By Theresa Pablos, DrBicuspid.com associate editor

June 6, 2019 -- Patients with at least one sign of metabolic syndrome may be at an increased risk for tooth loss, according to the findings of a recent study. The research is the latest to link periodontal and systemic health.

Metabolic syndrome is a cluster of factors associated with an increased risk for diabetes, periodontitis, and cardiovascular disease. The new research demonstrates that the condition may also be related to tooth loss, particularly for women and those in late middle age. Researchers published their analysis in the Yonsei Medical Journal (May 22, 2019).

"This study suggests that the presence of at least one metabolic syndrome component is associated with the prevalence of tooth loss in females and that its age-combined effect with an age between 50 and 64 years could have a stronger relationship," wrote the authors, led by Min-Jeong Cho from the Kyungpook National University School of Dentistry in Daegu, Korea. "Prevention against metabolic syndrome for a female of older age could help prevent teeth loss."

Shared risk factors

Previous research has established a link between periodontal disease and metabolic syndrome, likely because the two share common inflammatory risk factors. The researchers wondered whether these risk factors also related to tooth loss in middle age.

To find out, they enrolled about 700 participants ages 30 to 64 from Korea in their cohort study. Participants were tested for metabolic syndrome risk factors, including low levels of high-density lipoprotein cholesterol and high levels of fasting blood glucose, triglycerides, blood pressure, and abdominal fat. Participants also answered a survey question about whether they were missing any teeth, excluding third molars.

Chart showing participants with tooth loss by number of metabolic syndrome risk factors

Participants with at least one risk factor for metabolic syndrome were significantly more likely to have lost a tooth than those without any risk factors. After adjusting for other tooth loss risk factors, these participants still had about 47% higher odds of missing a tooth.

This association was especially prominent in women, the researchers found. They attributed their findings to inflammation underscoring both periodontal disease and metabolic syndrome.

"Adult tooth loss is primarily caused by alveolar bone destruction in the periosteal tissue of patients with elevated levels of various inflammatory markers," they wrote. "Inflammation in the periodontal tissues ... shares some common risk factors with metabolic syndrome, including hyperglycemia, obesity, dyslipidemia, and hypertension."

Researcher recommendations

“Patients with metabolic syndrome should receive intensive regular periodontal management.”
— Min-Jeong Cho and colleagues

The researchers cited a number of shortcomings, including that a dentist did not conduct an oral exam to determine the cause of tooth loss. In addition, patients with cancer and cardiovascular disease were excluded from the study.

Nevertheless, the findings show that metabolic syndrome risk factors may be independently associated with a risk for tooth loss in middle age. The researchers recommended dentists be vigilant about periodontal health for patients with the condition.

"In this study, we could expect that persons at higher risk of metabolic syndrome tend to lose teeth," the authors wrote. "Therefore, we would like to recommend that patients with metabolic syndrome should receive intensive regular periodontal management at [the] dental clinic."


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