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Updated: Oct 22, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Association between tooth loss and mortality in older adults with an intellectual disability
Katrina Byrne1, Bahman Honari2, Louise Lynch3
1School of Nursing and Midwifery, Trinity College Dublin, Ireland; School of Dental Science, Trinity College, University of Dublin, Dublin, Ireland.
Background:
While life expectancy for people with intellectual disabilities (ID) has improved, health inequalities, premature ageing and elevated mortality persist. Oral health is rarely considered as a determinant of survival, despite evidence in general populations linking tooth loss to increased mortality.
Objective/Hypothesis:
To determine whether tooth loss predicts all-cause and respiratory mortality in older adults with ID.
Methods:
A 13-year longitudinal analysis of 752 adults with ID aged ≥40 years at Wave 1 (2009/2010) of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing. Dentition was categorised as dentate, edentulous with dentures, or edentulous without dentures. Fully adjusted models used complete cases (n = 742). Mortality was determined through death-certificate linkage to March 2023 using Kaplan-Meier and Cox proportional hazards analyses.
Results:
Over follow-up, 225 participants with baseline dentition data died (29.9%), including 114 (15.2%) from respiratory causes. Mortality was highest among those edentulous without dentures (54.4%), compared with dentate participants (24.3%) and those edentulous with dentures (29.9%). After adjustment, edentulism without dentures remained associated with all-cause mortality (HR = 1.69, 95% CI: 1.21-2.35; p = .002) and respiratory mortality (HR = 1.92, 95% CI: 1.22-3.01; p = .005); edentulism with dentures was not significantly associated with either outcome.
Conclusions:
Complete tooth loss, particularly without denture replacement, was associated with increased mortality in adults with ID after adjustment for measured covariates. Preventive dental care and timely prosthodontic rehabilitation should be prioritised within disability health and ageing policies.
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