Wearing Removable Dentures Associates with Improved Survival

Objectives: Tooth loss associates with increased mortality and decreased masticatory function. Removable dentures have been linked to improved function and experienced quality of life. Past studies have suggested that wearing dentures associates with increased survival, possibly via changes in dietary behavior. However, research is scarce to date. We explored whether denture wear is associated with total-, or cardiovascular mortality.

Methods: The Parogene cohort consisted of N=508 Finnish adults (Mean age=63y, SD=9.1) all of whom underwent clinical and radiographic oral examinations. Baseline cardiovascular disease (CVD, ≥50% stenosis, n=353) was diagnosed by angiography. ICD-10 rated mortality data was gathered from the Finnish Causes of Death Register (mean follow-up time 7.81y, SD 1.45). “Edentates” (n=172) were defined at having <20 teeth, as an arbitrary cut-off for denture necessity. Survival analyses were conducted with cox-regression and adjusted for age, gender, smoking, prevalent CVD, number of teeth and alveolar bone loss (ABL).

Results: A total of n=147 subjects wore dentures (≥1 partial dentures [PD]n=116; whole dentures in both jaws [WD]n=31). Denture wear was associated with higher age, prevalent CVD, smoking, and inversely associated with prevalence of (≥1) caries, endodontic lesions and root canal fillings (p<0.05). A total of 80% ([PD]n=106; [WD]n=31) of the edentates wore dentures (p<00.1). In this subgroup, denture wear was inversely associated with prevalence of (≥1) caries, endodontic lesions, root canal fillings and ABL (p<0.05). Not wearing dentures (n=361) associated with 400% and 380% increased hazards for all-cause (n=70) and CVD-mortality (n=44) respectively (p<0.05). In the edentate, not wearing dentures (n=35) yielded hazards of 480% for all-cause mortality (n=39) and 470% for CVD-mortality (n=25, p<0.05) compared to denture wear.

Conclusions: Denture wear increased survival, irrespective of number of teeth present. Having dentures might reflect improved nutritional availability, high socioeconomic status, patient motivation towards a healthy lifestyle and usage of health care services.