Weekly physical activity and incident complete tooth loss among middle-aged and older adults: evidence from the health and retirement study

Whether physical activity is associated with subsequent complete tooth loss remains uncertain. We examined this association among adults aged 45 years or older in the Health and Retirement Study (HRS). We studied HRS participants who retained natural teeth in 2006 and assessed incident complete tooth loss in 2012. The fully adjusted sample included 11,147 participants. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for weekly moderate-to-vigorous physical activity (MVPA), with sequential adjustment for demographic characteristics, smoking and drinking, and chronic conditions. Additional analyses examined activity categories, participant subgroups, and adjustment for body mass index (BMI). Incident complete tooth loss was reported by 643 participants (5.77%) in the fully adjusted sample. Weekly MVPA was associated with lower odds of complete tooth loss (OR 0.74, 95% CI 0.62–0.89; P = 0.001). Compared with the low-activity group, the moderate- and high-activity groups had ORs of 0.80 (95% CI 0.66–0.97) and 0.65 (95% CI 0.52–0.81), respectively. There was no statistical evidence of interaction across the examined subgroups. After BMI adjustment, the sample decreased to 4,712 participants, and the estimate was less precise (OR 0.76, 95% CI 0.56–1.02). Weekly MVPA was associated with lower odds of subsequent complete tooth loss. Residual confounding, incomplete characterization of baseline oral health, and selection associated with missing data limit causal interpretation.