Association between number of missing teeth and stroke risk: an analysis of NHANES 2011-2020 data

Stroke is the second leading cause of death globally and the third leading cause of disability, severely impacting quality of life and increasing healthcare costs. Identifying underlying causes is critical for effective management. Oral health is closely linked to stroke occurrence, and tooth loss is a common oral health issue. However, few studies have explored the relationship between the number of missing teeth and stroke. This study aimed to elucidate the association between the number of missing teeth and stroke.

This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES). The number of missing teeth was assessed by professional dentists. To examine the relationship between tooth loss and stroke risk, multivariable logistic regression analysis and restricted cubic splines (RCS) were employed. Subgroup analyses were further conducted to verify the consistency of findings across populations.

The study enrolled 23,473 adult participants, of whom 4.19 % had a history of stroke. Participants diagnosed with stroke exhibited a higher number of missing teeth compared to those without stroke. In a model adjusted for multiple variables, each additional missing tooth was associated with a 2 % increased likelihood of stroke (OR = 1.02, 95 % CI: 1.01, 1.03). Participants with total tooth loss had a 163 % higher incidence of stroke compared to those with no missing teeth (OR = 2.63, 95 % CI: 1.90, 3.62). The RCS curve revealed a significant nonlinear positive correlation between the number of missing teeth and stroke risk.

A significant positive association between the number of missing teeth and stroke was observed among U.S. adults. Further large-scale, rigorously controlled studies are warranted to validate the reliability and generalizability of these findings.