Abstract
OBJECTIVE: This scoping review systematically mapped the evidence on the association between tooth loss and serum cholesterol levels in adults, addressing a significant gap in understanding the direct link beyond broader systemic conditions such as cardiovascular disease. METHODS: In accordance with the PRISMA-ScR guidelines, a comprehensive search of four electronic databases (PubMed, MEDLINE, EMBASE, and Cochrane Library) was conducted from July 1968 to September 2025. Studies involving adults (≥ 18 years) that quantified tooth loss and reported serum lipid profiles specifically high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and/or triglycerides levels - were included. RESULTS: Among the 23 studies synthesized, a majority demonstrated a significant association between greater tooth loss and adverse lipid profiles, characterized by lower high-density lipoprotein cholesterol levels, higher low-density lipoprotein cholesterol levels, and elevated triglyceride levels. A dose-response relationship was evident, with more extensive tooth loss correlated with progressively worsening cholesterol levels. Analysis of edentulous populations suggested that the primary mechanism in this population may be nutritional maladaptation from impaired masticatory function rather than systemic inflammation. Some evidence indicates a bidirectional relationship, where dyslipidemia may also be a risk factor for tooth loss. Notably, prosthetic rehabilitation for partial tooth loss was associated with improved cholesterol levels, an effect not consistently observed with complete dentures. CONCLUSION: This scoping review suggests an association between tooth loss and dyslipidemia, which may be mediated through dietary changes due to reduced masticatory function and systemic inflammatory pathways. However, as a scoping review that included studies of heterogeneous designs and did not perform a formal risk of bias assessment, these results are indicative of an association and cannot establish causality. Despite these limitations, the gathered evidence underscores the importance of considering oral health when developing strategies to maintain metabolic health.