Longitudinal Analysis of Tooth Loss as a Biomarker of Systemic Health: Insights From a 15-Year Study of 35 Patients.

Elizabeth Litvinov, Alan Litvinov
Author Information
  1. Elizabeth Litvinov: Microbiology and Immunology, University of Miami, Coral Gables, USA.
  2. Alan Litvinov: Oral Health Research and Private Practice, American Dental Association, Penfield, USA.

Abstract

Introduction Tooth loss, often perceived as a localized dental issue, has profound implications for systemic health. It is frequently associated with underlying factors such as periodontal disease, smoking, poor dietary habits, and psychological stress. These factors contribute to tooth loss locally and are linked to various systemic conditions, including diabetes and cardiovascular disease. This study explores the predictive value of tooth loss as a biomarker for systemic health conditions, emphasizing its potential to serve as an early warning indicator for broader health risks and highlighting the interconnected nature of oral and systemic health. Background The interconnection between oral and systemic health has received significant attention in recent years. Chronic oral conditions, particularly periodontal disease, contribute to systemic inflammation, a key factor in the development of diseases such as atherosclerosis and diabetes. Tooth loss, often resulting from severe oral pathology, reflects a history of chronic inflammation, poor oral hygiene, and adverse lifestyle choices. Despite its clinical relevance, tooth loss remains underutilized as a marker for systemic health status. This study seeks to address this gap by evaluating the systemic health trajectories of patients with significant tooth loss over a 15-year period. Materials and methods This study retrospectively analyzed the chart records of 35 patients who experienced significant tooth loss (321 teeth in total) due to factors such as age, smoking, dietary deficiencies, psychological stress, bruxism, fractures, and periodontal infections. Medical and dental records spanning a 15-year period were reviewed to monitor the progression of systemic health conditions. Statistical analyses, including correlation and logistic regression, were performed to evaluate the relationships between tooth loss and systemic health outcomes. Kaplan-Meier survival analysis assessed the time to disease onset in relation to oral health deterioration. A health score prediction equation was developed. Results The findings revealed that tooth loss was strongly associated with systemic conditions such as cardiovascular disease, diabetes, and respiratory disorders. A significant positive correlation was observed between tooth loss and diabetes (r = 0.72, p < 0.01) and cardiovascular disease (r = 0.68, p < 0.01). Logistic regression demonstrated that patients with severe periodontal disease had significantly higher odds of developing cardiovascular disease (OR = 3.5) and diabetes (OR = 2.8). Kaplan-Meier survival curves indicated that patients with extensive tooth loss experienced earlier onset of systemic conditions than those with minimal tooth loss (median time: 7 vs. 12 years, p = 0.03). Smoking, poor diet, and psychological stress emerged as exacerbating factors. Conclusions Tooth loss is a significant biomarker for systemic health conditions, reflecting the cumulative effects of chronic oral and systemic inflammation, adverse lifestyle factors, and psychological health. This study highlights the importance of integrating dental and medical care to address the root causes of both oral and systemic diseases. Proactive oral health interventions, with systemic disease prevention strategies, can improve overall health outcomes. Further research involving larger cohorts is recommended to validate the findings and enhance predictive models for clinical application.

Keywords

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