{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T14:57:45Z","timestamp":1781621865104,"version":"3.54.5"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Few studies have examined the association of edentulism and chronic kidney disease (CKD). This study aimed to investigate the association of edentulism and CKD, as well as the association of edentulism and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study analysed 19,427 patients with varying degrees of edentulism from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2020. The endpoints were all-cause mortality and CKD, which were determined through the National Death Index (NDI). CKD was calculated based on the estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio. A logistic regression classification model and interaction test were used to determine the association of edentulism and CKD. Kaplan\u2013Meier survival analysis, multivariate Cox regression survival models, and stratified analyses were used to explore the correlation between edentulism and mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the follow-up period that included the data of 19,427 individuals, a total of 1,579 cases of all-cause mortality were recorded, representing an incidence of 8.13%. Among these, 865 cases, accounting for 54.78% of the total mortality, were attributed to chronic kidney disease (CKD). After multivariable-adjusted logistic regression analysis, the risk of CKD increased by 39% among participants with complete edentulism (OR 1.39, 95% CI 1.17\u2009~\u20091.66;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                    <jats:p>\n                      Following multivariable-adjusted Cox regression models, a significant connection was identified between edentulism and mortality due to CKD or all causes. Compared with participants without tooth loss, those with maxillary tooth loss had a significantly increased all-cause mortality rate of 61% (HR 1.61, 95% CI 1.30\u2009~\u20091.98,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and the CKD-related mortality rate was significantly elevated by 45% (HR 1.45, 95% CI 1.11\u2009~\u20091.90,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). Participants with both maxillary and mandibular tooth loss presented a significant increase in the all-cause mortality rate of 102% (HR 2.02, 95% CI 1.73\u2009~\u20092.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The CKD mortality rate was significantly increased by 69% (HR 1.69, 95% CI 1.33\u2009~\u20092.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Complete loss of both maxillary and mandibular dentition not only increases the prevalence of CKD but also increases the all-cause mortality and the mortality rates associated with CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-025-07166-w","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T10:35:11Z","timestamp":1764585311000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The association between edentulism and chronic kidney disease with mortality: results from the NHANES study (2009\u20132020)"],"prefix":"10.1186","volume":"26","author":[{"given":"Huaxiang","family":"Jiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Gan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zishun","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"issue":"8","key":"7166_CR1","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1093\/ndt\/gfad269","volume":"39","author":"WM Zhao","year":"2024","unstructured":"Zhao WM, Li XL, Shi R, et al. Global, regional and national burden of CKD in children and adolescents from 1990 to 2019. Nephrol Dial Transplant. 2024;39(8):1268\u201378. https:\/\/doi.org\/10.1093\/ndt\/gfad269.","journal-title":"Nephrol Dial Transplant"},{"issue":"4","key":"7166_CR2","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1001\/jamainternmed.2022.6817","volume":"183","author":"L Wang","year":"2023","unstructured":"Wang L, Xu X, Zhang M, et al. Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance. JAMA Intern Med. 2023;183(4):298\u2013310. https:\/\/doi.org\/10.1001\/jamainternmed.2022.6817.","journal-title":"JAMA Intern Med"},{"issue":"10225","key":"7166_CR3","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","volume":"395","author":"GBD Chronic Kidney Disease Collaboration","year":"2020","unstructured":"GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709\u201333. https:\/\/doi.org\/10.1016\/S0140-6736(20)30045-3.","journal-title":"Lancet"},{"issue":"2","key":"7166_CR4","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1159\/000534071","volume":"148","author":"M Ying","year":"2024","unstructured":"Ying M, Shao X, Qin H, et al. Disease burden and epidemiological trends of chronic kidney disease at the global, regional, national levels from 1990 to 2019. Nephron. 