Multidimensional risk assessment for tooth loss in a geriatric population with diverse medical and dental backgrounds

To introduce a multidimensional approach to assess risk of tooth loss for older adults with diverse medical and dental backgrounds.

Retrospective longitudinal study.

Community-based geriatric dental clinic in Minnesota.

Four hundred ninety-one older adults who presented to the studied clinic as new patients between October 1999 and December 2006, remained dentate after finishing the initial treatment plan, and returned for care at least once thereafter were selected as participants.

All existing dental conditions were treated before enrollment. Comprehensive dental care was continually provided for all participants during follow-up.

Demographic information, together with medical, dental, functional, and cognitive assessment at arrival, was abstracted from dental records. Logistic, Cox, Poisson, and negative-binomial regressions were developed to assess risk of tooth loss from four dimensions: likelihood of tooth loss, time to first tooth loss, and frequency and rate of tooth loss per person-year.

Although the traditional single-dimensional risk assessment approach indicated that number of teeth being carious or retaining roots at arrival was the only contributing factor for tooth loss in older adults, the multidimensional approach found that risk factors of tooth loss differed when assessed from different perspectives. While likelihood of tooth loss and time to first tooth loss were associated only with dental factors, both dental and nondental factors were associated with frequency and rate of tooth loss.

A single-dimensional risk assessment approach focusing on likelihood of tooth loss alone fails to provide a comprehensive risk profile for older adults. A multidimensional approach should be considered during assessment and treatment planning.