The relationship between tooth loss and mortality from all causes, cardiovascular diseases, and coronary heart disease in the general population: systematic review and dose-response meta-analysis of prospective cohort studies

• Published in: Bioscience reports 2019-01, Vol.39 (1)
• Main Authors: Peng, Juxiang, Song, Jukun, Han, Jing, Chen, Zhu, Yin, Xinhai, Zhu, Jianguo, Song, Jinlin
• Format: Article
• Language: English
• Subjects: Alcohol Drinking - physiopathology; Cardiovascular Diseases - complications; Cardiovascular Diseases - mortality; Cardiovascular Diseases - pathology; Female; Humans; Male; Marital Status - statistics & numerical data; Prospective Studies; Regression Analysis; Risk Factors; Smoking - physiopathology; Social Class; Survival Analysis; Tooth Loss - complications; Tooth Loss - mortality; Tooth Loss - pathology
• ISSN: 0144-8463; 1573-4935
• DOI: 10.1042/BSR20181773

The association of tooth loss with mortality from all causes, cardiovascular diseases (CVD), and coronary heart disease (CHD) has been studied for many years; however, the results are inconsistent. PubMed, Embase, Web of Knowledge, and Cochrane Oral Health Group's Trials Register databases were searched for papers published from 1966 to August 2018. We conducted dose-response meta-analysis to quantitatively evaluate the relation between tooth loss and risk of mortality from all causes, CVD, and CHD. : In the present study, 18 prospective studies conducted until August 2018 were considered eligible for analysis. In the analysis of linear association, the summarized relative risk (RR) values for each 10-, 20-, and 32-tooth loss for all-cause mortality were 1.15 (1.11-1.19), 1.33 (1.23-1.29), and 1.57 (1.39-1.51), respectively. Subgroup and sensitivity analyses showed consistent results. A linear relationship was found among all-cause mortality, with = 0.306. The susceptibility to all-cause mortality increased by almost 1.48 times at very high tooth loss (28-32), and slight flattening of the curve was noted. However, the summarized RR values for increment for 10-, 20-, and 32-tooth loss were not or were marginally related to increased risk of mortality from CVD/CHD. Subgroup and sensitivity analyses revealed inconsistent results. Tooth loss showed linear association with CHD mortality but not with CVD mortality. The susceptibility to all-cause mortality increased by almost 1.48 and 1.70 times for CVD and CHD, respectively, at very high tooth loss (28-32). The curve exhibited slight flattening; however, no statistical significance was detected. : In the meta-analysis, our findings confirmed the positive relationship between tooth loss and susceptibility to all-cause mortality, but not for circulatory mortality. However, the finding that tooth loss might play a harmful role in the development of all-cause mortality remains inconclusive. Tooth loss may be a potential risk marker for all-cause mortality: however, their association must be further validated through large prospective studies.