2024;148(2):113\u201323. https:\/\/doi.org\/10.1159\/000534071.","journal-title":"Nephron"},{"issue":"10","key":"7166_CR5","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1038\/s41581-023-00736-7","volume":"19","author":"P Evenepoel","year":"2023","unstructured":"Evenepoel P, Stenvinkel P, Shanahan C, Pacifici R. Inflammation and gut dysbiosis as drivers of CKD-MBD. Nat Rev Nephrol. 2023;19(10):646\u201357. https:\/\/doi.org\/10.1038\/s41581-023-00736-7.","journal-title":"Nat Rev Nephrol"},{"key":"7166_CR6","doi-asserted-by":"publisher","unstructured":"Levin A, Stevens PE. Early detection of CKD: the benefits, limitations and effects on prognosis. Nat Rev Nephrol. 2011;7(8):446-457. Published 2011 Jun 28. https:\/\/doi.org\/10.1038\/nrneph.2011.86","DOI":"10.1038\/nrneph.2011.86"},{"issue":"9811","key":"7166_CR7","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/S0140-6736(11)60178-5","volume":"379","author":"AS Levey","year":"2012","unstructured":"Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012;379(9811):165\u201380. https:\/\/doi.org\/10.1016\/S0140-6736(11)60178-5.","journal-title":"Lancet"},{"key":"7166_CR8","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.amjcard.2022.05.028","volume":"178","author":"K Sumayin Ngamdu","year":"2022","unstructured":"Sumayin Ngamdu K, Mallawaarachchi I, Dunipace EA, et al. Association between periodontal disease and cardiovascular disease (from the NHANES). Am J Cardiol. 2022;178:163\u20138. https:\/\/doi.org\/10.1016\/j.amjcard.2022.05.028.","journal-title":"Am J Cardiol"},{"key":"7166_CR9","doi-asserted-by":"publisher","unstructured":"Liccardo D, Cannavo A, Spagnuolo G, et al. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci. 2019;20(6):1414. Published 2019 Mar 20. https:\/\/doi.org\/10.3390\/ijms20061414","DOI":"10.3390\/ijms20061414"},{"issue":"2","key":"7166_CR10","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.identj.2023.08.002","volume":"74","author":"GS Chatzopoulos","year":"2024","unstructured":"Chatzopoulos GS, Jiang Z, Marka N, Wolff LF. Periodontal disease, tooth loss, and systemic conditions: an exploratory study. Int Dent J. 2024;74(2):207\u201315. https:\/\/doi.org\/10.1016\/j.identj.2023.08.002.","journal-title":"Int Dent J"},{"issue":"7","key":"7166_CR11","doi-asserted-by":"publisher","DOI":"10.3390\/nu15071577","volume":"2023","author":"AWK Yeung","year":"2023","unstructured":"Yeung AWK, Leung WK. Functional neuroplasticity of adults with partial or complete denture rehabilitation with or without implants: evidence from fMRI studies. Nutrients. 2023;2023(7):1577. https:\/\/doi.org\/10.3390\/nu15071577.","journal-title":"Nutrients"},{"issue":"2","key":"7166_CR12","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1111\/jre.13083","volume":"58","author":"EM Lu","year":"2023","unstructured":"Lu EM. The role of vitamin D in periodontal health and disease. J Periodontal Res. 2023;58(2):213\u201324. https:\/\/doi.org\/10.1111\/jre.13083.","journal-title":"J Periodontal Res"},{"issue":"11","key":"7166_CR13","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.1111\/jcpe.13857","volume":"50","author":"J Kostunov","year":"2023","unstructured":"Kostunov J, Menzel R, Bermejo JL, Rammelsberg P, Giannakopoulos NN, Kappel S. Immediate loading of dental implants in edentulous mandibles using Locator attachments or Dolder bars: a 9-year prospective randomized clinical study. J Clin Periodontol. 2023;50(11):1530\u20138. https:\/\/doi.org\/10.1111\/jcpe.13857.","journal-title":"J Clin Periodontol"},{"key":"7166_CR14","doi-asserted-by":"publisher","unstructured":"Tran F, Schirmer JH, Ratjen I, et al. Patient Reported Outcomes in Chronic Inflammatory Diseases: Current State, Limitations and Perspectives. Front Immunol. 2021;12:614653. Published 2021 Mar 18. https:\/\/doi.org\/10.3389\/fimmu.2021.614653","DOI":"10.3389\/fimmu.2021.614653"},{"issue":"2","key":"7166_CR15","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1177\/154405910408300214","volume":"83","author":"F D'Aiuto","year":"2004","unstructured":"D\u2019Aiuto F, Parkar M, Andreou G, et al. Periodontitis and systemic inflammation: control of the local infection is associated with a reduction in serum inflammatory markers. J Dent Res. 2004;83(2):156\u201360. https:\/\/doi.org\/10.1177\/154405910408300214.","journal-title":"J Dent Res"},{"issue":"9","key":"7166_CR16","doi-asserted-by":"publisher","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","volume":"150","author":"AS Levey","year":"2009","unstructured":"Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604\u201312. https:\/\/doi.org\/10.7326\/0003-4819-150-9-200905050-00006.","journal-title":"Ann Intern Med"},{"key":"7166_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2020.154433","volume":"115","author":"DQ Sun","year":"2021","unstructured":"Sun DQ, Jin Y, Wang TY, et al. Mafld and risk of CKD. Metabolism. 