Non-Cochrane · aetiology · PM41851295
Association between atherosclerosis and tooth loss in adult patients: systematic review and meta-analysis.
Velasco-Ceballos Juan David, Varela Juan Pablo, Baena-Caldas Gloria Patricia, et al. · Evidence-based dentistry · 2026 · PubMed · doi:10.1038/s41432-026-01215-1
Findings
12 findings
| Population | ||||
|---|---|---|---|---|
| Adults (over 18 years) with atherosclerosis, including peripheral arterial disease and carotid calcifications | Exposure to atherosclerosis (diagnosed by angiography, CT, ultrasound, ABI or CBCT) | No or low atherosclerotic burden (unexposed) | Number of missing teeth Meta-regression: mean age as moderator | Meta-regression coefficient -0.115 [-0.42, 0.19] GRADE not reported 8 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Severe tooth loss (20 or more teeth lost) Adults in clinical or population settings · Overall | OR 1.27 [0.67, 2.40] 24 [-50, 68] more per 1000 Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness 4 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Number of missing teeth Adults in clinical or population settings · Overall | MD 3.08 [1.53, 4.64] Very low Downgraded: risk of bias, inconsistency, indirectness 8 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Severe tooth loss (20 or more teeth lost) Adults in clinical or population settings · Overall | OR 1.27 [0.45, 3.56] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness 4 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Number of missing teeth Adults in clinical or population settings · Overall | MD 3.08 [1.80, 4.37] Very low Downgraded: risk of bias, inconsistency, indirectness 8 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Number of missing teeth Adults in clinical or population settings · Diagnostic tool: CT-scan | MD 2.22 [-2.21, 6.66] GRADE not reported 3 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Number of missing teeth Adults in clinical or population settings · Diagnostic tool: CBCT-scan | MD 5.07 [-10.30, 20.45] GRADE not reported 2 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Number of missing teeth Adults in clinical or population settings · Exposure type: atherosclerosis | MD 2.16 [0.34, 3.97] GRADE not reported 5 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Number of missing teeth Adults in clinical or population settings · Exposure type: calcifications | MD 5.07 [-10.30, 20.45] GRADE not reported 2 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Number of missing teeth Adults in clinical or population settings · Diagnostic tool: cIMT by ultrasound | MD 2.06 [-11.16, 15.27] GRADE not reported 2 studies |
| Adults (over 18 years) with atherosclerosis, including peripheral arterial disease and carotid calcifications | Exposure to atherosclerosis (diagnosed by angiography, CT, ultrasound, ABI or CBCT) | No or low atherosclerotic burden (unexposed) | Number of missing teeth Meta-regression: age difference between exposed and unexposed groups | Meta-regression coefficient 0.008 [-0.63, 0.65] GRADE not reported 8 studies |
| Adults (over 18 years) exposed or unexposed to atherosclerosis | Exposure: atherosclerosis (including peripheral arterial disease and carotid artery calcifications) | Unexposed: low atherosclerotic burden | Severe tooth loss (20 or more teeth lost) Adults in clinical or population settings · Diagnostic tool: angiography | OR 1.27 [0.17, 9.28] GRADE not reported 3 studies |
Included primary studies 13
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Ahmed 2022 Missing Teeth as an Early Predictive "Sign" for Atherosclerosis: A Retrospective Study. PMID:40236976 | 2022 | this review only | Number of missing teeth | not extracted yet |
| Ahn 2016 Periodontitis is associated with the risk of subclinical atherosclerosis and peripheral arterial disease in Korean adults. PMID:27450785 | 2016 | this review only | Number of missing teeth | not extracted yet |
| Bilgin Cetin 2020 Relationship of periodontitis and edentulism to angiographically diagnosed coronary artery disease: A cross-sectional study. PMID:32648271 | 2020 | this review only | not stated | not extracted yet |
| de Onofre 2021 Association between internal carotid artery calcifications detected as incidental findings and clinical characteristics associated with… PMID:34814036 | 2021 | this review only | Number of missing teeth | not extracted yet |
| Donders 2020 Elevated Coronary Artery Calcium scores are associated with tooth loss. PMID:33326424 | 2020 | this review only | Number of missing teeth | not extracted yet |
| Donders 2021 The association between periodontitis and cardiovascular risks in asymptomatic healthy patients. PMID:34746932 | 2021 | this review only | Number of missing teeth | not extracted yet |
| Gomes 2012 Association between self-reported oral health, tooth loss and atherosclerotic burden. PMID:22892878 | 2012 | this review only | Severe tooth loss (20 or more teeth lost) | not extracted yet |
| Leao 2020 Tooth loss is associated with atherosclerosis and a poorer functional outcome among stroke patients. PMID:32436161 | 2020 | this review only | Severe tooth loss (20 or more teeth lost) | not extracted yet |
| Sen 2023 Association of Dental Infections with Intracranial Atherosclerotic Stenosis. PMID:37121226 | 2024 | this review only | Severe tooth loss (20 or more teeth lost) | not extracted yet |
| Shen 2023 Association of periodontitis and tooth loss with extent of coronary atherosclerosis in patients with type 2 diabetes mellitus. PMID:38075042 | 2023 | this review only | Number of missing teeth | not extracted yet |
| Shimizu 2022 Tooth Loss and Carotid Intima-Media Thickness in Relation to Functional Atherosclerosis: A Cross-Sectional Study. PMID:35887757 | 2022 | this review only | Severe tooth loss (20 or more teeth lost) | not extracted yet |
| Soto-Barreras 2013 Peripheral arterial disease associated with caries and periodontal disease. PMID:22680302 | 2013 | this review only | Number of missing teeth | not extracted yet |
| Yu 2014 Association of Carotid Intima-media Thickness and Atherosclerotic Plaque with Periodontal Status. PMID:24935064 | 2014 | this review only | Number of missing teeth | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults over 18 years | Adults with and without atherosclerosis (n=6680 participants in 13 studies) |
| Intervention | Exposure to atherosclerosis, including peripheral arterial disease and carotid artery calcifications | Atherosclerosis by angiography, CT, ultrasound cIMT, ABI, CBCT, CAC score (n=13) |
| Comparison | Unexposed: low atherosclerotic burden | Low or no atherosclerotic burden (n=13) |
| Outcomes | Number of missing teeth; severe tooth loss (20 or more teeth) | Missing teeth, MD (n=8 studies); severe tooth loss, OR (n=4 studies) |
| Study designs | Observational studies: case-control, cohort, cross-sectional | 12 cross-sectional studies and 1 case-control study |
| Timing | Not specified | Not specified |