Low income and tooth loss: a positive association

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Tooth loss has a negative impact on quality of life and affects appearance, speech chewing and social life. In the recent global burden of diseases study severe tooth loss was ranked 36th out of the 100 chronic diseases that affect life expectancy.  The aim of this review was to estimate the association between income and tooth loss.


Searches were conducted in PubMed, Scientific Electronic Library Online (SciELO), Web of Knowledge and Scopus. Studies reporting a relationship between income and tooth loss written in English, Portuguese or Spanish were considered. Two reviewers independently selected studies and extracted data. Study quality was assessed using a modified form of the Downs and Black Scale.


  • 11 studies were included.
  • 7 were from Brazil, 2 from USA and 1 from Chile, Norway and Sweden.
  •  All 11 studies were considered to be at low risk of bias.
  •  Meta-analysis (11 studies) found that those on lower levels of income had a greater chance of tooth loss; Odds Ratio [OR] = 2.52 (95% CI; 2.11- 3.01).
  • Adjusting for the effect of socioeconomic status (8 studies) OR = 1.66 (95% CI; 1.48 – 1.86)


The authors concluded:

Our results suggest a relationship between low income and tooth loss. Further investigations with longitudinal design and broader measures of socioeconomic position are encouraged in order to corroborate our findings.


While a broad search has been conducted to identify studies and publications in languages other than English a majority of the studies included in this review are from a single country, which may have implications for the findings. As noted by the authors all but two of the studies are cross-sectional in nature and some of the studies include patients with wide age range, although, studies in the elderly were excluded.


Seerig LM, Nascimento GG, Peres MA, Horta BL, Demarco FF. Tooth loss in adults and income: Systematic review and meta-analysis. J Dent. 2015 Jul 7. pii: S0300-5712(15)30009-9. doi: 10.1016/j.jdent.2015.07.004. [Epub ahead of print] PubMed PMID: 26163163.

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