Risk of Edentulism Among Older Adults with Multimorbidity

Objective: This study aimed to assess whether older American adults with multimorbidity are at higher risk of becoming edentate over time. Methods: We used data from three waves of the Health and Retirement Study (HRS), a longitudinal survey of older American adults aged 50 years and over. Data on multimorbidity was from 2012, while data on complete tooth loss was from 2018. Multimorbidity included five common and serious conditions, namely diabetes, heart conditions, lung diseases, cancer, and stroke. Socioeconomic factor was indicated by total wealth in 2006; behaviour was indicated by smoking in 2012. We used Structural Equation Modelling (SEM) to assess the relationship between multimorbidity in 2012 and complete tooth loss in 2018. Participants with complete tooth loss in 2012 were excluded from the analysis. Results: Among 6286 participants with complete data across all three waves, each additional chronic condition in 2012 was associated with 1.30 times higher odds of edentulism in 2018 (95% CI: 1.12, 1.52). In the SEM, multimorbidity in 2012 was positively associated with being edentate in 2018 (estimate: 0.01, 95% CI 0.01, 0.02); smoking and wealth were also significantly associated with edentulism. Wealth and smoking were also associated with multimorbidity. Conclusions: Older adults with multimorbidity appear to have a higher probability for becoming edentate. The findings highlight the need for oral health promotion activities for those with multimorbidity.