Clinical Professor, Advanced Prosthodontics, Loma Linda University, Loma Linda, USA; Interim Chair, Restorative Dentistry, UCLA, Los Angeles, USA; Private Practice Limited to Removable and Implant Prosthodontics, Koka Dental Clinic, San Diego, USA.
Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Harvard T.N. Chan School of Public Health, One Brigham Circle, 1620 Tremont Street 4-020, Boston, MA 02120, USA.
J Prosthodont Res. 2018 Apr;62(2):134-151. doi: 10.1016/j.jpor.2017.08.003. Epub 2017 Aug 30.
The purpose of this review was to analyze existing literature on the relationship between tooth count and mortality by evaluating the findings in the context of methodological variations. We aimed at addressing the question of whether preserving natural teeth can impact mortality.
PubMed, Web of Science and CINAHL databases were systematically searched using various combinations of related and synonymous keywords for "tooth count" and "mortality". The references of included articles were also evaluated for inclusion. Overall 49 studies found to be eligible were critically evaluated and their key findings were summarized.
Studies were conducted in various continents and differed substantially in regards to their sample size, population, methodology, the definition of the tooth count variable, the confounders as well as the mediators accounted for in the analysis. Follow-up period ranged from 1 to 56 years.
Although high variability in the studies precludes a definite conclusion about the relationship between number of teeth and mortality, the overall finding from this review is that reduced tooth count is associated with higher mortality. However the impact of factors such as smoking, health-care access, baseline co-morbidity and risk profile, dental and periodontal health, the presence of dental prosthesis as well as socio-economic status, in mediating whole or part of the association cannot be overlooked and needs further investigation using more standard methodologies. Any differences in males vs. females, as well as among different age groups, will also need further consideration in the future studies.
本综述旨在分析现有的关于牙齿数量与死亡率之间关系的文献，通过评估方法学变化对研究结果的影响来回答保留天然牙是否会影响死亡率的问题。
通过使用与“牙齿数量”和“死亡率”相关和同义词的各种组合，在 PubMed、Web of Science 和 CINAHL 数据库中进行了系统检索。还评估了纳入文章的参考文献以进行纳入。共发现 49 项符合条件的研究，对其进行了批判性评估，并总结了其主要发现。
研究在不同的大陆进行，在样本量、人群、方法学、牙齿计数变量的定义、分析中考虑的混杂因素以及中介因素方面存在很大差异。随访时间从 1 年到 56 年不等。
尽管研究之间存在很大的变异性，无法确定牙齿数量与死亡率之间的关系，但本综述的总体结论是，牙齿数量减少与死亡率升高有关。然而，不能忽视吸烟、获得医疗保健的机会、基线合并症和风险状况、口腔和牙周健康、是否有义齿以及社会经济地位等因素在整个或部分关联中起到的中介作用，需要使用更标准的方法进一步研究。未来的研究还需要进一步考虑男性与女性之间以及不同年龄组之间的差异。
