Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up study

Abstract This study examines the association between denture use and all-cause mortality risk among Chinese edentulous elderly, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2008–2014 waves). A cohort of 8444 adults aged $$\ge 60$$ with complete tooth loss was analyzed, w...

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Main Authors: Hong Tang, Gang Sun, Deping Sun
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-06852-7
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author Hong Tang
Gang Sun
Deping Sun
author_facet Hong Tang
Gang Sun
Deping Sun
author_sort Hong Tang
collection DOAJ
description Abstract This study examines the association between denture use and all-cause mortality risk among Chinese edentulous elderly, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2008–2014 waves). A cohort of 8444 adults aged $$\ge 60$$ with complete tooth loss was analyzed, with denture use recorded as a binary variable (yes/no) and mortality verified via follow-up linkages. Missing data were handled via multiple imputation (MICE), and propensity score matching (PSM) balanced covariates between denture users and non-users. Kaplan-Meier survival analysis demonstrated significantly improved survival probabilities among denture users compared to non-users (log-rank p = 0.0033). Multivariate Cox proportional hazards models, after full adjustment for potential confounders, consistently revealed that denture non-users faced a 15.8% higher mortality risk (HR = 1.158, 95% CI 1.082–1.239, P < 0.001). Mediation analyses elucidated potential pathways, identifying BMI as a significant partial mediator (indirect effect = − 0.010, P < 0.001) in the denture-mortality relationship. In contrast, neither dietary diversity (DDS: p = 0.105) nor daily staple food intake (DSFA: p = 0.190) demonstrated significant mediating effects. The robustness of these findings was confirmed through comprehensive sensitivity analyses, including complete-case analysis and evaluation of pre-propensity score matched cohorts, with all approaches yielding consistent results. This study provides robust evidence that denture use is significantly associated with reduced all-cause mortality among edentulous elderly adults, with BMI serving as a key mediating factor in this protective relationship.
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spelling doaj-art-08cccc060d8b49fa83c25052e8cc77fc2025-08-20T04:01:41ZengNature PortfolioScientific Reports2045-23222025-07-0115111410.1038/s41598-025-06852-7Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up studyHong Tang0Gang Sun1Deping Sun2Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical UniversityShapingba District People’s Hospital of Chongqing, Otorhinolaryngology Head and Neck SurgeryDepartment of Otorhinolaryngology Head and Neck Surgery, University-Town Hospital of Chongqing Medical UniversityAbstract This study examines the association between denture use and all-cause mortality risk among Chinese edentulous elderly, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2008–2014 waves). A cohort of 8444 adults aged $$\ge 60$$ with complete tooth loss was analyzed, with denture use recorded as a binary variable (yes/no) and mortality verified via follow-up linkages. Missing data were handled via multiple imputation (MICE), and propensity score matching (PSM) balanced covariates between denture users and non-users. Kaplan-Meier survival analysis demonstrated significantly improved survival probabilities among denture users compared to non-users (log-rank p = 0.0033). Multivariate Cox proportional hazards models, after full adjustment for potential confounders, consistently revealed that denture non-users faced a 15.8% higher mortality risk (HR = 1.158, 95% CI 1.082–1.239, P < 0.001). Mediation analyses elucidated potential pathways, identifying BMI as a significant partial mediator (indirect effect = − 0.010, P < 0.001) in the denture-mortality relationship. In contrast, neither dietary diversity (DDS: p = 0.105) nor daily staple food intake (DSFA: p = 0.190) demonstrated significant mediating effects. The robustness of these findings was confirmed through comprehensive sensitivity analyses, including complete-case analysis and evaluation of pre-propensity score matched cohorts, with all approaches yielding consistent results. This study provides robust evidence that denture use is significantly associated with reduced all-cause mortality among edentulous elderly adults, with BMI serving as a key mediating factor in this protective relationship.https://doi.org/10.1038/s41598-025-06852-7Denture useAll-cause mortalityElderlyEdentulismMediation analysisLongitudinal cohort study
spellingShingle Hong Tang
Gang Sun
Deping Sun
Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up study
Scientific Reports
Denture use
All-cause mortality
Elderly
Edentulism
Mediation analysis
Longitudinal cohort study
title Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up study
title_full Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up study
title_fullStr Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up study
title_full_unstemmed Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up study
title_short Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up study
title_sort denture use and all cause mortality risk in chinese edentulous elderly a follow up study
topic Denture use
All-cause mortality
Elderly
Edentulism
Mediation analysis
Longitudinal cohort study
url https://doi.org/10.1038/s41598-025-06852-7
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AT gangsun dentureuseandallcausemortalityriskinchineseedentulouselderlyafollowupstudy
AT depingsun dentureuseandallcausemortalityriskinchineseedentulouselderlyafollowupstudy