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Impact of Dental Diseases on Quality-Adjusted Life Expectancy in US Adults

Matsuyama, Y; Tsakos, G; Listl, S; Aida, J; Watt, RG; (2019) Impact of Dental Diseases on Quality-Adjusted Life Expectancy in US Adults. Journal of Dental Research , 98 (5) pp. 510-516. 10.1177/0022034519833353. Green open access

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Abstract

Comparing the burden of dental conditions to other health outcomes provides useful insight for public policy. We aimed to estimate quality-adjusted life expectancy (QALE) loss due to dental conditions in the US adult population. Social inequalities in QALE loss by dental conditions were also examined. Data from 3 cross-sectional waves of the National Health and Nutrition Examination Survey (NHANES waves 2001 to 2002, 2003 to 2004, and 2011 to 2012) were pooled and analyzed. The average age of study participants ( n = 9,445) was 48.4 y. Disutility scores were derived from self-rated health and the numbers of physically unhealthy days, mentally unhealthy days, and days with activity limitation, employing a previously published algorithm. The associations between the disutility scores and the numbers of decayed teeth, missing teeth, and periodontitis were examined by multiple linear regression stratified by age groups (20-39, 40-59, and ≥60 y), adjusted for other covariates (age, sex, wave fixed effect, educational attainment, smoking, and diabetes). The QALE loss due to dental conditions at the age of 20 was estimated using life tables. Decayed and missing teeth, but not periodontitis, were associated with a larger disutility score. The coefficient for decayed teeth was larger among the older population, whereas that of missing teeth was smaller among them. The estimated QALE loss was 0.43 y (95% confidence interval [CI], 0.28-0.59), which reached 5.3% of QALE loss (8.15 y; 95% CI, 8.03-8.27) due to overall morbidity. There were clear social gradients in QALE loss by dental conditions across the life course, and people with high school or less education had 0.32 y larger QALE loss in total compared with people with college or more education. This study suggests that improvements in people's dental health may yield substantial gains in population health and well-being. The necessity of more comprehensive public health strategies is highlighted.

Type: Article
Title: Impact of Dental Diseases on Quality-Adjusted Life Expectancy in US Adults
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/0022034519833353
Publisher version: https://doi.org/10.1177/0022034519833353
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: caries, dental public health, edentulous/edentulism, epidemiology, periodontal disease(s)/periodontitis, quality of life
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/10074346
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