OBJECTIVESTo analyze whether inflammatory processes in the periodontium in early old age are related to subsequent mortality during 21 years of follow-up in a nondisabled 70-year-old population.SETTINGCommunity-based population in Copenhagen.DESIGNThe study was based on the Glostrup Aging Study of the 1914 population, with baseline in 1984 when the participants were 70 years old and follow-up 21 years later.PARTICIPANTSThree hundred thirty-five dentate men and women participated in the clinical oral health examination.MEASUREMENTSSevere periodontal inflammation was measured for all teeth present as the number of teeth with inflammation and periodontal pockets 6 mm deep or more. Mortality data were obtained from the Danish Death Register at 21-year follow-up. The Cox proportional hazards regression model was used. Covariates were measured at baseline and included number of teeth, caries, sex, education, income, hypertension, diabetes mellitus, osteoarthritis, arteriostenosis, myocardial infarction, comorbidity, fatigue, and ability to brush teeth.RESULTSThe analyses showed that severe periodontal inflammation in at least three teeth at age 70 was marginally related to mortality during 21-year follow-up (crude hazard ratio (HR)=1.17, 95% confidence interval (CI)=0.91-1.78). The estimate increased slightly when adjusted for sex, income, fatigue, and smoking (adjusted HR=1.37, 95% CI=0.97-1.92). The estimates were attenuated when adjusted for the specific diseases, especially arteriostenosis and osteoarthritis.CONCLUSIONInflammation in the periodontium in early old age tends to be associated with mortality in older age.

OBJECTIVES The purpose of this study was to analyze the life-course effects of education, occupation, and income at ages 70, 75, 80, and 85 years, respectively, on dental caries experience of 85-year-olds. METHODS The present study includes follow-up data from a population-based study, which comprised a sample of 176 individuals aged 85 years. Data on social position were collected at ages 70, 75, 80, and 85 years by means of structured personal interviews. Clinical oral health examinations were conducted to obtain data on dental caries at age 85. Dental caries was recorded at tooth surface level and caries experience was expressed by the DMF Index: the decayed tooth surfaces (D component), missing tooth surfaces (M component), and filled tooth surfaces (F component). RESULTS The participants in the present study demonstrated a high level of dental caries experience; the prevalence rate for active dental caries (D-S) was 80 percent. Older adults with low education, low occupational status, and poor income tended to have more active dental caries compared to their counterparts. In contrast, individuals with high education (F-S = 35.5) and high occupational status (F-S = 36.0) had significantly more filled surfaces than persons with low education (F-S = 24.0) and low occupational status (F-S = 25.6). Individuals with high income at ages 75, 80, and 85 years had more filled surfaces (F-S = 31.9, 33.2, 34.1) compared to persons with low income (F-S = 25.5, 23.5, 22.8). CONCLUSION The study identified social inequalities across age among the very old individuals in relation to dental caries experience.

OBJECTIVES:To measure the prevalence of dental caries in the Danish adult population and to analyse how the risk of dental caries is affected by age, gender, region, area, and socio-economic factors. Furthermore to assess the impact on dental caries experience of use of oral health services during childhood and adult life. BASIC RESEARCH DESIGN ANDPARTICIPANTS: A cross-sectional study of a random sample of 1,115 Danish adults in ages 35-44 years and 65-74 years. Data were collected by means of personal interviews and by clinical examinations according to criteria of the World Health Organization. Dental caries was recorded at tooth and tooth surface levels.RESULTS:At age 35-44 years the mean caries experience was 46.6 DMF-S against a mean of 104.1 DMF-S in the total sample of 65-74-year-olds. The D-component was low (35-44 years D-S = 0.9; 65-74 years D-S = 1.5). The M-component was three times higher in the elderly than in the younger age group. The multivariate analysis showed that significantly more untreated decay was found among men, in rural areas and in low income groups. A significantly higher score of filled surfaces were found among older adults and in the group with more education (12-13 years) whereas the F-component was low in the low income group. The total DMF-S was significantly higher among the elderly, persons living in Jutland and in groups with less education, while men had low DMF-S compared to women.CONCLUSION:Reducing social inequality in dental caries experience remains a challenge to oral health services in Denmark; strengthening community-oriented oral disease prevention and health promotion is needed to improve the oral health in the Danish adult population.

