A study on the option of replacing missing teeth with a fixed prosthesis that can protect against cognitive decline was presented at the AADOCR 52nd Annual Conference and Exposition, held in conjunction with the 47th CADR Annual Meeting. The AADOCR/CADR Annual Meeting & Exhibition was held at the Oregon Convention Center in Portland, March 15-18.
Carrot Chewing Test:
A study by Elizabeth Kaye of Boston University examined 577 men in the VA Normative Aging Study (NAS) and the Dental Longitudinal Study. Tooth status and type of restoration, if any, were recorded at three-year dental examinations (1969-2001). Chewing efficiency was assessed by the carrot chewing test. The Spatial Copy Task (SCT) was administered up to four times between 1995 and 2001.
The investigators defined poor cognition as any weighted SCT score <13 (lowest tertile of initial SCT scores for all NAS participants). Cox proportional regression at the tooth level, accounting for clustering within individuals, estimated risk of poor cognition, adjusted for education, epilepsy medication use, and time-varying values of dental status (present, absent, fixed bridge/implant, removable restoration), age, cigarette smoking, and ischemic heart disease.
Replacement of Teeth
The mean age at initial cognitive testing was 68 ± 7 years. 45 percent of men had at least one low SCT score. The study found that 29 percent of participants lost no teeth during follow-up, 34% lost teeth that were not replaced, 13% had missing teeth subsequently replaced with fixed dentures, and 25% had missing teeth replaced with removable dentures.
New fixed prostheses were associated with a lower risk (HR=0.72, 95% CI=0.52-0.99) of poor cognition, while new removable prostheses were associated with a higher risk (HR=1.26, 95% CI= 1.01-1.56). Loss of a tooth without replacement was not associated with a significantly higher risk (HR=1.05 95% CI=0.91-1.21) of poor cognition.
Masticatory ability decreased by 6% in men with new fixed dentures compared to 9%, 10% and 13% in men with no tooth loss, new removable dentures and tooth loss but no replacement.
The study found that replacing missing teeth with fixed prostheses may protect against cognitive decline, and maintaining chewing ability may play a role in the protective link.
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