TY - JOUR
T1 - Impact of Dental Diseases on Quality-Adjusted Life Expectancy in US Adults
AU - Matsuyama, Y.
AU - Tsakos, G.
AU - Listl, S.
AU - Aida, J.
AU - Watt, R. G.
N1 - Funding Information:
1Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan 2Japan Society for the Promotion of Science, Chiyoda-ku, Japan 3Department of Epidemiology and Public Health, University College London, London, UK 4Department of Dentistry-Chair for Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, Netherlands 5Department of Conservative Dentistry–Section for Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany 6Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
Funding Information:
The authors gratefully acknowledge the participants in the NHANES surveys. This work was supported by grants from the Grant-in-Aid for JSPS Research Fellow (17J05974). The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.
Publisher Copyright:
© International & American Associations for Dental Research 2019.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
KW - caries
KW - dental public health
KW - edentulous/edentulism
KW - epidemiology
KW - periodontal disease(s)/periodontitis
KW - quality of life
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U2 - 10.1177/0022034519833353
DO - 10.1177/0022034519833353
M3 - Article
C2 - 30849271
AN - SCOPUS:85062704508
VL - 98
SP - 510
EP - 516
JO - Journal of Dental Research
JF - Journal of Dental Research
SN - 0022-0345
IS - 5
ER -
