Diet quality mediates link between tooth loss and faster ageing

Tooth loss is associated with accelerated ageing, and this relationship is partially mediated by dietary quality, a recent study has confirmed. Key mediating foods include fruits and vegetables.

The highest quartile of tooth loss positively correlated with accelerated ageing (β, 1.090, 95 percent confidence interval [CI], 0.555‒1.625; p<0.001). Moreover, diet quality got worse as the number of missing teeth increased and was negatively associated with accelerated ageing. [Am J Med 2023;136:773-779.E4]

In mediation analysis, the Healthy Eating Index 2015 (HEI-2015) score showed a partially mediating role in the association between tooth loss and accelerated ageing (proportion of mediation, 5.302 percent, 95 percent CI, 3.422‒7.182; p<0.001). Notably, plant foods such as fruits and vegetables were deemed as key mediating food.

Due to impaired masticatory function, intake of fruits, vegetables, and beans was reduced in individuals with severe tooth loss, leading to inadequate consumption of fibres, vitamins, and micronutrients. [J Dent 2014;42:1428-1435; J Am Dent Assoc 1996;127:459-467; J Am Dent Assoc 2003;134:1185-1192]

This could then result in faster ageing, with previous studies demonstrating a link between increased consumption of fruits and vegetables and delayed ageing, along with a lower risk for cardiovascular disease, stroke, cancer, diabetes, and all-cause mortality. [Arch Gerontol Geriatr 2020;89104044; Am J Clin Nutr 1995;61:1402S-1406S; BMJ 2010;341:c4229; J Nutr 2006;136:2588-2593]

“All these findings urge us to pay more attention to the oral health of the population because poor oral health not only impairs maxillofacial functions but also influences systemic health, disease development, and even mortality,” the investigators said.

“However, besides effective measures to promote oral health and prevent tooth loss, we also need to find other practical interventions to reduce the negative influences of tooth loss on systemic health once tooth loss has already occurred,” they added.

Additionally, these results could have significant implications for primary care physicians and future researchers. For instance, severe tooth loss can be used as a marker for ageing, indicating that physicians should pay more attention to the population with such a condition. Also, changes in dietary quality following tooth loss need more attention from both physicians and patients.

“[C]onsidering the limited mediating proportion of dietary quality, future studies can be performed to elucidate other potential pathways linking tooth loss and accelerated ageing,” the investigators said. “[Furthermore], close attention should be paid to early treatment of oral diseases and restoration of lost teeth to improve the quality of life and extend the healthy lifespan of the ageing population.”

The current study obtained data from the National Health and Nutrition Examination Survey. The missing tooth counts were recorded as the number of edentulous sites, while phenotypic accelerated ageing was measured using nine routine clinical chemistry biomarkers and chronological age.

The investigators used the HEI-2015 score to assess diet quality, as well as multivariate logistic regression and linear regression to explore the relationship between tooth loss and accelerated ageing. Finally, they examined the mediation role of diet quality in this association via mediation analyses.