Health Advice



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

Tien Jiang, DMD, MEd, Harvard Health Blog on

Published in Health & Fitness

When you hear the phrase tooth loss, what comes to mind first? Trauma? Tooth decay? 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 are keeping their teeth longer, according to a 2016 study. In fact, complete tooth loss has decreased by more than 75% in adults 65 to 75 years old over the past five decades.

However, keeping your teeth longer also means caring for them longer. This study also showed that the prevalence of complete or severe tooth loss is higher among individuals with chronic diseases or overall worse health, compared to those without these conditions. Given that six in 10 adults in the U.S. have a chronic disease, tooth loss is an important topic to discuss. Let’s break down an example of how chronic disease relates to tooth loss, what else influences tooth loss, and ways to prevent it.


Periodontitis is one of the leading causes of tooth loss. Bacteria, plaque, and tartar buildup on teeth can cause inflammation and infection that can spread below the gum and lead to loss of bone and teeth, if severe. It is very common, as about 70% of adults 65 and older and 47% of adults 30 and older have some form of periodontal disease. Over the years, research has shown that certain factors, including chronic diseases, increase risk for periodontal disease. For example, diabetes, which impacts one in 10 Americans, has a bidirectional relationship with periodontal disease, where controlled periodontal disease can help control blood sugar levels and vice versa.

Tooth decay

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



While periodontitis and tooth decay are highly preventable, accidents happen. Whether it’s sports or chewing hard food, teeth can be knocked out or break. In either scenario, it is critical to know how to manage dental emergencies and see your dentist immediately. If a tooth is knocked out, remember these dos and don’ts from the American Association of Endodontics:




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