Tooth loss truth: It’s no longer about the tooth fairy

What is the first thing that comes to mind when you hear the term tooth loss? Trauma? Caries? The tooth fairy? While all of these are acceptable associations, there are many more factors involved in tooth loss. From a population perspective, older Americans keep their teeth longer, according to a 2016 study. In fact, total tooth loss in adults aged 65 to 75 has decreased by more than 75% over the past five decades.

However, keeping teeth longer also means caring for them longer. This study also showed that the prevalence of total or severe tooth loss is higher in people with chronic conditions or in poorer overall health than people without these conditions. Given that six in ten adults in the United States have a chronic disease, tooth loss is an important topic to talk about. Let’s break down an example of how chronic diseases are related to tooth loss, what else affects tooth loss, and how to prevent it.

Periodontal disease

Periodontal disease is a major cause of tooth loss. Bacteria, plaque and tartar deposits on the teeth can cause inflammation and infections that spread below the gums and, in an emergency, can lead to bone and tooth loss. It is very common as around 70% of adults aged 65 and over and 47% of adults aged 30 and over have periodontal disease. Over the years, research has shown that certain factors, including chronic conditions, increase your risk of periodontal disease. For example, diabetes, which affects one in ten Americans, has a two-way relationship with periodontal disease, in which controlled periodontal disease can help control blood sugar levels and vice versa.


Tooth decay or tooth decay (tooth decay) is another major cause of tooth loss. As with periodontal disease, tooth decay is caused by bacteria in the mouth. These bacteria build up in sticky plaque on your teeth and feed on sugar in your diet. As a result, they release acids that break down your teeth. If left untreated, tooth decay can destroy large parts of your teeth, leading to pain, tooth fractures, and (in severe) tooth loss.


Periodontitis and tooth decay can be avoided, but accidents do occur. Whether doing sports or chewing hard food, teeth can be knocked out or broken. In either case, it is important to know how to deal with dental emergencies and to see your dentist immediately. If a tooth is knocked out, keep these dos and don’ts from the American Association of Endodontics in mind:

To do

  • Immediately reposition the tooth in the socket. If it can’t be replaced, put it in milk, in your mouth next to your cheek, or in an emergency tooth preservation kit.
  • If possible, see an endodontist or dentist within 30 minutes of the injury.


  • Don’t touch the root.
  • Do not rinse the tooth with soap or chemicals.
  • Do not wrap the tooth in a handkerchief or cloth.

If your tooth breaks but isn’t knocked out, call your dentist and make an appointment right away. Keep the area clean by rinsing it with warm water, especially if your gums are sore. If the tooth has sharp edges, tooth wax is available in most drug stores.

Social determinants of health and tooth loss

A study led by researchers at the Harvard School of Dental Medicine found that “machine learning algorithm models that incorporate socio-economic characteristics are better at predicting tooth loss than those that rely solely on routine clinical dental indicators.”

In addition, new research found that

  • Adults in urban areas visited the dentist more often than those in rural areas
  • Women visited the dentist more often than men in both rural and urban areas
  • the number of dentist visits by adults increased with increasing family income
  • non-Hispanic white adults were more likely to have dental visits in urban areas than hispanic and non-Hispanic black adults.

Therefore, it is important to consider how inequalities in access to and use of dental care affect not only tooth loss, but oral and general health as well.

Prevention and Oral Health in the Age of the Pandemic

Tooth loss is not just about losing a tooth. It can significantly affect the quality of your life, from impaired speech and self-esteem to restricting your diet (which can lead to either weight loss or obesity). In addition, the COVID-19 pandemic has led to an increase in stress-related oral health conditions such as teeth grinding and cracked or chipped teeth.

While the cause of tooth loss can be related to many things, it is largely preventable. You can avoid pain and losing your teeth at home with a few simple steps aimed at limiting the number of bacteria in your mouth and seeing your dentist regularly.

Finally, although there may be concerns about returning to normal life during the pandemic, Americans should feel reassured knowing that dental offices have remained safe, likely due to the fact that dentistry led the way in infection control even before COVID-19 .

For more information on tooth loss and dental health, see Harvard Health Publishing’s Special Health ReportDental Health for Adults.

As a service to our readers, Harvard Health Publishing offers access to our library of archived content. Please note the date of the last review or update for all articles. No content on this website, regardless of the date, should never be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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