Dental healthcare utilization and mortality: a population-based prospective cohort study in southern Sweden

Authors

  • Martin Lindström Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University, Malmö, Sweden
  • Aron Naimi-Akbar Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
  • Emma Lindström Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University, Malmö, Sweden; Department of Speech Language Pathology, Faculty of Arts, Theology and Psychology, Åbo Akademi University, Turku, Finland
  • Maria Rosvall Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University, Malmö, Sweden; Department of Community Medicine and Public Health, Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
  • Mirnabi Pirnouzifard Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University, Malmö, Sweden

DOI:

https://doi.org/10.2340/aos.v85.46190

Keywords:

dental healthcare utilization, oral health, mortality, Sweden

Abstract

Objective: The aim was to investigate associations between dental healthcare utilization and all-cause, cardiovascular (CVD), cancer, and other-cause mortality.

Materials and methods: A postal public health survey was distributed in the autumn of 2008 to a stratified random sample of the population aged 18–80 in Scania, southern Sweden (response rate 54.1%). Baseline survey data were linked to mortality data, creating a prospective cohort study with 8.3-year follow-up. The present study entails 26,115 respondents. Associations between dental healthcare utilization and mortality were investigated in survival analyses and analyses with a nested case–control design.

Results: In all, 68.4% had visited dental healthcare <1 year ago; 19.0%, 1–2 years ago; 6.7%, 3–5 years ago; 5.5%, >5 years ago; and 0.4%, never. The groups that had visited dental healthcare 1–2 years ago, 3–5 years ago, and >5 years ago displayed increased hazard ratios of all-cause mortality throughout the multiple- adjusted survival analyses compared to the <1-year reference group. Conditional logistic regression analyses with a nested case–control design confirmed results with a clearer gradient in all-cause mortality. CVD, cancer, and other-cause mortality showed some significant associations with dental healthcare utilization.

Conclusions: Dental healthcare utilization was associated with all-cause mortality, with a clear gradient in the nested case–control design.

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References

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Published

2026-05-29

Issue

Vol. 85: (2026): Acta Odontologica Scandinavica

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Research article

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Copyright (c) 2026 Martin Lindström, Aron Naimi-Akbar, Emma Lindström, Maria Rosvall, Mirnabi Pirnouzifard

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