Evidence map›Paper›PMID 40873151›Full record

ArticleJournal of oral rehabilitation2025

Socioeconomic Inequalities in Oral Frailty Among Older Adults: A Causal Mediation Analysis on the Role of Prevention From Tooth Loss.

Mieko Fujita, Kenji Takeuchi, Yudai Tamada, Taro Kusama, Tatsuo Yamamoto, Katsunori Kondo, Ken Osaka

Abstract read
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In one paragraph

Article in Journal of oral rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mieko FujitaDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
Kenji TakeuchiDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.ORCID https://orcid.org/0000-0001-8769-8955
Yudai TamadaDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
Taro KusamaDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
Tatsuo YamamotoDepartment of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan.
Katsunori KondoDepartment of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Kashiwa, Chiba, Japan.
Ken OsakaDepartment of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.

Funding

Japan Health Promotion and Fitness FoundationJapan Science and Technology AgencyJapan Society for the Promotion of ScienceMinistry of Health, Labour and WelfareNational Research Institute for Earth Science and Disaster ResilienceTMDU priority research areas grant
6 · The paper itself

Abstract

backgroundAlthough social inequalities in oral health have been suggested, the link between socioeconomic status (SES) and oral frailty (OF) remains unclear. We aimed to investigate the inequalities in OF according to SES and the extent to which inequalities are mitigated by preventing tooth loss.

methodsWe used cross-sectional data from 21 542 functionally independent participants aged ≥ 65 (48.5% men) from the Japan Gerontological Evaluation Study. The prevalence of OF, number of teeth, and educational attainment (EA) and equivalent income (EI) were used as outcome, mediator and explanatory variables, respectively. A Poisson regression model was used to examine the association between SES and OF. Causal mediation analysis was performed to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs) of the controlled direct effects (CDEs) of the number of teeth. The proportion eliminated (PE) of the ≥ 20 remaining teeth was calculated.

resultsOverall 7984 participants had OF. The prevalence of OF was 1.45 times higher in participants with ≤ 9 years of EA and 1.38 times higher in participants with an EI of < $20.000. The estimated total effect (TE) of low EA or low EI on the prevalence of OF was mediated by the number of teeth (TE PR, 1.30 [95% CI, 1.25-1.35]; CDE PR, 1.22 [95% CI, 1.10-1.33]; PE, 28.2%) or (TE PR, 1.26 [95% CI, 1.22-1.31]; CDE PR, 1.23 [95% CI, 1.14-1.32]; PE, 12.9%).

conclusionOF showed a clear social gradient based on SES. However, this association could be mediated by the remaining ≥ 20 teeth.

Indexed as

Frail ElderlyFrailtyHealth Status DisparitiesOral HealthSocial ClassTooth LossAgedAged, 80 and overCross-Sectional StudiesFemaleHumansJapanMaleMediation AnalysisPrevalenceSocioeconomic FactorsfrailtyJapanmediation analysessocial classtooth loss

Identifiers

PMID40873151
PMCPMC12624153

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.