Non-Cochrane · aetiology · PM42656563
Examining the link between tooth loss and multiple health outcomes: a comprehensive synthesis of evidence from meta-analyses.
Song Siping, Xie Wanqing, Huang Shuqi, et al. · Frontiers in public health · 2026 · PubMed · doi:10.3389/fpubh.2026.1857651
Findings
40 findings
| Population | ||||
|---|---|---|---|---|
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Hypertension Observational cohorts, case-control and cross-sectional samples, multiple countries · Severe tooth loss | OR 1.20 [1.10, 1.30] Low 28 studies · 1224821 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Cardiovascular disease mortality Follow-up 3.1 to 49 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · Edentulous or fewer than 10 teeth present | HR 1.66 [1.32, 2.09] Very low Downgraded: inconsistency 12 studies · 90305 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Alzheimer's disease Follow-up mean 8.6 years (2 to 20) · Observational cohorts, case-control and cross-sectional samples, multiple countries · More tooth loss | RR 1.12 [1.02, 1.23] Very low Downgraded: inconsistency 6 studies |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Coronary heart disease Follow-up 5 to 21 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · 0 to 10 teeth missing | RR 1.34 [1.10, 1.63] Very low Downgraded: inconsistency 7 studies · 112273 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Dementia Follow-up mean 8.6 years (2 to 20) · Observational cohorts, case-control and cross-sectional samples, multiple countries · Fewer than 10 remaining teeth | RR 1.22 [1.11, 1.33] Very low Downgraded: inconsistency 9 studies · 356297 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | All-cause mortality Follow-up 1 to 57 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · 0 teeth remaining vs 1 to 32 teeth (reference) | HR 1.94 [1.19, 3.15] Very low Downgraded: imprecision, inconsistency 14 studies · 4711667 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Esophageal cancer Observational cohorts, case-control and cross-sectional samples, multiple countries · More teeth lost (any lost, 16 to 32 lost, 24 to 32 lost, edentulous) | OR 1.46 [1.27, 1.69] Low 10 studies · 107028 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Cognitive decline Follow-up mean 8.6 years (2 to 20) · Observational cohorts, case-control and cross-sectional samples, multiple countries · Edentulism | RR 1.27 [1.14, 1.41] Low 3 studies · 356297 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Dementia Follow-up mean 8.6 years (2 to 20) · Observational cohorts, case-control and cross-sectional samples, multiple countries · Edentulism | RR 1.15 [1.10, 1.20] Low 6 studies · 356297 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Cognitive decline Follow-up mean 8.6 years (2 to 20) · Observational cohorts, case-control and cross-sectional samples, multiple countries · Fewer than 10 remaining teeth | RR 1.2 [1.00, 1.44] Very low Downgraded: inconsistency 5 studies · 356297 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Pancreatic cancer Follow-up 4 to 41 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · More tooth loss | HR 1.19 [0.97, 1.46] Very low Downgraded: imprecision, inconsistency 17 studies · 1352256 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Cognitive decline Follow-up mean 8.6 years (2 to 20) · Observational cohorts, case-control and cross-sectional samples, multiple countries · More tooth loss | RR 1.2 [1.14, 1.26] Low 8 studies · 356297 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Stroke Follow-up 12 to 57 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · More tooth loss | RR 1.39 [1.13, 1.65] Very low Downgraded: inconsistency 9 studies |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Obesity Observational cohorts, case-control and cross-sectional samples, multiple countries · More tooth loss (any tooth loss) | OR 1.41 [1.11, 1.79] Very low Downgraded: inconsistency 2 studies · 3841 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Dementia Follow-up 2.4 to 37 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · More tooth loss (number of teeth missing or present) | OR 1.55 [1.41, 1.70] Very low Downgraded: inconsistency 21 studies · 561846 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Oral squamous cell