Tooth loss in North Americans under 35: A Systematic Review

Objectives: The aim of this study was to systematically report data reflective of the prevalence of tooth loss in North America in individuals under 35 years of age.
Methods: An electronic search was conducted on Medline (Ovid), Cochrane, and EMBASE. Studies were considered if they were conducted in North America and reported any number of tooth loss in the age range between 0-34 years. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool for cross sectional studies.
Results: Literature search initially identified 4,675 articles. After application of inclusion/exclusion criteria, nineteen studies were finally included. Among these studies, eleven were from the USA, two from Puerto Rico, four from Mexico, and one from Canada. One study explored multiple countries including Cayman Islands, Honduras, Jamaica, Nicaragua, Panama and USA. Prevalence of tooth loss was reported in various ways, including percentage and mean number. Some studies used the DMF index to calculate these values. Overall, the included articles revealed that the prevalence of tooth loss in North Americans under 35 years of age is as high as 37.5%. Higher prevalence of tooth loss was observed in Panama, Puerto Rico and Jamaica. Additionally, individuals from the USA who were considered low socio-economic status, smoked, or had a greater sugar intake demonstrated higher prevalence of tooth loss.
Conclusions: There is limited available literature that specifically discusses the prevalence of tooth loss within the age range of 0-34 years in North America. Although our results revealed that tooth loss was associated with caries and periodontitis, it was still difficult to distinguish cause due to limitations in reporting. Additional high-quality studies should provide more definitive reasons for cause of tooth loss in order to facilitate better preventive efforts for the younger population.