Tooth Loss

Tooth loss in adults is more than just a cosmetic concern—it’s a warning sign that something deeper is happening with your oral health. While losing baby teeth is a normal childhood milestone, losing permanent teeth can trigger a cascade of problems affecting your ability to eat, speak, and feel confident in your smile.

Table of contents

• What Is Tooth Loss?
• How Common Is Tooth Loss?
• Warning Signs of Tooth Loss
• What Causes Tooth Loss?
• Risk Factors for Tooth Loss
• Complications of Tooth Loss
• How Is Tooth Loss Diagnosed?
• Treatment Options for Tooth Loss
• What to Do If a Tooth Is Knocked Out
• How to Prevent Tooth Loss

What Is Tooth Loss?

Tooth loss happens when a permanent adult tooth falls out or needs to be removed. Unlike losing baby teeth as a child, which is completely normal, losing permanent teeth signals that something is wrong with your oral health^[1].

When you lose a permanent tooth, it’s like pushing over the first domino in a row. Once it happens, it can lead to other problems like bone loss in your jaw, shifting of nearby teeth, or pain in your jaw joints. If tooth loss isn’t treated, it often leads to more teeth falling out in the future^[1].

Tooth loss can affect more than just your mouth. It can make eating difficult, change how you speak, lower your self-esteem, and reduce your overall quality of life^[2]. Missing teeth affect not just your appearance but your overall health, as your mouth is the first organ of your digestive system^[4].

How Common Is Tooth Loss?

Tooth loss is surprisingly common in the United States. Around 178 million adults in the U.S. have lost at least one tooth, and around 40 million adults have lost all their teeth^[1].

Among adults aged 20 to 64 years, the average person has 25.5 remaining teeth^[6]. By age 50, the average American has lost 12 permanent teeth^[4]. The good news is that tooth loss has been declining among older adults over recent decades^[2].

In the period from 2017 to March 2020, about 1 in 10 adults (11%) aged 65 to 74 years had lost all their teeth, and about 1 in 5 adults (20%) aged 75 years or older had lost all their teeth^[2].

Some groups are more affected by tooth loss than others. Complete tooth loss was more common among older adults who were non-Hispanic Black, had lower incomes, had a high school education or less, or currently smoke^[2].

Warning Signs of Tooth Loss

Losing a tooth might come as a surprise, but there are often warning signs that appear before it happens. If you notice any of these symptoms, tell your dentist right away—early treatment may save your tooth^[1]:

• Bad breath
• Bleeding gums
• A loose tooth
• Swollen gums
• Toothache

What Causes Tooth Loss?

Gum disease (also called periodontal disease) is the leading cause of tooth loss among adults^[1][2]. This condition starts when plaque—a sticky film of bacteria—builds up on teeth and hardens over time. When brushing and flossing don’t remove plaque, it can cause the gums to become inflamed and infected^[4].

Over time, gum disease causes the gums to pull away from the teeth, creating gaps that can become infected. This process can break down the bone and tissue supporting the teeth, causing them to become loose and eventually fall out^[1].

Cavities (tooth decay) are another leading cause of tooth loss^[1][2]. Bacteria in your mouth feed on sugars from food and drink and produce acid that breaks down teeth. If left untreated, decay can destroy large portions of teeth, leading to pain, tooth fracture, and tooth loss^[4].

Dental trauma—such as accidents, injuries, or sports-related incidents—can cause immediate tooth loss or damage that later requires removal^[1]. Teeth can be knocked out or broken from severe impact or force^[3].

Teeth grinding (called bruxism) is another cause. Grinding or clenching your teeth, especially during sleep, can weaken teeth over time and lead to fractures that may result in tooth loss^[1].

Risk Factors for Tooth Loss

A risk factor is something that increases your chances of developing a certain condition. Several factors can make you more likely to lose teeth^[1]:

• Poor oral hygiene: Neglecting regular brushing and flossing leads to plaque and tartar buildup, causing decay and gum disease
• Smoking or using tobacco: Tobacco use greatly increases the risk of gum disease and tooth loss^[2]
• Not visiting the dentist: Skipping regular dental checkups means problems can develop without being caught early
• Certain health conditions: Diabetes (especially when not well managed), heart disease, rheumatoid arthritis, asthma, emphysema, and autoimmune diseases like Sjögren’s syndrome increase risk^[1][2]
• Dry mouth: Having a dry mouth, whether from medications or other causes, increases risk
• Hormonal changes: Changes like menopause can affect oral health
• Vaping: Using electronic cigarettes can harm oral health
• Age: Being older than 35 increases risk^[8]
• Gender: Men are more likely to experience tooth loss than women^[8]

Genetics also play a role. Some people are more prone to tooth loss because of their genes. If your parents, grandparents, or siblings have gum disease, you’re more likely to develop it yourself^[1].

Research shows that people with chronic conditions more often have untreated dental problems, which can result in tooth loss. Among U.S. adults 50 years or older, those with certain chronic conditions such as diabetes, heart disease, or emphysema have more frequently experienced tooth loss^[2].

