Association of edentulism with incident non-communicable diseases among middle-aged and older adults: a population-based cohort study

Edentulism has been associated with multiple non-communicable diseases (NCDs). However, existing evidence from China is largely limited to specific high-risk regions or lacks national representativeness, and large-scale population-based prospective studies remain scarce. This study investigated the association between edentulism and the risk of developing NCDs in middle and older adults from China. We examined the relationship between edentulism and NCDs in the CHARLS study, a large prospective cohort of 17,708 adults in China. Follow-up started from the baseline survey in 2011 and ended at the 2018 survey, and the primary endpoint was the first diagnosis of any NCD during follow-up. Cox proportional hazards models were used to estimate hazard ratio (HR) and 95% confidence interval (CI) with adjustment for potential confounders. A total of 6,585 participants were included, with a mean follow-up of 6.46 years. Participants with edentulism had a higher risk of NCDs (HR = 1.17, 95% CI: 1.03–1.33), asthma (HR = 2.83, 95% CI: 1.38–5.79), hypertension (HR = 1.21, 95% CI: 1.01–1.45), and cancer (HR = 2.66, 95% CI: 1.46–4.84) than those who had teeth. No statistically significant associations between edentulism and other diseases were found. Stratified analyses showed effect modification by age for asthma and by sex for dyslipidemia. The study from China found that edentulism was associated with NCDs, asthma, hypertension, and cancer, and also with the other cancers category, although this finding was unstable. No significant associations were found between edentulism and other individual NCDs or specific cancer types including breast, reproductive, and gastrointestinal cancer.