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      Prevalence and determinants of dental visits among older adults: findings of a nationally representative longitudinal study

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          Abstract

          Background

          The first aim was to present descriptive data on the frequency of dental visits among older adults in Germany. The second aim was to identify the determinants of the number of dental visits using a longitudinal approach.

          Methods

          Longitudinal data were derived from the German Ageing Survey, which is a nationally representative sample of community-dwelling individuals ≥40 years in Germany. The frequency of dental visits in the past 12 months was recorded in the years 2002, 2008 and 2011. In order to control for time-constant unobserved heterogeneity, Poisson fixed effects regressions were used.

          Results

          While the mean number of dental visits was 2.3 (SD: 2.0) in 2002, it was 2.0 (SD: 1.7) in 2008 and 2.1 (SD: 1.7) in 2011. The frequency of dental visits declined with age (total sample and women), transitions from normal weight to overweight (total sample), changes from divorced/widowed/single/married, living separated from spouse to ‘married, living together with spouse’ in women and with a decrease in the number of physical illnesses (total sample and men).

          Conclusions

          The frequency of dental visits declines with age in older adults. While some of the determinants of frequency are non-modifiable (e.g., ageing and worsening of general health), others are modifiable (e.g., change in weight category).

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          Most cited references27

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          Heteroskedasticity-Robust Standard Errors for Fixed Effects Panel Data Regression

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            Periodontal Disease and Incident Type 2 Diabetes

            OBJECTIVE—Type 2 diabetes and periodontal disease are known to be associated, but the temporality of this relationship has not been firmly established. We investigated whether baseline periodontal disease independently predicts incident diabetes over two decades of follow-up. RESEARCH DESIGN AND METHODS—A total of 9,296 nondiabetic male and female National Health and Nutrition Examination Survey (NHANES I) participants aged 25–74 years who completed a baseline dental examination (1971–1976) and had at least one follow-up evaluation (1982–1992) were studied. We defined six categories of baseline periodontal disease using the periodontal index. Of 7,168 dentate participants, 47% had periodontal index = 0 (periodontally healthy); the remaining were classified into periodontal index quintiles. Incident diabetes was defined by 1) death certificate (ICD-9 code 250), 2) self-report of diabetes requiring pharmacological treatment, or 3) health care facility stay with diabetes discharge code. Multivariable logistic regression models assessed incident diabetes odds across increasing levels of periodontal index in comparison with periodontally healthy participants. RESULTS—The adjusted odds ratios (ORs) for incident diabetes in periodontal index categories 1 and 2 were not elevated, whereas the ORs in periodontal index categories 3 through 5 were 2.26 (95% CI 1.56–3.27), 1.71 (1.0–2.69), and 1.50 (0.99–2.27), respectively. The OR in edentulous participants was 1.30 (1.00–1.70). Dentate participants with advanced tooth loss had an OR of 1.70 (P < 0.05) relative to those with minimal tooth loss. CONCLUSIONS—Baseline periodontal disease is an independent predictor of incident diabetes in the nationally representative sample of NHANES I.
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              Periodontal Disease, Tooth Loss, and Incidence of Ischemic Stroke

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                Author and article information

                Contributors
                a.hajek@uke.de
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                20 August 2019
                20 August 2019
                2019
                : 19
                : 590
                Affiliations
                [1 ]ISNI 0000 0001 2180 3484, GRID grid.13648.38, Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, , University Medical Center Hamburg-Eppendorf, ; Hamburg, Germany
                [2 ]ISNI 0000 0001 2180 3484, GRID grid.13648.38, Institute of Medical Sociology, Center of Psychosocial Medicine, , University Medical Center Hamburg-Eppendorf, ; Hamburg, Germany
                [3 ]ISNI 0000 0001 2180 3484, GRID grid.13648.38, Department of Health Economics and Health Services Research, , University Medical Center Hamburg-Eppendorf, ; Hamburg, Germany
                Author information
                http://orcid.org/0000-0002-6886-2745
                Article
                4427
                10.1186/s12913-019-4427-0
                6702718
                31429740
                4b99303d-b6ab-43bd-a8ef-b0ec21036e3c
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 March 2019
                : 12 August 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Health & Social care
                health care use,dental services utilization,dental visits,longitudinal study,older adults,german ageing survey

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