology Society and John Wiley & Sons A/S.)

Background: This study evaluates associations between oral health-related factors and chewing ability, and quantifies the risk contributed by each factor., Materials and Methods: Chewing ability and information on number of teeth, dentures and dental problems over the last 12 months were collected by mailing questionnaires to a random sample of 60- to 71-year-olds from Adelaide, South Australia. Logistic regression was used to model oral status and oral symptoms as predictors of chewing disability, and to estimate the population-attributable fraction., Results: A total of 444 persons responded (response rate = 68.8%). Among dentate subjects, 10.3% were chewing-deficient, with chewing disability more prevalent (p < 0.05) among those with <21 teeth (26.4%), dentures (20.4%), painful aching in the mouth (25.4%), pain in the face (16.7%), broken/chipped teeth (15.6%), sensitive teeth (14.1%), loose teeth (37.1%), and sore gums (18.0%). Adjusted Odds ratios (OR) showed inadequate dentition (OR = 4.20), painful aching in the mouth (OR = 4.88), and presence of loose teeth (OR = 4.70) were associated with chewing disability (p < 0.01), and their population attributable fractions were 18.5%, 15.1% and 7.8% respectively., Conclusions: Loose teeth, number of teeth and pain in the mouth were associated with chewing disability, with an inadequate dentition and pain in the mouth contributing most to chewing disability in this population., (© 2012 The Gerodontology Society and John Wiley & Sons A/S.)

Objective: To assess the effect of baseline serum calcium on the progression of periodontal disease in non-institutionalized elderly., Background: Although a few studies have found some evidence of the role played by dietary calcium in periodontal disease process, there is a paucity of information pertinent to longitudinal assessment of serum calcium-periodontal relationships., Material and Methods: Clinical attachment levels of 266 Japanese subjects aged 70 years were recorded at baseline and annually for six consecutive years. Progression of periodontal disease (PPD) was defined as the number of teeth that showed additional attachment loss of > or =3 mm during the 6 years. The number of PPD was calculated for each subject and categorised into four levels, namely, PPD(0), PPD(1), PPD(2) and PPD(3) where the number of teeth with additional attachment loss ranged from 0, 1-10, 11-20 and >20 respectively. The levels of serum calcium, albumin, random blood sugar, immunoglobulin (IgG, IgA and IgM), gender, smoking habits, education, gingival bleeding and the number of teeth present were obtained at baseline., Results: Serum calcium, IgA, smoking, gingival bleeding and teeth present were associated with PPD at p < or = 0.10 and were included in a multinomial logistic regression analysis. Serum calcium was the only variable that was significantly associated with PPD with relative risks of 100 at PPD(1) and PPD(2), respectively, and 1000 at PPD(3)., Conclusion: Serum calcium may be considered a risk factor for periodontal disease progression in non-institutionalized elderly.

Objective: This study used a precise weighing method to assess whether tooth loss was related to nutrient intake in elderly Japanese subjects., Material and Methods: Fifty-seven subjects aged 74 years were randomly selected from a longitudinal interdisciplinary study of ageing. Complete 3-day food intake data were obtained by a precise weighing method. The dietary intakes of energy and nutrients were calculated based on the Standard Tables of Food Composition in Japan (5th ed.). A clinical evaluation of the number of teeth present was carried out. Multiple regression standardised coefficients for each nutrient was estimated based on a continuous scale adjusted for gender, smoking habits, and educational level. After dividing the subjects into two groups according to the number of teeth present (0-19, 20+), the difference in the intake of nutrients and the amount of food consumed per day was evaluated., Results: The number of teeth present had a significant relationship with the intake of several nutrients. In particular, total protein, animal protein, sodium, vitamin D, vitamin B1, vitamin B6, niacin, and pantothenic acid were significantly associated with the number of teeth present and with the two groups (0-19, 20+). The intake of vegetables and fish, shellfish, and their products was significantly lower among subjects with fewer teeth., Conclusion: This study suggests that there was a significant relationship between nutrient intake, such as minerals and vitamins from food, and tooth loss.

Objective: The number of remaining teeth may indicate the extent of life-long exposure to inflammation, a known risk factor for muscle loss and consequent disability. The aim was to study dental health status as a risk factor for muscle strength loss in very old people., Design: Cross-sectional and prospective cohort study over a 5-year follow-up., Setting: Research laboratory., Participants: One hundred and ninety-three 80-year-old people participated in the baseline examinations. Five years later, 79 survivors were retested., Main Outcome Measures: Number of remaining teeth, presence of periodontitis and handgrip strength., Results: At baseline, grip strength of men correlated positively with number of teeth but not with the presence of periodontitis. In women, the cross-sectional associations were not statistically significant. In the prospective analyses, the presence of periodontitis at baseline showed a clear association with a steeper decline in handgrip over the 5-year follow-up in both sexes. The values adjusted for gender, height, weight, number of chronic conditions and physical activity were -28.3% (SE 5.7) among those with periodontitis vs. -11.9% (SE 3.1, p = 0.015) among those with healthy gingiva. No association between the number of teeth at baseline and change in grip strength over 5 years was observed., Conclusions: The presence of oral inflammation may lead to loss in muscle strength increasing the risk of disability. Therefore, good dental care throughout the life span may decrease risk of disability in old age.

Objective: To examine the association between dental functional status and dietary intakes of Chinese vegetarian old age home residents., Subjects and Methods: A cross-sectional survey was performed in a group of 76 older vegetarian Chinese women living in an old age home. Oral examination was performed by a dental surgeon. Sixty-eight of them had a 24-hour food record by direct observation, analysed by a Chinese food composition table. Nutritional status was measured by Body Mass Index (BMI), and the functional status by modified Barthel Index (BI)., Results: Forty-two subjects (55.3%) were edentulous; 59 subjects (77.6%) had chewing difficulties; 35 subjects (46%) had poor dental functional status defined by having five or less functional teeth unit (FTU). When compared with those older people with better dental functional status, the poor dental functional status group was more likely to have chewing difficulties, tolerate soft diet only, and be functionally dependent (BI < 15/20). Poor dental functional status was associated with lower mean daily fibre intake, but not with intakes of macronutrients and micronutrients, after adjustment by BI categories., Conclusion: Poor dental functional status is associated with impaired chewing and lower fibre intake in Chinese vegetarian old age home residents, but it is not associated with reduced intakes of macronutrients or micronutrients.

Objective: To evaluate the masticatory performance of elderly people at the age of 80 years., Subjects: A total of 283 individuals of 80 years of age took part in a general and dental health survey., Main Outcome Measures: A dental examination including the number of remaining teeth, occlusion, prostheses, bite force recording, and a questionnaire regarding masticatory performance were recorded., Setting: Five municipalities (Okazaki city, Tokoname city, Tahara town, Atsumi town and Minami-chita town) in Aichi prefecture, Japan., Results: There were 20 or more teeth in 7.4% subjects, and 44.5% were edentulous. Subjects with no occlusion accounted for 77.4% of the total. Subjects with prostheses accounted for 90.8%. Maximum bite force and masticatory ability score for patients with 20 or more teeth or not wearing prostheses were higher than other groups. The non-wearing prostheses group had a low masticatory ability score., Conclusion: Most of the 80-year-old individuals recovered their masticatory ability with the assistance of prostheses. Several individuals with 20 or more remaining teeth or without removable dentures present in both jaws had a high score for bite forces and masticatory abilities.