Complications of Tooth Loss

Without treatment, tooth loss can cause serious complications^[1]:

• Bone loss in your jaw: When a tooth is missing, the jawbone in that area begins to deteriorate because it lacks stimulation from the tooth root. This process, called bone resorption, can lead to changes in facial appearance over time^[1]
• Shifting teeth: Surrounding teeth can shift into the gap left by a missing tooth, creating alignment problems and a “bad bite” (called malocclusion)^[1]
• Excess pressure on remaining teeth: The teeth that remain must work harder, which can cause additional problems
• Speech changes: Missing teeth can affect how you speak and make it difficult to pronounce certain words clearly
• TMJ disorder: Tooth loss can contribute to problems with the jaw joint
• Cosmetic changes: Gaps in your smile and facial sagging from lack of support can affect your appearance^[1]

The longer you wait to replace a lost tooth, the more likely you are to lose another one in the future^[1].

How Is Tooth Loss Diagnosed?

A dentist diagnoses tooth loss during a dental exam. They will check the health of your teeth and gums to see if you have conditions that might contribute to tooth loss, such as tooth decay or gum disease^[1].

Your dentist will also need to take X-rays. These images can tell them how much bone you’ve lost in the area where the tooth was and whether any tooth fragments remain in the socket^[1].

Treatment Options for Tooth Loss

Replacing a lost tooth gives you the best chance for long-term oral health. There are several options available^[1]:

Dental implants are considered the closest thing to natural teeth. An implant is a titanium screw that replaces your missing tooth root. It’s placed into your jawbone during a surgical procedure, and over several months, your jawbone grows around the screw to firmly anchor it in place. Then, your dentist attaches a crown (artificial tooth) to the top of the implant. Dental implants last longer than any other replacement option^[1].

Because implants integrate with your jawbone, they help prevent bone loss by providing the stimulation the jaw needs. They look, feel, and function like natural teeth^[1].

Dental bridges are another option. A bridge attaches to the natural teeth on either side of the gap for support, and an artificial tooth fills in the space. The supporting teeth are covered with crowns, and the replacement tooth is fused to these crowns. Bridges last five to 15 years, on average^[1].

Dentures can replace multiple missing teeth or all the teeth in your upper or lower jaw. Full dentures replace an entire arch of missing teeth, while partial dentures replace several missing teeth. You can get traditional dentures (which rest on your gums) or implant-supported dentures (which attach to dental implants for added stability). On average, dentures last seven to 10 years^[1].

Your dentist can advise you on which option is best for you based on the state of your teeth, gums, and jawbone, as well as your overall health and any chronic conditions you may have^[4].

What to Do If a Tooth Is Knocked Out

If your tooth has been knocked out due to trauma or an accident, there is still hope to save it—but only if you act quickly. Time is critical. You typically have about one hour to save the tooth^[7].

Here’s what to do^[7]:

1. Handle the tooth carefully: Pick it up by the crown (the white top part) only. Don’t touch the root, as this can damage cells that are essential for re-implantation.
2. Rinse the tooth gently: If the tooth has dirt on it, rinse it briefly with cow’s milk or your own saliva. Don’t use tap water or hold it under running water, as too much tap water can kill the cells on the root surface. Don’t scrub or wipe the tooth.
3. Try to put the tooth back in its socket: If possible, reposition the tooth in the socket immediately. If it doesn’t go all the way in, bite down slowly and gently on gauze or a clean cloth to hold it in place.
4. Keep the tooth moist: If you can’t reinsert the tooth, place it right away in a container with cow’s milk or saliva. Don’t store it in water. You can also place it in your mouth between your cheek and gums.
5. Get to a dentist immediately: See a dentist within 30 minutes of the injury if possible. If a dentist is unavailable, go to an emergency room. Bring your tooth with you.

Don’t wrap the tooth in tissue or cloth, as this damages the root surface and makes the tooth less likely to survive^[7].

How to Prevent Tooth Loss

Tooth loss is largely preventable. A combination of good oral hygiene practices, overall self-care, and professional dental care can help you avoid tooth loss^[2].

Practice good oral hygiene at home:

• Brush your teeth twice a day with fluoride toothpaste for at least two minutes, making sure to reach all surfaces of your teeth^[1][2]
• Floss daily to remove plaque and food particles from between your teeth and along the gumline^[2]
• Use an antimicrobial mouthwash to reduce plaque and fight gum disease

Visit your dentist regularly:

• Have at least a yearly dental checkup, even if you have no natural teeth remaining^[2]
• Get professional dental cleanings to remove tartar that can’t be removed by brushing alone
• Regular checkups allow dentists to detect problems early, before they lead to tooth loss^[1]

Make healthy lifestyle choices:

• Eat a balanced diet rich in fruits, vegetables, lean proteins, and dairy products, which provide essential nutrients for strong teeth and gums
• Limit foods and beverages that are high in added sugar^[2]
• Stay hydrated by drinking plenty of water
• Avoid tobacco in all forms—smoking and using smokeless tobacco greatly increase the risk of gum disease and tooth loss^[1][2]
• Avoid vaping

Protect your teeth from injury:

• Wear a mouthguard when playing contact sports
• If you grind your teeth at night, ask your dentist about getting a nightguard to protect your teeth from wear and damage
• Don’t use your teeth as tools to open packages or bottles
• Be cautious with hard foods like ice, popcorn kernels, and hard candies

Manage your overall health:

• Keep chronic conditions like diabetes well-controlled, as these affect oral health^[1]
• Tell your dentist about all medications you take and any health conditions you have

Remember, prevention is key to keeping your smile healthy. Regular dental care and good daily habits can help you keep your teeth for your entire life^[1].