(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
NO, THERE is no relationship between tooth loss and mortality.
Much has been written about this connection but a study led by Juxiang Peng of the Guiyang Hospital of Stomatology, Guiyang, China, and Jukun Song of the Department of Oral and Maxillofacial Surgery, Guizhou Provincial People’s Hospital, debunks the association.
The study, published in Bioscience Reports, traced the relationship between tooth loss and mortality from all causes, including cardiovascular diseases (CVD), and coronary heart disease (CHD) in the general population.
The association has been studied for many years; however, most results were inconsistent, according to the study.Tooth loss plays an important role in human health and significantly influences the ability to chew properly which, in turn, affects diet, nutrient intake, esthetics, and food choice.
In adults, the number of tooth loss can be viewed as an index of lifetime accumulation of poor oral health mainly caused by tooth decay and gum disease.
As people age, they lose their teeth. Most of the missing teeth of an elderly subject would have been infected before tooth loss or extractions; hence, the number of missing teeth could be an indicator of poor oral health.
Two major biological mechanisms could explain the link between tooth loss and mortality. Infectious agents in the oral cavity, for example, may cause diseases. This condition can deteriorate the individual’s quality of life. Altered diet choices may lead to malnutrition because of the insufficient ability to chew as a consequence of tooth loss.
Malnutrition may be caused by reduced intake of vegetables, dietary fiber, and whole-meal bread and could be directly proportional to increased mortality.
Tooth loss has been associated with multiple adverse health effects, including epilepsy, cognitive impairment, heart disease, heart failure, stroke, cancer, and vascular disease (when plaque made of fat and cholesterol slows down or blocks blood flow inside the arteries or veins).
Studies have been conducted to determine the association between tooth loss and susceptibility to mortality from all causes. However, says lead author Juxiang Peng, these studies have found conflicting results.
Previous studies that examined the association between tooth loss and mortality employed small sample sizes, leading to decreased statistical significance.
According to the report on Global Burden of Diseases, severe tooth loss affects 2 percent of populations worldwide and is listed 36th among the most prevalent chronic diseases that affect life expectancy.
The study was conducted because of the high incidences of CVD and CHD, their economic costs to the society, and their potential effect on public health.
The researchers performed a literature search that covered PubMed, Embase, Web of Knowledge, and Cochrane Oral Health Group’s Trials Register databases for papers published from 1966 to August 2018 without restriction to regions, publication types, or languages.
After the electronic search, a manual search was also conducted through the reference lists from original research and review articles. The study then focused their analysis on 18 studies conducted until August 2018.
The study found that tooth loss was associated with CHD mortality but not with CVD mortality.
The susceptibility to mortality increased by almost 1.48 in persons with CVD and 1.7 times for those with CHD, the study found. However, the study found no statistical significance in these figures.
The conclusion: tooth loss, and in particular complete tooth loss (edentulism), could increase the risk of all-cause mortality.
However, study observed, “the finding that tooth loss might play a harmful role in the development of all-cause mortality remains inconclusive.”
The study could not conclude that tooth loss may be a casual factor for all-cause mortality. “Careful interpretations of their relationship with mortality are needed. Additional large-scale and high-quality prospective studies are also required to evaluate the association between tooth loss and CVD/CHD mortality.”
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail ./PN
