Cumulative Lead Exposure and Tooth Loss in Men: The Normative Aging Study.

PHYSIOLOGICAL effects of lead; TOOTH loss; PERIODONTAL disease; PHYSIOLOGICAL effects of tobacco; CIGARETTE smokers; BIOMARKERS; AGING; PATELLA; X-ray spectroscopy

Background: Individuals previously exposed to lead remain at risk because of endogenous release of lead stored in their skeletal compartments. However, it is not known if long-term cumulative lead exposure is a risk factor for tooth loss. Objectives: We examined the association of bone lead concentrations with loss of natural teeth. Method s: We examined 333 men enrolled in the Veterans Affairs Normative Aging Study. We used a validated K-shell X-ray fluorescence (KXRF) method to measure lead concentrations in the tibial midshaft and patella. A dentist recorded the number of teeth remaining, and tooth loss was categorized as 0, 1-8 or ⩾ 9 missing teeth. We used proportional odds models to estimate the association of bone lead biomarkers with tooth loss, adjusting for age, smoking, diabetes, and other putative confounders. Results: Participants with ⩾ 9 missing teeth had significantly higher bone lead concentrations than those who had not experienced tooth loss. In multivariable-adjusted analyses, men in the highest tertile of tibia lead (> 23 μg/g) and patella lead (> 36 μg/g) had approximately three times the odds of having experienced an elevated degree of tooth loss (⩾ 9 vs. 0-8 missing teeth or ⩾ 1 vs. 0 missing teeth) as those in the lowest tertile [prevalence odds ratio (OR) = 3.03; 95% confidence interval (CI), 1.60?5.76 and OR = 2.41; 95% CI, 1.30?4.49, respectively]. Associations between bone lead biomarkers and tooth loss were similar in magnitude to the increased odds observed in participants who were current smokers. Conclusion: Long-term cumulative lead exposure is associated with increased odds of tooth loss. [ABSTRACT FROM AUTHOR]