OBJECTIVES:To assess the periodontal health status in the Danish adult population and to analyze how the level of periodontal health is associated with age, gender, urbanization, socio-economic factors, and dental visiting habits; furthermore, to compare the periodontal health status of Danish adults with that of adults in other industrialized countries.MATERIAL AND METHODS:A cross-sectional study of a random sample of 1,115 Danish adults aged 35-44 years and 65-74 years. Data were collected by means of personal interviews and by clinical examinations in accordance with the World Health Organization Basic Methods Criteria.RESULTS:The clinical examination revealed a low prevalence of healthy periodontal conditions in both age groups: at age 35-44 years 7.7% and at age 65-74 years 2.4% had healthy periodontal conditions. A high proportion of the elderly had scores of severe periodontal health; more than 82% of older participants had pockets of 4-5 mm or deeper against 42% in younger adults. In both age groups, the mean number of teeth with periodontal pockets deeper than 4-5 mm was high in individuals with low education. Only a weak association between periodontal health and income was found. High Community Periodontal Index scores were seen for irregular dental visitors, but in the 35-44-year-olds deep periodontal pockets were more often seen among young regular dental visitors. The multivariate analysis showed that participants with low or medium levels of education had significantly more teeth with shallow and deep pockets than those with high education. Persons with regular dental visiting habits had fewer teeth with gingival bleeding, shallow and deep pockets than individuals with irregular dental visiting habits.CONCLUSION:Reorientation of the Danish dental health-care services is needed with further emphasis on preventive care, and public health programs should focus on risk factors shared by chronic diseases in order to improve the periodontal health of Danish adults.

Objectives: This study analyzes the current profile of dentate status and use of dental health services among adults in Denmark at the turn of the millennium, assesses the impact on dentate status of sociodemographic factors and use of dental health services in adulthood and in childhood, and highlights the changes over time in dental health conditions among adults. Finally, the intention of the study was to evaluate the Danish dental health care system's level of achievement of the official goals for the year 2000 as formulated by the World Health Organization and the National Board of Health. The subjects of this study included a national representative sample of 16,690 Danish citizens aged 16 years and older (response rate=74.2%). A subsample (n=3,818) took part in a survey of dental care habits in childhood and prevalence of removable dentures; 66 percent of persons selected responded. Methods: Personal interviews were used to collect information on dentate status, use of dental health services and living conditions; data on dental care habits in childhood and prevalence of removable dentures were collected by self-administered questionnaires. Results: In all, 8 percent of interviewed persons were edentulous, while 80 percent had 20 or more natural teeth. At age 65-74 years, 27 percent were edentulous and 40 percent had 20 teeth or more; 58 percent wore removable dentures. Dentate status and prevalence of dentures were highly related to educational background and income, particularly for older age groups. Among persons interviewed, 80 percent paid regular dental visits and visits were most frequent among persons of high education and income. At age 35-44 years 95 percent had participated in regular dental care in childhood compared to 49 percent of 65-74-year-olds. Multivariate analyses revealed that sociobehavioral factors had significant effects on dentate status. Conclusions: Compared to similar studies carried out in 1987 and 1994, the present survey indicates a positive trend of improved dentate status in adult Danes in general and regular use of dental health services increased considerably overtime. The WHO goals for better dental health by the year 2000 were achieved for 35-44-year-olds, whereas the goal of more people with functional dentitions at age 65 years or older was not achieved. it remains a challenge to the Danish dental health system to help even out the social inequalities in dental health.

OBJECTIVES:To assess the present level of oral hygiene practices in the Danish adult population aged 16 or above, in particular to analyse how self-care practices in terms of oral hygiene habits and cleaning of dentures are affected by socio-economic factors, dental status, actual dental visiting habits, and the experience of oral health care during school years.BASIC RESEARCH DESIGN AND PARTICIPANTS:A cross-sectional study of 5802 persons, randomly sampled amongst the Danish population aged 16 years or above. Data were collected by means of personal interviews and self-administered questionnaires. The response rate was 66%.RESULTS:Toothbrushing twice-a-day was reported by 68% of the dentates while 32% brushed their teeth once-a-day or less frequent. Daily use of toothpicks was reported by 28% while daily use of dental floss was reported by 11%. Oral hygiene habits were more frequent amongst women. Toothbrushing twice-a-day was related to regular dental visits, dental care during school years, and a high level of education. Daily use of toothpicks was more common among females and older persons. Regular dental visits, having 20 or more teeth in situ, and regular dental service through school years were predictors for daily use of toothpicks. Amongst denture wearers, one-third cleaned their dentures twice-a-day. Frequency of denture cleaning was significantly associated with gender, age, number of teeth left, and educational level.CONCLUSION:Intensive population-directed strategies for oral health education should be considered in order to further improve the oral hygiene practices of the entire population.