Abstract
The purpose of this prospective cohort study was to investigate the relationship between having a regular dentist and the incidence of long-term care in the elderly in the community. A community-based comprehensive geriatric assessment, including a dental examination and questionnaire about the utilization of dental services, was conducted with 834 elderly residents (52% women), aged≥70 years (mean, 75 years) in a suburban area of Sendai, Japan. The questionnaire recorded presence or absence of a regular dentist, the motive for using dental services, and the last time dental services were used. The association between having a regular dentist and the incidence of long-term care was examined using a Cox regression model adjusted for age, sex, current illness, smoking, alcohol consumption, duration of education, nutritional status, cognitive impairment, depressive symptoms, physical function, social support, and number of remaining teeth. In a baseline survey, 778 (86%) subjects had a regular dentist. The subjects with regular dentists had more positive behaviors associated with the utilization of dental services than those without a regular dentist. During a mean follow-up of 6.2 years, 304 (37%) incidences of long-term care were recorded. There was a significant difference in the incidence of long-term care between subjects with or without a regular dentist (Log-rank test, p＜0.01). Compared to the presence of a regular dentist, the adjusted hazard ratio was significantly higher for absence of a regular dentist (1.4, 95% confidence interval＝1.0〜1.9). On the other hand, the motive for using dental services and the last time of dental services were not associated with the incidence of long-term care. The absence of a regular dentist was independently associated with long-term care insurance certification. It was suggested that a regular dentist contributed to prevention of conditions requiring long-term care.
