Periodontitis, Edentulism, and Risk of Mortality: A Systematic Review with Meta-analyses.

Area of Science:

• Public Health
• Epidemiology
• Oral Health Research

Background:

• Periodontitis is linked to chronic noncommunicable diseases, major global causes of death.
• The association between periodontitis/edentulism and mortality requires comprehensive investigation.

Purpose of the Study:

• To systematically review and meta-analyze cohort studies assessing the risk of all-cause and cause-specific mortality in individuals with periodontitis or edentulism compared to those without.
• To quantify the association between periodontitis/edentulism and mortality outcomes.

Main Methods:

• Systematic review and random-effects meta-analysis of cohort studies.
• Inclusion criteria: studies evaluating periodontitis or edentulism and mortality, reporting effect estimates (HR, RR, OR) or crude numbers.
• Data extraction, risk-of-bias assessment, and meta-analysis performed by independent reviewers.

Main Results:

• 57 studies involving 5.71 million participants were included.
• Periodontitis associated with increased all-cause mortality (RR 1.46) and mortality from cardiovascular diseases (RR 1.47), cancer (RR 1.38), coronary heart disease (RR 2.58), and cerebrovascular diseases (RR 3.11).
• Edentulism associated with increased all-cause mortality (RR 1.66) and mortality from cardiovascular diseases (RR 2.03), cancer (RR 1.55), pneumonia (RR 1.72), coronary heart disease (RR 2.98), and cerebrovascular diseases (RR 3.18).

Conclusions:

• Periodontitis and edentulism are significantly associated with an increased risk of all-cause and cause-specific mortality.
• Findings underscore the importance of oral health in the context of systemic health and longevity.
• Further research may explore underlying mechanisms linking oral infections to systemic disease and mortality.