The risk of tooth loss in patients with diabetes: A systematic review and meta‐analysis

Abstract

Aim The aim of this systematic review was to comprehensively and critically summarize and synthesize the risk of losing teeth among with diabetes mellitus (DM) compared to those without DM, as established in observational studies. Materials and methods MEDLINE‐PubMed and Cochrane databases were searched through a period from their inception through October 2020 to identify eligible studies. Papers that primarily evaluate the number of teeth in DM patients compared to non‐DM individuals were included. A descriptive analysis of the selected studies was conducted, and when feasible, a meta‐analysis was performed. The quality of the studies was assessed. Results A total of 1087 references were generated, and screening of the papers resulted in 10 eligible publications. A descriptive analysis demonstrated that six of these studies indicate a significantly higher risk of tooth loss in DM patients. This was confirmed by the meta‐analysis risk ratio of 1.63 95% CI (1.33; 2.00, p < 0.00001). Subgroup analysis illustrates that this is irrespective of the risk‐of‐bias assessment. The higher risk of tooth loss in DM patients was also higher when only DM type II patients or studies with a cross‐sectional design were considered. Patients with a poor DM control status presented a significantly increased risk of tooth loss. When the data were separated by the world continent where the study was performed, Asia and South America had numerically higher risks and a 95% CI that did not overlap with Europe and North America. Conclusion There is moderate certainty for a small but significantly higher risk of tooth loss in DM patients as compared to those without DM.

Association of occlusal support with type 2 diabetes: A community-based study

“…Older adults with worse occlusal support had higher risk of type 2 diabetes, which was not elucidated in previous studies (18,30). However, risk of type 2 diabetes was proved to be significantly associated with tooth loss (18,31), which was closely correlated with lower occlusal support (17,32).…”

“…Older adults with worse occlusal support had higher risk of type 2 diabetes, which was not elucidated in previous studies (18,30). However, risk of type 2 diabetes was proved to be significantly associated with tooth loss (18,31), which was closely correlated with lower occlusal support (17,32). Demmer et al found missing ≥ 25 teeth was significantly associated with increased incidence of diabetes compared to those missing 0-8 teeth (33).…”

“…There were multiple studies on the association between occlusal support and type 2 diabetes (18)(19)(20)(21). More evidence was needed to further investigate the association between occlusal support and type 2 diabetes.…”

Association of the number of teeth and self-rated mastication with self-rated health in community-dwelling Japanese aged 40 years and older: the Yamagata cohort study

“…The risk of osteoporosis and metabolic abnormalities such as glucose metabolism disorders derived from a reduction in postmenopausal estrogen level is also well-known 39,40 . Furthermore, these diseases are well-known risk factors not only for poor SRH but also for periodontal disease that can lead to tooth loss [41][42][43][44] . Therefore, age-related changes such as menopause in women also may affect SRH.…”

Periodontal conditions in a 65-year-old population and prevalence of periodontitis according to three different bone level thresholds

“…In addition, periodontitis has been shown to affect oral health-related quality of life [ 12 ]. Periodontitis may also increase the risk of complications of systemic diseases [ 1 ] and has shown associations to systemic diseases that are highly prevalent with increasing age [ 13 , 14 ]. A high prevalence of periodontal disease among older adults, along with the increasing proportion of elderly in the world population [ 15 ] may therefore have an impact on the need for health care services in the years to come.…”