carcinoma (head and neck cancer) Observational cohorts, case-control and cross-sectional samples, multiple countries · More tooth loss (more than 5, 16 or 20 teeth lost, or only 5 teeth present) | OR 1.13 [0.99, 1.26] Very low Downgraded: imprecision, inconsistency 27 studies · 20513 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Gastric cancer Follow-up 1 to 21 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · More tooth loss | RR 1.44 [1.05, 1.98] Very low Downgraded: imprecision, inconsistency 9 studies · 245752848 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Cardiovascular disease events Follow-up 1 to 57 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · 0 teeth remaining vs 1 to 32 teeth (reference) | HR 2.92 [1.77, 4.82] Very low Downgraded: imprecision, inconsistency 44 studies · 4697021 participants |
| Adults (general population and patient samples; observational studies) | Tooth loss (greater number of teeth lost, categorical exposure) | Fewer teeth lost or more teeth remaining (reference category) | Lung cancer Follow-up mean 7.6 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · More than 10 teeth lost | HR 1.59 [1.21, 2.11] Very low Downgraded: imprecision, inconsistency 6 studies · 62821 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | Lung cancer Follow-up mean 7.6 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 5 teeth lost | HR 1.09 [1.07, 1.11] Low Downgraded: inconsistency 8 studies · 252178 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | Cognitive decline Follow-up mean 5.3 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 1 tooth lost | HR 1.01 [1.01, 1.02] Moderate Downgraded: inconsistency 3 studies · 38763 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | Esophageal cancer Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 1 tooth lost | RR 1.01 [1.00, 1.03] Low Downgraded: inconsistency 10 studies · 88274 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | All-cause mortality Follow-up 3.7 to 57 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 32 teeth lost (all teeth) | RR 1.57 [1.41, 1.75] Low Downgraded: inconsistency 17 studies · 306807 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | All-cause mortality Follow-up 3.7 to 57 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 10 teeth lost | RR 1.15 [1.11, 1.19] Low Downgraded: inconsistency 17 studies · 306807 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | Stroke Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 2 teeth lost | RR 1.03 [1.03, 1.04] Moderate 17 studies · 879084 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | Cardiovascular disease Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 2 teeth lost | RR 1.03 [1.02, 1.04] Low Downgraded: inconsistency 17 studies · 879084 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | Colorectal cancer Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 2 teeth lost | RR 1.06 [1.02, 1.11] Moderate 6 studies · 160182 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | Dementia Follow-up mean 11.9 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 1 tooth lost | HR 1.01 [1.00, 1.02] Moderate 6 studies · 38763 participants |
| Adults (general population; observational studies) | Tooth loss as a continuous exposure (each additional tooth or teeth lost) | No additional tooth loss (per-increment dose-response) | All-cause mortality Follow-up 3.7 to 57 years · Observational cohorts, case-control and cross-sectional samples, multiple countries · Dose-response: per 20 teeth lost | RR 1.33 [1.24, 1.42] Low Downgraded: inconsistency 17 studies · 306807 participants |
| Adults (observational studies) | Alzheimer's disease | No Alzheimer's disease (controls) | Edentulism Observational cohorts, case-control and cross-sectional samples, multiple countries | OR 2.26 [1.70, 3.01] Very low Downgraded: inconsistency 6 studies · 13472 participants |
| Adults (observational studies) | Hypertension | No hypertension | Tooth loss Observational cohorts, case-control and cross-sectional samples, multiple countries | OR 1.35 [1.07, 1.62] Very low Downgraded: imprecision, inconsistency 56 studies · 1224821 participants |
| Adults (observational studies) | Diabetes mellitus | No diabetes | Tooth loss Observational cohorts, case-control and cross-sectional samples, multiple countries | OR 1.87 [1.62, 2.13] Very low Downgraded: inconsistency 22 studies · 677532 participants |
