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26 March 2024

Correlation of oral health and mortality among the elderly

Simona Chirico

The evidence on the association between oral health and mortality is inconclusive and few studies have accounted for nonrandom selection bias in estimating their relationship.

Materials and methods

In a study, conducted by Yu et al, published in the American Journal of Preventive Medicine, the authors investigate the link between oral health and mortality in community-dwelling older adults by adjusting for confounding factors with a doubly robust survival estimate.

Data were from the third National Health and Nutrition Examination Survey (1988-1994) and were linked to National Mortality Index data through December 2015. The analytic sample consisted of 4880 adults aged ≥60 years. Oral health measures included objective clinical indicators (edentulism, periodontitis, and untreated dental caries) and a self-assessment of oral health.

Cox proportional hazards regression and inverse probability weighting models with regression adjustment for the observational estimate of survival time were used to evaluate the relationship between oral health and mortality. The analyzes were conducted in 2021.


Edentulism (mean treatment effect = -26.13, 95% CI = -48.69, -3.57) was associated with decreased survival time.

Periodontal conditions and dental caries were related to all-cause mortality in the Cox models, but became nonsignificant when inverse probability weighting was applied with the regression-adjusted survival estimate.


Good self-rated oral health was significantly related to increased survival time (mean treatment effect = 21.50; 95% CI = 4.92, 38.07).

The study therefore shows that both objective and subjective oral health are risk factors for mortality among the elderly. Improving access to dental screening and treatment among community-dwelling older adults has the potential to reduce oral health-related mortality risks.

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