Dental prosthesis use and mortality: A time-varying exposure analysis with machine learning

Area of Science:

• Gerontology
• Dental Public Health
• Epidemiology

Background:

• Tooth loss is a known risk factor for mortality.
• Dental prostheses may restore masticatory function and potentially mitigate mortality risk.
• Previous studies often overlooked changes in prosthesis use over time.

Purpose of the Study:

• To investigate the association between time-varying dental prosthesis use and mortality in older Japanese adults.
• To analyze how changes in dental prosthesis use impact survival probability.
• To assess this association in different subgroups based on natural tooth count.

Main Methods:

• Prospective cohort study using data from the Japan Gerontological Evaluation Study (n=47,698).
• Follow-up data on all-cause mortality up to 2022 (median 9.2 years).
• Time-varying exposure and covariate data collected via surveys in 2013, 2016, and 2019; doubly robust estimator used.

Main Results:

• 19.0% of participants died during follow-up; 55.8% used dental prostheses at baseline.
• Consistent dental prosthesis use was associated with a 3.7% higher survival probability compared to nonuse.
• The association was more pronounced in individuals with fewer natural teeth (<10 natural teeth).

Conclusions:

• Consistent dental prosthesis use is associated with increased survival probability in older Japanese adults.
• The positive impact of dental prostheses on survival is greater for individuals with severe tooth loss.
• Maintaining dental prosthesis use may be a key factor in promoting longevity among the elderly.