| Adults (observational studies) | Obesity | No obesity | Tooth loss Observational cohorts, case-control and cross-sectional samples, multiple countries | OR 1.49 [1.20, 1.86] Very low Downgraded: inconsistency 3 studies · 7994 participants |
| Adults (observational studies) | Depression | No depression | Tooth loss Observational cohorts, case-control and cross-sectional samples, multiple countries | OR 1.31 [1.24, 1.37] Low 16 studies |
| Adults (observational studies) | Depression and anxiety | No depression or anxiety | Tooth loss Observational cohorts, case-control and cross-sectional samples, multiple countries | OR 1.22 [1.14, 1.30] Low 26 studies · 334503 participants |
| Adults (observational studies) | Peripheral artery disease | No peripheral artery disease | Number of teeth missing Observational cohorts, case-control and cross-sectional samples, multiple countries | MD 3.75 [1.31, 6.19] Very low Downgraded: inconsistency 7 studies · 4307 participants |
| Adults (observational studies) | Stroke | No stroke (controls) | Number of teeth present Observational cohorts, case-control and cross-sectional samples, multiple countries | SMD -0.33 [-0.44, -0.21] Low 1191 participants |
| Adults (observational studies) | Metabolic syndrome | No metabolic syndrome | Number of teeth present Follow-up 2 to 33 years · Observational cohorts, case-control and cross-sectional samples, multiple countries | SMD -2.77 [-4.56, -0.98] Very low Downgraded: imprecision, inconsistency 12 studies · 26750 participants |
| Adults (observational studies) | Schizophrenia | No schizophrenia (controls) | Number of teeth missing Observational cohorts, case-control and cross-sectional samples, multiple countries | SMD 0.79 [0.59, 0.98] Very low Downgraded: imprecision 3 studies · 712 participants |
| Adults (observational studies) | Chronic obstructive pulmonary disease (COPD) | No COPD (controls) | Number of remaining teeth Observational cohorts, case-control and cross-sectional samples, multiple countries | MD -3.73 [-5.12, -2.33] Very low Downgraded: inconsistency 14 studies · 23960 participants |
Included primary studies 27
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Humphrey 2008 Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis. PMID:18807098 | 2008 | 1 other review | not stated | not extracted yet |
| Lafon 2014 Periodontal disease and stroke: a meta-analysis of cohort studies. PMID:24712659 | 2014 | 1 other review | not stated | not extracted yet |
| Mahuli 2023 A Systematic Review and Meta-Analysis Assessing the Role of Oral Health as a Risk Factor in Oral Cancer. PMID:37398714 | 2023 | 1 other review | not stated | not extracted yet |
| Ahmadinia 2022 Association between type 2 diabetes (T2D) and tooth loss: a systematic review and meta-analysis. PMID:35418054 | 2022 | this review only | not stated | not extracted yet |
| Aminoshariae 2024 Tooth Loss is a Risk Factor for Cardiovascular Disease Mortality: A Systematic Review with Meta-analyses. PMID:38945200 | 2024 | this review only | not stated | not extracted yet |
| Beukers 2021 Lower Number of Teeth Is Related to Higher Risks for ACVD and Death-Systematic Review and Meta-Analyses of Survival Data. PMID:34026863 | 2021 | this review only | not stated | not extracted yet |
| Cademartori 2018 Is depression associated with oral health outcomes in adults and elders? A systematic review and meta-analysis. PMID:30191327 | 2018 | this review only | not stated | not extracted yet |
| Chen 2015 Teeth loss, teeth brushing and esophageal carcinoma: a systematic review and meta-analysis. PMID:26462879 | 2015 | this review only | not stated | not extracted yet |
| Chen 2016 Tooth loss is associated with increased risk of esophageal cancer: evidence from a meta-analysis with dose-response analysis. PMID:26742493 | 2016 | this review only | not stated | not extracted yet |
| Cheng 2018 Tooth loss and risk of cardiovascular disease and stroke: A dose-response meta analysis of prospective cohort studies. PMID:29590166 | 2018 | this review only | not stated | not extracted yet |
| Dai 2015 A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke. PMID:24960298 | 2015 | this review only | not stated | not extracted yet |
