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Natural tooth loss and mortality risk

Each row is one study of death risk from tooth loss. The bright line is what that study found. The band around it is the range the data still supports — it fades where the evidence thins. Left of the centre line is lower risk.

what the study foundstill plausibleno change
self-reported tooth loss due to disease/decay vs no loss
Wu et al. 2021
15% higher
range 5–26% higher
periodontal disease vs no periodontal disease (mostly clinical diagnosis)
Guo et al. 2023
31% higher
range 7–61% higher

What it is

Whether you have lost any natural adult teeth to disease or decay — a self-report this calculator scores as none vs one or more, not a tooth count and not a gum-disease exam.

Why it matters for longevity

The engine uses Wu 2021 (Sister Study, 50,884 women, self-reported disease/decay-related tooth loss): ACM HR 1.15 (1.05–1.26). Same-cohort self-reported periodontal disease was NS (HR 1.08, 0.98–1.19) — that is why the question is tooth loss, not gum health. No matching-construct ACM meta of binary any-vs-none self-report was opened; Peng 2019 is the nearest tooth-loss pool and is a graded count (Table 3: RR 1.15 per 10 missing, 1.57 at 32), and it dropped binary papers. Romandini 1.46 / 1.66 and Guo 1.31 are clinical periodontitis or edentulism, not this UI. Peng’s own conclusion is risk marker, not a proven treatment effect. Engine not moved.

How to improve it

  • See a dentist/hygienist regularly
  • Treat bleeding gums or decay early, before a tooth is lost
  • Discuss replacement options (implant/bridge/denture) if a tooth is already missing

Evidence, by endpoint

EndpointGradeFinding
All-cause mortality (per 10 teeth lost)B
Nearest meta is graded, not binary (Peng 2019)
Table 3 ACM RR 1.15 per 10 missing teeth, 1.57 at 32. Dropped seven binary any-vs-none papers. Per-10 1.15 is not Wu’s binary 1.15. No matching-construct meta opened.
All-cause mortality (periodontitis / edentulism)C
1.46 / 1.66 is not this score (Romandini 2020)
Clinical periodontitis RR 1.46; edentulism (total loss) RR 1.66. Different construct from None Lost / 1+ Lost. Do not paste those onto the engine’s 1.15.
All-cause mortality (periodontal disease)C
Treating PD vs death is untested (Guo 2023)
PD pool RR 1.31 is mostly clinical exam. Self-report PD did not raise ACM. Authors: unknown whether treating PD cuts death. Marker, not a treatment effect.
All-cause mortality (self-reported tooth loss, women only)C
1.15 in Women Only, From the Sister Study (Wu 2021)
Engine paper: the Sister Study followed 50,884 women aged 35–74 (each with a sister who had breast cancer), mean 10.9 years, 2,058 deaths. Self-reported disease- or decay-related tooth loss carried ACM HR 1.15 (95% CI 1.05–1.26); self-reported periodontal disease alone was not significant (HR 1.08, 0.98–1.19). An all-women cohort, not the general population this calculator serves.

What argues against this

Romandini 2020 (57 studies/48 cohorts, 5.71 million people, slot 'competing') is the strongest opposing number in this set, though it disagrees on construct and magnitude rather than direction: it reports clinical periodontitis ACM RR 1.46 and edentulism (total tooth loss) RR 1.66 — both notably larger than the engine's self-reported any-tooth-loss HR of 1.15 from Wu 2021 — because it measures a more severe, clinically confirmed construct rather than the self-reported binary this calculator asks about. It does not argue the direction is wrong, only that pasting its larger numbers onto this calculator's construct would overstate the risk.

Last reviewed 2 September 2026

Evidence

  1. Wu et al. (2021) — Journal of Clinical Periodontology
    Associations of periodontal disease and tooth loss with all-cause and cause-specific mortality in the Sister Study
    View source
  2. Peng et al. (2019) — Bioscience Reports
    The relationship between tooth loss and mortality from all causes, cardiovascular diseases, and coronary heart disease in the general population: systematic review and dose-response meta-analysis of prospective cohort studies
    View source
  3. Romandini et al. (2020) — Journal of Dental Research
    Periodontitis, Edentulism, and Risk of Mortality: A Systematic Review with Meta-analyses
    View source
  4. Guo et al. (2023) — PLOS ONE
    Periodontal disease and subsequent risk of cardiovascular outcome and all-cause mortality: A meta-analysis of prospective studies
    View source
  5. Kotronia et al. (2021) — Scientific Reports
    Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA
    View source
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