Healthy teeth will help your patients live longer

Highlights:

• Having 20 natural teeth or more is a minimum to fulfill healthy nutritional requirements 
• Poor oral health may affect food selection and nutrient intake, leading to malnutrition  as well as prevalence of infectious diseases, sarcopenia, and geriatric syndromes
• Daily toothbrushing before sleep, flossing, and regular check-ups with the dentist at least once a year are basic rules of dental health
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Introduction

Taking care of diet, physical and mental health are beneficial for our well-being and longevity, but there are other less-known healthy habits that we could maintain, in order to live longer. One of them is caring for our teeth. The oral cavity is the first part of the digestive system. There is evidence of a close relationship between dental health, the prevalence of geriatric syndromes, and mortality (1). Poor dental health influences the ability to chew and subsequently leads to poor nutrient intake. The elderly with chewing difficulties were reported to be more disabled, depressed, and have a lower quality of life (2). Oral hygiene regulates nutritional status, osteoporosis, or even cognitive and physical activity in older people. It also plays a role in the prevention of infectious diseases because the oral cavity inhabited by bacteria is the entry point to your digestive and respiratory tracts, and some of these bacteria can cause disease. Taken together, healthy teeth will allow your patients to live longer (1).
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Do fewer teeth mean shorter life?

The connection between tooth loss and mortality goes through one of two reasons. The first one is the chronic inflammation of the oral cavity, primarily caused by periodontal disease which may cause a mild but persistent systemic inflammatory response of the organism. Secondly, the nutrition of people who lost many teeth is significantly worse as they have more difficulty chewing. They tend to reduce their intake of fruit and vegetables and switch to a higher-fat and lower-fiber diets, leading to an increased risk of disease and death (3). Having 20 natural teeth or more seems to be a bare minimum to fulfill healthy nutritional requirements and comfortably eat most types of food. Hirotomi et.al. stated that people retaining 20 teeth or more had a visibly lower mortality rate (2.5 %) than subjects with 19 teeth or less in the period of 5 years (3).

Another study done on residents of Miyako Islands, Okinawa, Japan shows that 20 % of the people over the age of 40 years suffered some form of dysphagia (swallowing difficulties) due to fewer teeth. Using dentures improved it by around 60 % in both men and women. In men without dentures, the critical tooth number was 20 at age 40 years and decreased to 10 at age 80 years. In women, this number was 19 at age 40 years and decreased to four at age 80 years (4). The same cohort of community-residing older people in Okinawa was observed for 15 years. The dental care factors, such as dentures, were again associated in this study with mortality rates, especially in female subjects with less than 10 functional teeth, suggesting that oral health impacts longevity. However, the relationship between life expectancy and the number of teeth does not suggest that a pristine smile is the unique factor in increasing life expectancy, but it is for sure one of the important ones (5).