Burden of tooth loss in individuals with Sjögren disease: a meta-analysis and meta-regression

Sjögren disease (SD) is a chronic autoimmune disorder that primarily affects the exocrine glands, often resulting in significant oral health complications, such as dental caries and periodontal disease. Tooth loss, a potential consequence of these conditions, has not yet been conclusively associated to SD. This systematic review, meta-analysis, and meta-regression aimed to determine whether individuals with SD exhibit higher tooth loss compared to healthy controls.

Five databases and gray literature were searched. Observational studies were included. Meta-analysis and meta-regression were performed on continuous data, with results expressed as mean difference (MD) and 95 % confidence intervals (CI). Risk of bias was appraised using the Newcastle-Ottawa scale, and the certainty of evidence was assessed using GRADE.

Among 1264 records, 21 studies comprising 3702 participants were included. Meta-analysis (k = 13) revealed that individuals with SD had significantly more tooth loss than healthy controls (MD=2.77; 95 % CI 2.05-3.50). Meta-regression attributed 97.8 % of the heterogeneity to country income level (p = 0.02). Most studies demonstrated a satisfactory risk of bias, but comparability was a common drawback. Evidence strength was low.

Although the extensive data disparities between the countries, individuals with SD were significantly more likely to experience tooth loss compared to healthy populations.

Clinical dentistry plays a pivotal role in detecting, managing, and improving the quality of life of individuals with Sjögren disease. This condition heightens the risk of dental caries, periodontal disease, and tooth loss, underscoring the centrality of dental care in mitigating its oral health impacts.