Dental healthcare utilization and mortality: a population-based prospective cohort study in southern Sweden

OBJECTIVE: The aim was to investigate associations between dental healthcare utilization and all-cause, cardiovascular (CVD), cancer, and other-cause mortality. MATERIALS AND METHODS: A postal public health survey was distributed in the autumn of 2008 to a stratified random sample of the population aged 18-80 in Scania, southern Sweden (response rate 54.1%). Baseline survey data were linked to mortality data, creating a prospective cohort study with 8.3-year follow-up. The present study entails 26,115 respondents. Associations between dental healthcare utilization and mortality were investigated in survival analyses and analyses with a nested case-control design. RESULTS: In all, 68.4% had visited dental healthcare <1 year ago; 19.0%, 1-2 years ago; 6.7%, 3-5 years ago; 5.5%, >5 years ago; and 0.4%, never. The groups that had visited dental healthcare 1-2 years ago, 3-5 years ago, and >5 years ago displayed increased hazard ratios of all-cause mortality throughout the multiple- adjusted survival analyses compared to the <1-year reference group. Conditional logistic regression analyses with a nested case-control design confirmed results with a clearer gradient in all-cause mortality. CVD, cancer, and other-cause mortality showed some significant associations with dental healthcare utilization. CONCLUSIONS: Dental healthcare utilization was associated with all-cause mortality, with a clear gradient in the nested case-control design.