Association between type 2 diabetes (T2D) and tooth loss: a systematic review and meta-analysis

Abstract

Background Several studies have assessed the relationship between type 2 diabetes (T2D) and tooth loss; however, results have been inconsistent. Therefore, the present systematic review and meta-analysis of observational studies was designed to examine the association between T2D and tooth loss. Methods This systematic review and meta-analysis was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline. We searched all the relevant studies in international databases of Scopus, PubMed, ProQuest, Web of Science, Cochrane Library, and Google scholar search engine until February 2022. The heterogeneity of the studies was calculated using the I2 index. Measure of effect and 95% confidence interval (CI) were extracted from each study. The results of the study were analyzed using the random effects model. Results In the present study, 22 eligible studies were included. Meta-analysis of unadjusted and adjusted results showed that T2D significantly increased the risk of tooth loss, and Odds Ratio (OR) unadjusted was 1.87 (95% CI: 1.62–2.13, p < 0.001), and OR adjusted was 1.20 (95% CI: 1.10–1.30, p < 0.001), respectively. Subgroup analysis based on study design for adjusted OR indicated that in the cohort study (OR: 1.29, 95% CI: 1.07–1.51), in the cross-sectional study (OR: 1.15, 95% CI: 1.06–1.23), and in the case-control study (OR: 5.10, 95% CI: 1.01–9.18) there was a significant association between T2D and tooth loss. Other subgroups analyses showed consistent results and no publication bias existed. Conclusions The findings suggest that T2D is associated with increased risk of tooth loss. This conclusion may provide useful evidence for correlated clinical researches.

The effect of Insulin and Metformin on Prevalence and Severity of Tooth Wear in type2 Diabetic Patients.

“…7 Ahmadinia et al had conducted a recent systematic review and meta-analysis to study Association between T2DM and tooth loss, found that a positive association between T2DM and tooth loss in cross-sectional studies and no significant association between T2DM and tooth loss was found in cohort studies with increase the risk of oral disease in T2DM directly (e.g., gingival inflammatory response) and indirectly (e.g., decreased saliva production due to medication e.g., metformin). 9 These results in agree with our findings that antidiabetic drugs may effect on salivary gland secretion and later lead to xerostomia and increase risk of developing dental erosion and attrition, due to loss of salivary protection of the teeth against acids, extrinsic or intrinsic factors which causing these conditions.…”

“…Previous research had linked diabetes duration and severity to increased decaying, periodontal-affected teeth, tooth loss, decreased saliva production due to medication and tooth wear, as well as a deterioration in quality of life. 9,17 A recent meta-analysis, on the other hand, found no significant link between poorly controlled T2DM and oral health; this discrepancy underscores the need for more research. 10 There are just a few epidemiological studies that look at the link between diabetes and glycemic management, tooth loss, wear, and dental prosthetics for treating biting and chewing issues .…”

“…6 Diabetes increases the risk of oral disease directly (e.g., gingival inflammatory response) and indirectly (e.g., decreased saliva production due to medication). 9 It has also been reported that oral health may have an impact on T2DM risk and its metabolic control, suggesting a complex bidirectional link between T2DM and oral diseases. 10 Mohiti 11 found that diabetes mellitus causes a reduction in saliva pH and increases saliva viscosity, which can cause qualitative and quantitative changes in saliva and oral health.…”

Teeth and gums in diabetes

“…Having type 2 diabetes increases the risk of tooth loss compared with people without diabetes. A meta‐analysis including 22 studies found that the odds ratio (OR) for tooth loss was 1.87 (1.62–2.13), adjusted OR 1.20 (1.10–1.30) 1 . In the ADVANCE study, 10,958 people with type 2 diabetes counted their teeth at the start and after five years.…”

“…A meta-analysis including 22 studies found that the odds ratio (OR) for tooth loss was 1.87 (1.62-2.13), adjusted OR 1.20 (1.10-1.30). 1 In the ADVANCE study, 10,958 people with type 2 diabetes counted their teeth at the start and after five years. After controlling for confounders, edentulous people were more likely to die of cardiovascular and non-vascular causes that those with ≥22 teeth.…”