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According to a Study

Surprising Link Between Tooth Loss and Mortality Risk

Tooth Loss in Old Age: Warning Signs for Early Mortality
Tooth loss in old age—warning signs for early mortality Photo: Getty Images
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October 21, 2025, 2:26 pm | Read time: 4 minutes

How many teeth one loses with age might reveal more about one’s health than previously thought. A new study from China shows something surprising: Those who lose teeth more quickly in older age have a significantly higher risk of death—regardless of how many teeth they originally had. This brings an often underestimated health factor into focus: tooth loss. The findings could have important implications for prevention, care, and public health strategy.

Is Tooth Loss More Than an Inevitable Part of Aging?

Tooth loss is often accepted as a normal part of aging. However, it can have far-reaching consequences: It not only makes chewing difficult but is also associated with poor nutrition, inflammation in the body, social withdrawal, and higher mortality. Many previous studies have only considered a single point in time—namely, how many teeth a person had at the start of the respective study.1

The new study took it a step further: It analyzed how tooth loss developed over time—specifically, how many teeth were lost per year—and whether this was linked to the mortality risk of older adults. Crucially, the connection was examined independently of how many teeth people had at the beginning.

The data comes from the Chinese Longitudinal Healthy Longevity Survey (CLHLS)—one of the largest long-term studies on older adults worldwide. Given the aging global population and the fact that tooth loss is influenced by modifiable factors such as smoking, dental care, and dental treatment, the findings are also of great importance for prevention and health policy.

Study Design: How Was It Conducted?

The researchers used data from 8,073 older individuals aged 65 and above (average age: 83 years; 47 percent men). The number of natural teeth was recorded during two consecutive surveys, depending on when they participated in the study. For some, this was in 1998 and 2000, for others in 2014 and 2018. Importantly, only real teeth were counted, and dentures were not included.2

From the difference between the two measurements, the researchers calculated the average annual tooth loss. Depending on the result, participants were divided into four groups:

  • Stable: no tooth loss per year
  • Slow loss: less than two teeth per year
  • Moderate loss: two to less than four teeth per year
  • Rapid loss: four or more teeth per year

Subsequently, over a period of 3.5 years, the number of people who died in each group was documented. The statistical calculations were performed using so-called Cox regressions. This is a method that determines the relationships between risk factors and mortality.

Additionally, so-called spline analyses were conducted. This is a statistical method that allows for a very precise graphical and computational examination of whether there is a relationship between risk factors and mortality.

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Rapid Tooth Loss Is Linked to Significantly Increased Mortality

Over a period of 3.5 years, the number of people in each group who died was documented. The central finding: The faster the tooth loss, the higher the risk of death. And this was true even when all other health factors were taken into account.

Specifically, it was found:

  • People who lost teeth more slowly (less than two teeth per year) had a significantly higher risk of death compared to those who lost no teeth.
  • With moderate tooth loss (two to four teeth per year), the risk was about 20 percent higher.
  • Those who lost four or more teeth per year had about a one-third higher risk of death compared to people with no tooth loss.

Moreover, it was found that for every additional tooth lost per year, the risk of death increased by about 4 percent.

These relationships were true for all groups studied, regardless of the number of teeth they had at the beginning or at the end of the study.

What Do the Results Mean?

The study is the first large-scale investigation to examine the relationship between the speed of tooth loss and the mortality of older adults over several years. The methodology is robust, the number of participants is substantial, and the results have been thoroughly validated.

However, there are some limitations:

  • Transferability: The data comes exclusively from China. Whether the results can be applied to other countries or populations remains open.
  • Self-reported data: The number of teeth was self-reported by participants. This can lead to minor inaccuracies—even though previous studies have shown that such information is usually quite accurate.
  • Lack of data on periodontal status or the quality of dental prostheses. These factors could also have an impact.
  • Potential bias: More than 4,000 people with a “tooth gain” between the two time points were excluded. This could lead to some bias, but it was considered in further analyses.

Tooth loss is therefore very likely a warning sign—whether it is also a direct cause remains open.

This article is a machine translation of the original German version of FITBOOK and has been reviewed for accuracy and quality by a native speaker. For feedback, please contact us at info@fitbook.de.

Sources

  1. Koka, S., Gupta, A. (2018). Association between missing tooth count and mortality: A systematic review. J Prosthodont Res. ↩︎
  2. Duan, L., Yang, L., Ruan, H. et al. (2025). Tooth loss progression and mortality among older adults: results from the Chinese longitudinal healthy longevity survey (CLHLS). BMC Geriatrics. ↩︎
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