Abstract
Background: 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.Method: 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.Results: 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 Pnonlinearity = 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.Conclusion: 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.
Highlights
Tooth loss plays an important role in human health [1] and significantly influences masticatory capacity, diet, nutrient intake, aesthetics, and food choice [2]
In the linear dose–response analysis, we found 15%, 33%, and 57% increments in the relative risks of all-cause mortality per 10, 20, and 32-tooth loss; 21%, 45%, and 83% increments in the relative risk of cardiovascular diseases (CVD) per 10, 20, and 32-tooth loss; and 21%, 47%, and 87% increments in the relative risk of coronary heart disease (CHD) per 10, 20, and 32-tooth loss, respectively
Tooth loss was associated with increased risk of all-cause mortality
Summary
Tooth loss plays an important role in human health [1] and significantly influences masticatory capacity, diet, nutrient intake, aesthetics, and food choice [2]. Epidemiological studies have been conducted to determine the association between tooth loss and susceptibility to mortality from all causes, cardiovascular diseases (CVD), and coronary heart disease (CHD). Given the high incidences of CVD and CHD, their economic costs to the society, and their potential effect on public health, we conducted a dose–response meta-analysis to explore the association of tooth loss with all-cause and cause-specific mortality. We aimed to clarify the strength of the relationship, the shape of the dose–response association curve, and the potential confounding factors of tooth loss and mortality Elucidating this relationship may emphasize the importance of preventive methods for all-cause and cause-specific mortality. The association of tooth loss with mortality from all causes, cardiovascular diseases (CVD), and coronary heart disease (CHD) has been studied for many years; the results are inconsistent. Tooth loss may be a potential risk marker for all-cause mortality: their association must be further validated through large prospective studies
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