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PLoS One. 2018 Feb 1;13(2):e0192251. doi: 10.1371/journal.pone.0192251. eCollection 2018.

Does poor oral health status increase the risk of falls?: The JAGES Project Longitudinal Study.

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Division of Dental Sociology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan.
Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.
Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
Center for Well-being and Society, Nihon Fukushi University, Nagoya, Japan.


We sought to examine if self-reported oral health conditions regarding difficulty eating tough foods, dry mouth, choking, number of teeth and denture use are associated with incident falls. Our study was based on panel data from the Japan Gerontological Evaluation Study conducted in 2010 and 2013 using self-administered questionnaires. Data from 19,995 male and 20,858 female community-dwelling older people aged ≥65 years without a history of falls within the previous year in 2010 were analyzed. Multilevel logistic regression models were used to determine the association between poor oral health in 2010 and multiple incident falls in 2013 after adjusting for possible confounders and considering differences in municipalities. The percentage of males and females who reported falls in 2013 were 2.4% and 2.1%, respectively. After adjusting for age, educational attainment, equivalized income, depression, self-rated health, instrumental activities of daily living, body mass index, present illness related to falls, social participation, walking in min/day, alcohol drinking status, and municipality population density, dry mouth in males (odds ratio [OR] = 1.41; 95% confidence interval [CI]: 1.12-1.77) and choking in females (OR = 1.64; 95% CI: 1.27-2.11) were significantly associated with incident falls. Difficulty eating tough foods in both sexes and choking in males were marginally associated with incident falls (p<0.1). Females having 10-19 teeth without dentures (OR = 1.63; 95% CI: 1.14-2.31), ≤9 teeth with dentures (OR = 1.36; 95% CI: 1.03-1.80), and ≤9 without dentures (OR = 1.46; 95% CI: 1.02-2.08) were significantly associated with incident falls compared with those having ≥20 teeth, respectively. These findings suggest that poor oral function, having fewer teeth, and not using dentures are predictors of incident falls. Further studies are needed to determine whether improving oral health can reduce the risk of falls.

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