Abstract
Conflicting results identifying the association between tooth loss and cardiovascular disease and stroke have been reported. Therefore, a dose-response meta-analysis was performed to clarify and quantitatively assess the correlation between tooth loss and cardiovascular disease and stroke risk. Up to March 2017, seventeen cohort studies were included in current meta-analysis, involving a total of 879084 participants with 43750 incident cases. Our results showed statistically significant increment association between tooth loss and cardiovascular disease and stroke risk. Subgroups analysis indicated that tooth loss was associated with a significant risk of cardiovascular disease and stroke in Asia and Caucasian. Furthermore, tooth loss was associated with a significant risk of cardiovascular disease and stroke in fatal cases and nonfatal cases. Additionally, a significant dose-response relationship was observed between tooth loss and cardiovascular disease and stroke risk. Increasing per 2 of tooth loss was associated with a 3% increment of coronary heart disease risk; increasing per 2 of tooth loss was associated with a 3% increment of stroke risk. Subgroup meta-analyses in study design, study quality, number of participants and number of cases showed consistent findings. No publication bias was observed in this meta-analysis. Considering these promising results, tooth loss might provide harmful health benefits.
Highlights
Cardiovascular disease affects millions of people in developed and developing countries that is a public health crisis
The results show no obvious evidence of publication bias was found in the relationship between tooth loss and cardiovascular disease and stroke risk (S1 Table)
Tooth loss has been found to be associated with decreased risks of lung cancer, colorectal cancer, prostate cancer, breast cancer and pancreatic cancer[30]
Summary
Cardiovascular disease affects millions of people in developed and developing countries that is a public health crisis. Despite the decline in the mortality rate of developed countries, cardiovascular disease is still the main cause of death and has caused serious social and economic distress on a global scale over the past few decades. In low and middle-income countries, the incidence of cardiovascular disease has risen sharply [1,2,3]. Tooth loss and cardiovascular disease and stroke expected to be the leading cause of morbidity and mortality in most developing countries[4]. The etiology of cardiovascular disease involves both genetic and environmental factors. Understanding the impact of environmental factors on cardiovascular disease will help to prevent cardiovascular disease
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