INTRODUCTION

The loss of all of one’s teeth (complete edentulism) has been noted as a public health concern since the early 1900s.1,2 Reports by the NIH connect edentulism to death and other conditions.3,4

Recent research addressing the relationship between edentulism and death has shown its association with increased all-cause mortality in male veterans.5 Complete edentulism rather than missing some teeth is associated with all-cause mortality.6 Although thought of as an older person’s condition, Brown (2009) found that complete edentulism prior to age 65 years is also associated with all-cause mortality.7 Other work has linked edentulism with cardiovascular disease (CVD),8,9 diabetes,10 and dental care.9,11, 12, 13 Prior work has shown that age, level of education, SES, and being female are significant factors in edentulism among older adults.14

In this work, the value of creating clusters of individual risk profiles rather than viewing a list of significant individual characteristics was demonstrated to help develop a practical strategy to improve population health. This work focused on perceived health need to establish a baseline risk and remove the necessity of receiving health care. These clusters were validated on external variables to see whether there is a pattern among them. A 2-stage clustering method was used, where clusters with baseline risk characteristics were created, and then similar clusters were grouped with a hierarchical method. Instead of targeting specific populations, the study included all those aged ≥18 years. This approach uncovers patterns and relationships that are not revealed in regression studies and can be used by health plans and policymakers to target appropriate interventions to improve the health of high-risk individuals or those with potential at-risk profiles.