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Prev Chronic Dis. 2019 Sep 26;16:E132. doi: 10.5888/pcd16.180641.

Current Knowledge on Correlations Between Highly Prevalent Dental Conditions and Chronic Diseases: An Umbrella Review.

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Institute of Medical Biometry and Informatics, University of Heidelberg, Marsilius-Arkaden Turm West, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany. E-mail:
Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany.
Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Healthcare, Nijmegen, The Netherlands.
Dental Academy for Continuing Professional Development, Karlsruhe, Germany.
Christian-Albrechts-University Kiel, Clinic for Conservative Dentistry and Periodontology, Kiel, Germany.
PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
University of Heidelberg, Institute of Medical Biometry and Informatics, Heidelberg, Germany.



Studies have investigated the relationships between chronic systemic and dental conditions, but it remains unclear how such knowledge can be used in clinical practice. In this article, we provide an overview of existing systematic reviews, identifying and evaluating the most frequently reported dental-chronic disease correlations and common risk factors.


We conducted a systematic review of existing systematic reviews (umbrella review) published between 1995 and 2017 and indexed in 4 databases. We focused on the 3 most prevalent dental conditions and 10 chronic systemic diseases with the highest burden of disease in Germany. Two independent reviewers assessed all articles for eligibility and methodologic quality using the AMSTAR criteria and extracted data from the included studies.


Of the initially identified 1,249 systematic reviews, 32 were included for qualitative synthesis. The dental condition with most frequently observed correlations to chronic systemic diseases was periodontitis. The chronic systemic disease with the most frequently observed correlations with a dental condition was type 2 diabetes mellitus (T2DM). Most dental-chronic disease correlations were found between periodontitis and T2DM and periodontitis and cardiovascular disease. Frequently reported common risk factors were smoking, age, sex, and overweight. Using the AMSTAR criteria, 2 studies were assessed as low quality, 26 studies as moderate quality, and 4 studies as high quality.


The quality of included systematic reviews was heterogeneous. The most frequently reported correlations were found for periodontitis with T2DM and for periodontitis with cardiovascular disease. However, the strength of evidence for these and other disease correlations is limited, and the evidence to assess the causality of these disease correlations remains unclear. Future research should focus on the causality of disease links in order to provide more decisive evidence with respect to the design of intersectoral care processes.

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