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Meta-Analysis
, 39 (1)

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

Affiliations
Meta-Analysis

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

Juxiang Peng et al. Biosci Rep.

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 P nonlinearity = 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.

Keywords: CardioVascular Diseases; Coronary Heart Disease; Mortality; Systematic Review; Tooth Loss.

Conflict of interest statement

The authors declare that there are no competing interests associated with the manuscript.

Figures

Figure 1
Figure 1. Flow chart of study selection
Figure 2
Figure 2. Linear dose–response analysis between tooth loss and all-causes mortality
Figure 3
Figure 3. Nonlinear dose–response analysis between tooth loss and all-causes mortality
Figure 4
Figure 4. Linear dose–response analysis between tooth loss and CVD mortality
Figure 5
Figure 5. Nonlinear dose–response analysis between tooth loss and CVD mortality
Figure 6
Figure 6. Linear dose–response analysis between tooth loss and CHD mortality
Figure 7
Figure 7. Nonlinear dose–response analysis between tooth loss and CHD mortality

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