The association of tooth loss with all-cause and circulatory mortality. Is there a benefit of replaced teeth? A systematic review and meta-analysis

Abstract

We systematically reviewed whether the number of teeth is related to all-cause or circulatory mortality and whether replaced teeth are protective against all-cause or circulatory mortality. The search was based on the PubMed database. All cohort studies published in peer-reviewed journals were selected. Studies on periodontal disease and mortality were excluded if they did not provide information on the number of teeth. Risk estimates from studies with appropriate exposure definition, confounder adjustment and sample size were included in a meta-analysis. Three high-quality studies found a relationship between the number of teeth and circulatory mortality, whereas a moderate study did not. Two out of four moderate- to high-quality studies reported a relationship between the number of teeth and all-cause mortality. No study has investigated whether replaced teeth are protective against mortality. Therefore, denture use was taken as proxy. The methodological quality of studies on denture use and mortality was generally low to moderate. The findings of two moderate studies indicated an effect of prosthodontic replacements on all-cause mortality, which was supported in bias analysis. It is open whether competing risks of cause-specific death other than circulatory mortality reduce an effect of the number of teeth on all-cause mortality. An effect of denture use on circulatory mortality remains to be established, as well as whether the number of replaced teeth affects mortality. Specifying the role of potential pathways by which tooth loss-related mortality is mediated will possibly increase the value of dental treatment for general health.

Missing Teeth Predict Incident Cardiovascular Events, Diabetes, and Death

“…The studies that measure the association between missing teeth and signs of CVD-such as coronary atherosclerotic burden with coronary angiography, carotid ultrasound, arterial stiffness, or self-reported angina pectoris-support our results (Desvarieux et al 2003;Desvarieux et al 2005;Gomes et al 2012;Holmlund and Lind 2012;Medina-Solis et al 2014;Asai et al 2015). Presently, we analyzed the association between missing teeth and various incident cardiovascular events, while most studies have used mortality rates as the outcome (Ragnarsson et al 2004;Cabrera et al 2005;Polzer et al 2012;Watt et al 2012). Record linkage through national registers has proven to be a reasonably valid indicator for detecting incident CHD events (Pajunen et al 2005).…”

Factors Related to Tooth Loss Among Community-Dwelling Middle-aged and Elderly Japanese Men

“…1 , 2 In addition, tooth loss affects daily activities such as speaking, smiling, chewing, and tasting. 3 Prevention of tooth loss thus helps maintain good general health and high quality of life.…”

Oral and dental health in Huntington‘s disease - an observational study

“…As possible pathways, the effects of masticatory dysfunction on dietary behaviour, nutrition and systemic diseases and inflammatory effects on the circulatory system are discussed [27-29]. Oral disease was found to be associated with excess cardiovascular disease risk, with possibly common pathogenetic mechanisms between poor oral health and cardiovascular disease [30].…”