Wei Xindi, Zhuang Longfei, Zhang Xiao, Deng Ke, Chen Ruiying, Liu Beilei, Lai Hongchang
Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
Huishang Dental Clinic, Shanghai, China.
Int Dent J. 2025 Sep 15;75(6):103901. doi: 10.1016/j.identj.2025.103901.
The world is rapidly ageing. Tooth loss, the consequence of various age-related oral diseases, leads to decreased chewing function and has emerged as a significant public health concern. The aim of this study was to investigate the association between masticatory function and mortality in older adults.
Data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018 were analysed. Mortality details were obtained from the National Death Index (NDI). Chewing capacity was determined by the number of functional tooth units (FTUs) that was defined as pairs of opposing natural and artificial teeth in the premolar and molar regions. Weighted Cox proportional hazards models were employed to assess the relationship between FTU and mortality risk. Propensity score matching (PSM) analyses and subgroup analyses were conducted to further assess the association between FTU and mortality.
5,780 individuals aged 60 and above were involved in this study. The risk of all-cause mortality (HR = 2.4, 95%CI 1.8-3.3) was higher for participants with 0 ≤ FTUs ≤ 3 compared to those in the 10 ≤ FTUs ≤ 12 group. After PSM, a significant increase in the risk of all-cause mortality (HR = 1.8, 95%CI 1.4-2.2) was observed in the 0 ≤ FTUs ≤ 3 group compared to the reference group. Subgroup analyses revealed consistent results across all subgroups.
The findings revealed an association between impaired masticatory function and an increased risk of all-cause mortality among older adults.
Study findings show that maintaining and enhancing oral function may help to promote healthy longevity. They also offer guidance for decision-making among older adults and their caregivers.
世界正在迅速老龄化。牙齿脱落是各种与年龄相关的口腔疾病的后果，会导致咀嚼功能下降，并已成为一个重大的公共卫生问题。本研究的目的是调查老年人咀嚼功能与死亡率之间的关联。
分析了2009 - 2018年美国国家健康与营养检查调查（NHANES）的数据。死亡详情来自国家死亡指数（NDI）。咀嚼能力通过功能性牙单位（FTU）的数量来确定，功能性牙单位定义为前磨牙和磨牙区域相对的天然牙和人工牙对。采用加权Cox比例风险模型评估FTU与死亡风险之间的关系。进行倾向得分匹配（PSM）分析和亚组分析以进一步评估FTU与死亡率之间的关联。
本研究纳入了5780名60岁及以上的个体。与FTU为10≤FTU≤12组的参与者相比，FTU为0≤FTU≤3的参与者全因死亡率风险更高（HR = 2.4，95%CI 1.8 - 3.3）。PSM分析后，与参照组相比，FTU为0≤FTU≤3组的全因死亡率风险显著增加（HR = 1.8，95%CI 1.4 - 2.2）。亚组分析在所有亚组中均显示出一致的结果。
研究结果揭示了老年人咀嚼功能受损与全因死亡率风险增加之间的关联。
研究结果表明，维持和增强口腔功能可能有助于促进健康长寿。它们还为老年人及其护理人员的决策提供了指导。
