The Effect of Tobacco Smoking on Tooth Loss: A Systematic Review and Meta‐Analysis

AIMS: This systematic review aims to examine the causal effect of tobacco smoking on tooth loss. Further, the impact of different frequencies, intensities and lifetime exposures to tobacco smoking on tooth loss and whether the relationship differs by socioeconomic status (SES) are reviewed in the sub-group analysis. METHODS: An electronic search was conducted in Embase (Ovid), Ovid MEDLINE and Web of Science for studies published up to May 2025. No limits on publication dates were applied. This review included case-control and cohort studies that reported the effect of tobacco smoking on tooth loss. Risk of Bias of included studies was assessed by ROBINS-E assessment tool. RESULTS: A total of 30 studies were included in this systematic review. The meta-analysis from five studies indicated that current smokers have 1.41 times higher risk of tooth loss (RR 1.41, 95% CI: 1.24-1.60) than nonsmokers (sample size range: 273-34,975, n = 5). Past smoking also increases the risk of having tooth loss (RR 1.21, 95% CI: 1.07-1.37) (sample size range: 547-34,975, n = 2). None of the studies examined the effect of smoking on tooth loss by different SES. CONCLUSIONS: This systematic review highlights the importance and urgency of quitting smoking for better oral health.