Abstract
BACKGROUND: Edentulism(partial/complete) is a significant public health concern, impacting masticatory function, nutritional intake, and overall quality of life. Emerging evidence underscores the bidirectional relationship between oral and systemic health, where chronic oral inflammation like dental caries, periodontal diseases, trauma, and tooth loss may contribute to or exacerbation of systemic conditions such as cardiovascular diseases, hypertension, diabetes mellitus and osteoporosis. PURPOSE OF STUDY: To determine prevalence of systemic diseases among edentulous patients attending dental department of a tertiary hospital in Nepal. METHODS: A descriptive, cross-sectional study was conducted among 384 edentulous patients consented to participate visiting dental department of Patan Academy of Health Sciences (PAHS) from September 2019 to September 2022. Ethical clearance was obtained from Institutional Review Committee, PAHS (Ref: drs1805291179). Sociodemographic data, medical history, current history of medications for self-reported conditions and dental history were collected through face-to-face interviews. A comprehensive intraoral examination was then conducted to record in Performa sheet and verify missing permanent dentition. Data obtained were entered in Epi data version 5 followed by bivariate and multivariable analysis in Statistical Package for Social Sciences (SPSS) version 21. RESULTS: Among 384 edentulous patients, 35.70% self- reported at least one systemic disease, with hypertension (21.60%) and diabetes (10.70%) were most prevalent. While 87.60% of those with systemic disease were under medication, 12.04% remained untreated and only 8.7% acknowledged a link between systemic disease and tooth loss. Bivariate analysis showed significant associations between systemic disease and age, edentulousness duration, occupation, and cause of tooth loss. However, in multivariable analysis age and edentulousness duration demonstrated inverse association, suggesting possible reverse causality. Periodontitis and trauma were significantly more common cause of tooth loss in individuals with systemic diseases. CONCLUSIONS: Edentulous patients exhibit a high burden of systemic disease, often without full treatment or awareness of systemic links. Regression analysis suggests a complex, potentially bidirectional relationship between edentulism and systemic disease, challenging assumption of linear causality. Surprisingly, people with higher education or professional jobs were not protected from these conditions. These results highlight the need for better awareness, integrated care between dental and medical services.