Tooth loss among residents of Appalachian Coal mining counties

Background. The authors compared odds of any tooth loss, partial, and total edentulism between adult residents of Appalachian coal mining areas and other areas of the nation before and after control for covariate risks. Methods. The authors merged 2006 national Behavioral Risk Factor Surveillance System data with county coal mining data and other county characteristics. Odds of three measures of tooth loss were examined controlling for age, race\ethnicity, drinking, smoking, income, education, supply of dentists, receipt of dental care, and other variables. Data were analyzed using SUDAAN to account for the multilevel complex sampling structure. Results. Residents of Appalachian mining counties had significantly elevated odds of all measures of tooth loss before covariate adjustment. After adjustment, odds remained elevated for two of three measures of tooth loss: any tooth loss (OR=1.29 ,95% CI = 1.19, 1.40), and a 4-level edentulism scale (OR=1.20, 95% CI = 1.12, 1.28). For the third measure, complete tooth loss, odds were elevated for all coal mining residents, not limited to Appalachia (OR=1.19, 95% CI = 1.08, 1.32.) Conclusions. Greater odds of tooth loss among adult residents of coal mining areas is present and is not explained by differences in reported receipt of dental care, supply of dentists or other behavioral or socioeconomic risks. Possible exposure to environmental contaminants may contribute to observed differences.