Lower Educational Level is a Risk Factor for Tooth Loss - Analysis of a Swiss Population (KREBS Project)

To analyse risk factors for tooth loss in women and men seeking treatment at the University of Basel, Switzerland.

Records of patients from the pool of patients at the department were consecutively screened between January 2009 and October 2011. Gender, smoking habits, education, profession, general health status and dental variables were recorded. Tooth loss was assessed on full-mouth periapical radiographs. Gender-nested logistic regression models were applied for statistical analysis.

The sample consisted of 161 participants (4012 teeth in total, 3988 after exclusion of third molars), 80 women and 81 men, with a mean age of 48.0 ± 14.6 in women and 47.7 ± 12.5 in men. There were no significant differences in smoking status between men and women. Oral clinical data revealed similar gingival inflammation (BI) and number of sites with a periodontal probing depth (PPD) ≥ 5 mm among men and women. However, oral hygiene (PI) differed between men and women, with women having better oral hygiene (p < 0.01). Tooth loss increased from the front to the molar regions. A significant risk for tooth loss was associated with decreasing educational level. Compared to advanced education, individuals with 'no school graduation' showed a significantly higher risk for tooth loss in women (OR = 3.2, p = 0.02) and men (OR = 3.6, p = 0.03). Age ≥ 50 years significantly predicted tooth loss in men only (OR 2.2, p = 0.01).

The results from the present study demonstrate lower educational level as a strong risk factor for tooth loss in this Swiss cohort. The educational level may need to be considered for diagnosis and treatment planning, and particularly for patient information practices to increase the patients' understanding of the development of oral diseases leading to tooth loss.