Counting teeth, countering frailty: A systematic review and meta-analysis

To investigate the relationship between the number of remaining teeth and frail and pre-frail status in the older adults.

Frailty and the number of remaining teeth are significant concerns in aging populations. However, evidence from various studies exploring this association is limited.

We conducted a comprehensive search of databases (PUBMED, MEDLINE, EMBASE, SCOPUS, Web of Science and LILACS) for relevant literature up to May 2024 using a predefined search strategy. Various study designs were considered for inclusion, following the PRISMA guidelines. The risk of bias for the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). A total of 18,472 participants aged 60 years and above from eleven studies demonstrating an association of frailty and pre-frailty with the number of remaining teeth were included in the systematic review. The random-effects model was used to obtain the pooled odds ratio (OR). Individuals with fewer than 20 teeth had 3.6 times higher odds of developing frailty compared to those with 20 or more teeth (OR 3.60, 95% CI: 2.93-4.42; p = 0.0001). Both pre-frailty and frailty were significantly affected by the number of remaining teeth, highlighting the broader impact of dental health on overall frailty status.

This systematic review and meta-analysis underscores the significant association between the number of remaining teeth and both frailty and pre-frailty in older adult populations. Maintaining dental health may help prevent or delay the onset of frailty, improving the quality of life in aging individuals.