2021;115:154433. https:\/\/doi.org\/10.1016\/j.metabol.2020.154433.","journal-title":"Metabolism"},{"issue":"5","key":"7166_CR18","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1111\/jre.13255","volume":"59","author":"H Wu","year":"2024","unstructured":"Wu H, Wang S, Wei Z. Periodontitis and risk of mortality in patients with chronic kidney disease: a systematic review with meta-analysis. J Periodontal Res. 2024;59(5):868\u201376. https:\/\/doi.org\/10.1111\/jre.13255.","journal-title":"J Periodontal Res"},{"issue":"2","key":"7166_CR19","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1111\/j.1752-7325.2012.00350.x","volume":"73","author":"E Ioannidou","year":"2013","unstructured":"Ioannidou E, Hall Y, Swede H, Himmelfarb J. Periodontitis associated with chronic kidney disease among Mexican Americans. J Public Health Dent. 2013;73(2):112\u20139. https:\/\/doi.org\/10.1111\/j.1752-7325.2012.00350.x.","journal-title":"J Public Health Dent"},{"issue":"9","key":"7166_CR20","doi-asserted-by":"publisher","first-page":"260","DOI":"10.62547\/VYCO2960","volume":"83","author":"P Fujimoto","year":"2024","unstructured":"Fujimoto P, Wong KA, Kataoka-Yahiro M. Behind the Smile: Detecting Chronic Kidney Disease Through Oral Health Screenings. Hawaii J Health Soc Welf. 2024;83(9):260\u20132. https:\/\/doi.org\/10.62547\/VYCO2960.","journal-title":"Hawaii J Health Soc Welf"},{"issue":"1","key":"7166_CR21","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1007\/s00467-022-05590-6","volume":"38","author":"B Sezer","year":"2023","unstructured":"Sezer B, Kaya R, Kodaman Dokumac\u0131gil N, et al. Assessment of the oral health status of children with chronic kidney disease. Pediatr Nephrol. 2023;38(1):269\u201377. https:\/\/doi.org\/10.1007\/s00467-022-05590-6.","journal-title":"Pediatr Nephrol"},{"issue":"2","key":"7166_CR22","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1111\/jcpe.12502","volume":"43","author":"P Sharma","year":"2016","unstructured":"Sharma P, Dietrich T, Ferro CJ, Cockwell P, Chapple IL. Association between periodontitis and mortality in stages 3\u20135 chronic kidney disease: NHANES III and linked mortality study. J Clin Periodontol. 2016;43(2):104\u201313. https:\/\/doi.org\/10.1111\/jcpe.12502.","journal-title":"J Clin Periodontol"},{"key":"7166_CR23","doi-asserted-by":"publisher","unstructured":"Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Primers. 2017;3:17038. Published 2017 Jun 22. https:\/\/doi.org\/10.1038\/nrdp.2017.38","DOI":"10.1038\/nrdp.2017.38"},{"key":"7166_CR24","doi-asserted-by":"publisher","unstructured":"\u017dmavc JB, Verdenik M, Skomina Z, Ihan Hren N. Tooth Loss and Systemic Diseases in the Slovenian Elderly Population: A Cross-Sectional Study of the Associaton Between Oral and Systemic Health. Zdr Varst. 2024;63(3):142\u2013151. Published 2024 Jun 14. https:\/\/doi.org\/10.2478\/sjph-2024-0019","DOI":"10.2478\/sjph-2024-0019"},{"key":"7166_CR25","doi-asserted-by":"publisher","unstructured":"Issrani R, Reddy J, Dabah THE, et al. Exploring the Mechanisms and Association between Oral Microflora and Systemic Diseases. Diagnostics (Basel). 2022;12(11):2800. Published 2022 Nov 15. https:\/\/doi.org\/10.3390\/diagnostics12112800","DOI":"10.3390\/diagnostics12112800"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-025-07166-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-025-07166-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-025-07166-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T14:47:27Z","timestamp":1781621247000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12903-025-07166-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7166"],"URL":"https:\/\/doi.org\/10.1186\/s12903-025-07166-w","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6548683\/v1","asserted-by":"object"}]},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]},"assertion":[{"value":"28 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate:"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"44"}}