Patients With CKD Exhibit Poorer Oral Hygiene, Greater Tooth Loss

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CKD is linked to having fewer than 20 teeth, with higher tooth loss risk tied to reduced renal function, comorbidities, and poor oral hygiene habits.

“Previous studies have shown that 90% of patients with chronic renal failure (CRF) have oral lesions that affect both bone and soft tissue,” researchers wrote in Renal Failure. “To date, some domestic and foreign precedent studies on the association between [chronic kidney disease (CKD)] and the number of teeth have been conducted, but they are still insufficient.”

The study team aimed to examine the association between CKD and the number of teeth using a national database, focusing on adults aged 40 years and older. They defined CKD using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and employed multiple logistic regression analysis to examine the association between CKD and the number of teeth.

CKD, Comorbidities, and Dental Outcomes

The analysis included 16,125 patients, including 428 (2.7%) with CKD and 15,697 (97.3%) without. The overall mean age of participants was 55.6±0.1, though patients with CKD had a significantly higher mean age (67.6±0.6) than those who did not (55.3±0.6; P<0.001).

Comorbidities, including diabetes and hypertension, were also more common in patients with CKD, as were poorer oral hygiene habits. Further, the average number of teeth was 20.8±0.4 for participants with CKD and 24.4±0.4 for those without CKD.

After adjusting for age, sex, household income, education, alcohol consumption, smoking, body mass index, hypertension, diabetes, angina, myocardial infarction, stroke, dyslipidemia, and having an oral examination within 1 year, daily toothbrushing frequency, and hygiene product use, CKD was associated with having fewer than 20 teeth (odds ratio, 1.34).

“According to these results, individuals with CKD with reduced renal function may have a reduced number of teeth and a higher likelihood of subsequent edentulousness,” the researchers wrote.

Incorporating Oral Health in Management of CKD

The findings confirm an association between CKD and the number of teeth, the study team continued. Further, until this study, no earlier research classified CKD using the 2021 CKD-EPI creatinine equation and analyzed the association with oral health status, they noted.

“When establishing a comprehensive health prevention and management plan for individuals with CKD, it is thought that efforts to link programs to improve oral health will be necessary,” the study team wrote. “Dental professionals should be aware of the impact of various factors including CKD on a decreased number of teeth. In the future, large-scale longitudinal studies adjusted for additional risk factors are needed to clarify the relationship between tooth loss and CKD.”