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Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies
Fang WL, Jiang MJ, Gu BB, Wei YM, Fan SN, Liao W, Zheng YQ, Liao SW et al.. BMC psychiatry, 2018-10-20
Topic: Risk, prevention and care in population studies
Background Tooth loss is suggested to be associated with an increased risk of dementia in many studies. But the relationship between tooth loss and dementia is not yet fully understood. This systematic review and meta-analysis aimed to determine the relative effect of tooth loss on dementia risk. Methods An electronic search of PubMed, Scopus, Embase, and Web of Knowledge was conducted in March 2018 to identify relevant observational studies with the English language restriction. Studies were included if they assessed the relationship between tooth loss and risk of dementia. Study quality was detected by the modified Downs and Black scale. Odds risks (ORs) were pooled using a random-effects model in the crude model. Results The literature search initially yielded 1574 articles, and 21 observational studies published between 1994 and 2017 were finally included for the analyses. The crude results with random-effects model showed that patients with multiple tooth loss had higher incidence of dementia (OR 2.62, 95% CI 1.90-3.61, P 2 = 90.40%). The association remained noted when only adjusted results were pooled from 18 studies (OR 1.55, 95% CI 1.41-1.70, P = 0.13, I 2 = 28.00%). Meta-regression analysis showed that study design explained about 16.52% of heterogeneity in the crude model. The overall quality rating scores of studies ranged from 11 to 16. Conclusions Findings from this review evidenced that tooth loss is positively associated with an increased risk of dementia in adults. Future well-designed longitudinal researches examining the direct and indirect relationship between tooth loss and dementia risk are encouraged.
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APA 7th
Fang, W. L., Jiang, M. J., Gu, B. B., Wei, Y. M., Fan, S. N., Liao, W., et al. (2018). Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies. BMC psychiatry. https://doi.org/10.1186/s12888-018-1927-0
Vancouver
Fang WL, Jiang MJ, Gu BB, Wei YM, Fan SN, Liao W, et al. Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies. BMC psychiatry. 2018. doi:10.1186/s12888-018-1927-0. PMID: 30342524.
BibTeX
@article{fang2018-30342524,
author = {Fang, W. L. and Jiang, M. J. and Gu, B. B. and Wei, Y. M. and Fan, S. N. and Liao, W. and Zheng, Y. Q. and Liao, S. W. and others},
title = {{Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies}},
journal = {BMC psychiatry},
year = {2018},
doi = {10.1186/s12888-018-1927-0},
pmid = {30342524},
url = {https://doi.org/10.1186/s12888-018-1927-0}
}
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Key findings
- Background Tooth loss is suggested to be associated with an increased risk of dementia in many studies.
- Results The literature search initially yielded 1574 articles, and 21 observational studies published between 1994 and 2017 were finally included for the analyses.
- The crude results with random-effects model showed that patients with multiple tooth loss had higher incidence of dementia (OR 2.62, 95% CI 1.90-3.61, P 2 = 90.40%).
- The association remained noted when only adjusted results were pooled from 18 studies (OR 1.55, 95% CI 1.41-1.70, P = 0.13, I 2 = 28.00%).
- Meta-regression analysis showed that study design explained about 16.52% of heterogeneity in the crude model.
Why it matters
This meta-analysis of observational studies found that people with multiple tooth loss had a higher incidence of dementia, and the association remained when adjusted results were pooled. As a review of observational studies, it shows an association and cannot establish that tooth loss causes dementia.
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Study details
- Study designsystematic review
- Effect sizeOR 2.62; 90.40%; OR 1.55
- Evidence strengthHigh
How this study scored 62/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMC psychiatry) |
| Journal's citation record | 2 / 4 | BMC Psychiatry: journal h-index 198 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 107 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.7 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 2 / 6 | Cited 1.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 39 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Jun Liu: h-index 37 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Sun Yat-sen University: institution h-index 851 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 30342524) |
| Free to read | 2 / 2 | Free to read |
| Total | 62 / 100 | — |
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