| Dioguardi 2020 The Association between Tooth Loss and Alzheimer's Disease: a Systematic Review with Meta-Analysis of Case Control Studies. PMID:31052367 | 2019 | this review only | not stated | not extracted yet |
| Fang 2018 Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies. PMID:30342524 | 2018 | this review only | not stated | not extracted yet |
| Kisely 2016 The oral health of people with anxiety and depressive disorders - a systematic review and meta-analysis. PMID:27130961 | 2016 | this review only | not stated | not extracted yet |
| Li 2023 Tooth loss and the risk of cognitive decline and dementia: A meta-analysis of cohort studies. PMID:37139053 | 2023 | this review only | not stated | not extracted yet |
| Ma 2018 Tooth loss and risk of colorectal cancer: a dose-response meta-analysis of prospective cohort studies. PMID:29606880 | 2018 | this review only | not stated | not extracted yet |
| Nascimento 2016 Is there a relationship between obesity and tooth loss and edentulism? A systematic review and meta-analysis. PMID:27125768 | 2016 | this review only | not stated | not extracted yet |
| Peng 2019 The relationship between tooth loss and mortality from all causes, cardiovascular diseases, and coronary heart disease in the general… PMID:30530864 | 2019 | this review only | not stated | not extracted yet |
| Qi 2021 Dose-Response Meta-Analysis on Tooth Loss With the Risk of Cognitive Impairment and Dementia. PMID:34579934 | 2021 | this review only | not stated | not extracted yet |
| Shi 2018 Patients with Chronic Obstructive Pulmonary Disease Suffer from Worse Periodontal Health-Evidence from a Meta-Analysis. PMID:29422870 | 2018 | this review only | not stated | not extracted yet |
| Souza 2019 Association between metabolic syndrome and tooth loss: A systematic review and meta-analysis. PMID:31761016 | 2019 | this review only | not stated | not extracted yet |
| Sun 2021 Poor Oral Health in Patients with Schizophrenia: a Meta-Analysis of Case-Control Studies. PMID:32483766 | 2021 | this review only | not stated | not extracted yet |
| Xu 2022 (hypertension) Association between tooth loss and hypertension: A systematic review and meta-analysis. PMID:35661800 | 2022 | this review only | not stated | not extracted yet |
| Xu 2022 (pancreatic cancer) Associations Between Poor Oral Hygiene and Risk of Pancreatic Cancer: A Meta-analysis of Observational Studies. PMID:36607944 | 2022 | this review only | not stated | not extracted yet |
| Yang 2018 Association between periodontitis and peripheral artery disease: a systematic review and meta-analysis. PMID:29980169 | 2018 | this review only | not stated | not extracted yet |
| Yin 2016 Association between Tooth Loss and Gastric Cancer: A Meta-Analysis of Observational Studies. PMID:26934048 | 2016 | this review only | not stated | not extracted yet |
| Yoon 2022 Tooth Loss and Risk of Lung Cancer among Urban Chinese Adults: A Cohort Study with Meta-Analysis. PMID:35626036 | 2022 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| The Association of Periodontitis With Cardiovascular Disease Parameters: A Synthesis of Systematic Reviews. (2026) | 2 | 0.01 |
| Risk of cancer in periodontal disease: an umbrella review of meta-analyses. (2026) | 1 | 0.01 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Populations of observational studies examining tooth loss and systemic health outcomes | Adults in observational studies (n=27 meta-analyses) |
| Intervention | Tooth loss (exposure) or systemic condition (exposure with tooth loss as outcome) | Tooth loss as exposure (categorical and dose-response) and systemic conditions as exposures for tooth loss |
| Comparison | Less tooth loss or absence of the systemic condition | Fewer teeth lost or absence of the condition |
| Outcomes | Cardiovascular, cancer, neurodegenerative, metabolic, mental and respiratory outcomes; tooth loss as outcome | Cardiovascular diseases (n=14 estimates), neurodegenerative diseases (n=10), cancer (n=8), metabolic disorders (n=4), mental disorders (n=3), respiratory disease (n=1) |
| Study designs | Meta-analyses of cohort, case-control and cross-sectional studies | Observational studies: cohort, case-control, cross-sectional (3 to 44 primary studies per estimate) |
| Timing | Not specified | Follow-up 1 to 57 years where reported |