Association between tooth loss and hypertension: A systematic review and meta-analysis

Kehui Xu; Weiwei Yu; Yuanyuan Li; Yutao Li; Qianqian Wan; Li Chen; Yan Dong; Franklin R Tay; Lina Niu

doi:10.1016/j.jdent.2022.104178

Association between tooth loss and hypertension: A systematic review and meta-analysis

J Dent. 2022 Aug:123:104178. doi: 10.1016/j.jdent.2022.104178. Epub 2022 Jun 2.

Authors

Kehui Xu¹, Weiwei Yu¹, Yuanyuan Li², Yutao Li¹, Qianqian Wan¹, Li Chen¹, Yan Dong¹, Franklin R Tay³, Lina Niu⁴

Affiliations

¹ State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
² Department of General Dentistry, Chenggong Hospital Affiliated to Medical School of Xiamen University (The 73rd Army Hospital of Chinese PLA), Xiamen, Fujian 361000, China.
³ The Dental College of Georgia, Augusta University, Augusta, GA 30912, United States. Electronic address: tayfranklin7@gmail.com.
⁴ State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi 710032, China; The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Hena 453003, China. Electronic address: niulina@fmmu.edu.cn.

PMID: 35661800
DOI: 10.1016/j.jdent.2022.104178

Abstract

Objectives: Poor oral health status may increase the risk of cardiovascular disease. However, whether a specific association exists between tooth loss and hypertension is inconclusive. Accordingly, a quantitative systematic review was conducted to investigate the relationship between tooth loss and hypertension.

Methods: Systematic search, data analysis and quality assessment were conducted on relevant literature published in PubMed, Embase, Web of Science and Cochrane Libraries until October 2021. Odds ratio (OR) with 95% confidence interval (CI) was used as effect size to evaluate the association between tooth loss and hypertension. Meta-regression and subgroup analyses were performed to identify whether difference was associated with study-level factors.

Results: Of the 56 studies selected, 28 studies in 16 different countries involving 1,224,821 individuals were eligible for the systematic review. After adjustment for confounding factors, individuals with tooth loss had a higher risk for hypertension (OR 1.20; 95%CI 1.10-1.30, I² = 40.02%). With respect to the risk of hypertension on tooth loss, individuals with hypertension still had a higher risk for tooth loss (OR 1.35; 95%CI 1.07-1.62, I² = 51.10%). Age limitation of the included population is the major source of heterogeneity. However, studies in which the population was limited to the elderly did not report an increase in association between tooth loss and hypertension compared with studies without age limitation.

Conclusions: The results suggest a bidirectional association between tooth loss and hypertension. Future longitudinal prospective studies are required to establish causality between tooth loss and hypertension.

Clinical significance: Subjects with severe tooth loss should be carefully monitored for the manifestation of hypertension. The oral health status of hypertensive patients should also be meticulous maintained to prevent unwarranted tooth loss.

Keywords: Blood pressure; Cardiovascular diseases; Edentulous; Epidemiology; Oral health; Periodontal diseases.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cardiovascular Diseases* / complications
Humans
Hypertension* / complications
Odds Ratio
Prospective Studies
Tooth Loss* / complications
Tooth Loss* / epidemiology