Summary
This systematic review and meta-analysis of 75 prospective cohort studies (44 included in quantitative synthesis) demonstrates that lower tooth number is a statistically significant risk factor for both atherosclerotic cardiovascular disease and all-cause mortality. The magnitude of association varied by study design and adjustment strategy, with cumulative incidence analyses showing stronger associations (RR 1.69–2.93 for ACVD) than incidence density analyses with multiple adjustment (HR 1.02–1.21). The authors conclude that dental health warrants greater clinical attention as a modifiable risk factor for cardiovascular outcomes and survival.
UK applicability
These findings are directly applicable to UK clinical and public health practice, particularly given the NHS's focus on prevention of chronic disease and the high burden of dental disease in the UK population. Dental professionals and general practitioners should use this evidence to reinforce patient education on the importance of preventive oral care.
Key measures
Pooled risk ratio (RR) for ACVD cumulative incidence: 1.69–2.93; pooled RR for all-cause mortality cumulative incidence: 1.76–2.27; pooled adjusted hazard ratio (HR) for ACVD incidence density: 1.02–1.21; pooled HR for all-cause mortality incidence density: 1.02–1.30
Outcomes reported
The study quantified the association between lower tooth number (tooth loss) and risk of atherosclerotic cardiovascular disease (ACVD) events and all-cause mortality through meta-analysis of prospective cohort studies. Pooled risk ratios and hazard ratios were calculated for cumulative incidence and incidence density respectively.
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