Does adherence to supportive periodontal care lower the risk of caries and related tooth loss? A systematic review and meta-analysis.

OBJECTIVES

The present systematic review critically summarizes the results of clinical studies investigating the risk of crown or root caries and tooth loss in adult patients suffering from periodontitis in relation to their adherence to supportive periodontal care (SPC).

MATERIALS AND

METHODS

Five electronic databases were searched for studies from 1947 to 2025. Odds ratios (or) were calculated for continuous outcome data (e.g., the number of new caries lesions or lost teeth) in a fixed or random-effects model.

RESULTS

Thirty-nine articles, reporting 34 studies with 9685 patients at baseline with at least 157 779 teeth, were included. One study investigated the development of root caries at tooth level, 25 examined tooth loss at patient level, and 13 tooth loss at tooth level. A meta-analysis was not feasible for the outcome root caries. At patient level, significantly more less-adherent patients experienced tooth loss compared with adherent patients (OR = 1.50, 95% CI: 1.11-2.01). At tooth level, adherent patients showed significantly fewer lost teeth than less-adherent patients (OR = 1.64, 95% CI: 1.17-2.29).

CONCLUSIONS

Adhering to SPC reduces the risk of tooth loss in periodontitis patients. In contrast, evidence on root caries prevention is limited, with only one study addressing this outcome.

CLINICAL RELEVANCE: Prevention of caries and subsequent tooth loss is highly relevant for patients undergoing SPC. However, it remains insufficiently addressed in the current literature, underscoring the need for further well-designed studies investigating caries progression in periodontally compromised patients.