The Association Between Tooth Loss And Handgrip Strength In Adults: A Cohort Study

Objectives: 1.Based on the baseline and longitudinal data of the Tianjin Chronic Low-grade Systemic Inflammation and Health(TCLSIH)Cohort Study,we analyzed the association between tooth loss and handgrip strength(HGS)and annual change in HGS in general adults,provided theoretical foundation in preventing muscle strength deterioration.2.This cross-sectional study aimed to investigate the current status of tooth loss and analyze the correlative factors of tooth loss in Tianjin general adults,provided theoretical foundation in preventing tooth loss.Methods: 1.We used baseline and longitudinal data of TCLSIH Cohort Study during 2013～2017.A total of 29,411 participants were enrolled in the cross-sectional study and 9,687 participants were enrolled in the longitudinal study.We adopted self-reported missing teeth number which were classified into four groups depending on the number of missing teeth: 0,1-2,3-9 and ≥ 10.HGS was measured using a handheld type dynamometer.Annual change in HGS was obtained by dividing the current HGS subtraction from the baseline with interval years.Analysis of covariance was used to examine the relationships between tooth loss and HGS,weight-adjusted HGS,annual change in HGS and weight-adjusted annual change in HGS according to gender.2.A questionnaire survey was conducted on 1,004 general adults in Tianjin using the oral health questionnaire.Multiple logistic regression models were used to analyze the correlation between tooth loss and periodontal status,caries and oral health knowledge,attitudes,and behaviors.If the OR value is > 1,the factor is a risk factor.If the OR value is < 1,the factor is a protective factor.Spearman rank correlation and covariance analysis(ANCOVA)were used to analyze the relationship between tooth loss and oral health.Results: 1.In cross-sectional 29,411 subjects,22.4% were missing 1～2 teeth,13.0% were missing 3～9 teeth,and 1.91% were missing ≥ 10 teeth.The average HGS was 43.7 kg in males and 25.9 kg in females.After adjustment for potential confounders,the geometrical means(95% CI)for HGS across tooth loss categories were 43.3(43.1,43.4),43.3(43.1,43.5),42.3(42.0,42.6),39.2(38.5,39.9)(P for trend < 0.0001)in males;and were 25.6(25.5,25.7),25.6(25.4,25.7),24.6(24.4,24.9),23.6(23.0,24.2)(P for trend < 0.0001)in females.Moreover,loss of more than 3 teeth was significantly associated with reduced muscle strength(P < 0.01).In longitudinal 9,687 subjects,the average annual change in HGS was 0.17 kg/y in all people,0.32 kg/y in males,and-0.01 kg/y in females.There was a trending association between the decreased annual change in HGS and weight-adjusted annual change in HGS and fewer retained teeth both in males(P for trend < 0.01);whereas no significant association in females.The mean(95% CI)for the annual change in HGS across tooth loss categories were 0.41(0.27,0.54),0.28(0.07,0.49),-0.11(-0.41,0.19),0.03(-0.73,0.80)in males;and-0.07(-0.19,0.05),0.02(-0.18,0.22),0.14(-0.16,0.44),0.11(-0.71,0.93)in females.2.The average number of self-reported tooth loss in Tianjin was 0.47(range 0-8),and the proportion of missing teeth was 28.8%.The results showed that over 60 years of age,minorities,and oral treatment when required were risk factors for tooth loss;brushing teeth for more than three minutes was a protective factor for tooth loss.There was a significant association between tooth loss and oral health(P < 0.0001).Conclusions: 1.The cross-sectional study showed that tooth loss was independently associated with HGS and weight-adjusted HGS.The longitudinal study demonstrated that tooth loss was significantly associated with annual change in HGS and weight-adjusted annual change in HGS in males and not associated in females.The findings suggest that new precautionary measures aimed at tooth loss may be proposed to maintain muscle strength and prevent sarcopenia and adverse health outcomes.2.The self-reported tooth loss proportion of a general adult population in Tianjin was lower than the national average proportion.The participants lacked of oral health knowledge,were poor in oral care practices,but the willingness to improve oral health was stronge.Tooth loss was closely related to the oral health status.