Is tooth loss associated with subsequent cognitive decline and dementia in ageing populations?

A COMMENTARY ON: Chen H, Ji L, Wang Y, Klineberg I, Chen H. Dentition-Cognition Relationship in Aging Populations: A Meta-Analysis of Longitudinal Data. J Oral Rehabil 2026; 53: 924-38.

DESIGN

Systematic review and meta-analysis of longitudinal observational studies.

CASE SELECTION: Longitudinal cohort and case-control studies assessing dentition status (tooth loss or edentulism) and cognitive outcomes (dementia or mild cognitive impairment [MCI]) were included. Twenty-one studies with approximately 35.7 million participants and a mean follow-up of 8.9 years were analysed.

DATA ANALYSIS: Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models depending on heterogeneity. Study quality was assessed using the Newcastle-Ottawa Scale.

RESULTS

Tooth loss was associated with an increased risk of both dementia (OR 1.26, 95% CI 1.07-1.49) and MCI (OR 1.40, 95% CI 1.14-1.71), with stronger associations observed in individuals with edentulism, particularly for MCI (OR 1.90, 95% CI 1.07-3.35) and to a lesser extent dementia (OR 1.16, 95% CI 1.09-1.23). Findings also suggested a dose-response relationship, whereby increasing severity of tooth loss corresponded to greater cognitive risk. Subgroup analyses indicated higher risks in women and Western populations. Limited evidence also suggested that denture use attenuated this association, showing no significant increased dementia risk among denture wearers (OR 1.03, 95% CI 0.82-1.28).

CONCLUSIONS

Tooth loss is associated with an increased risk of cognitive decline and dementia, with more severe tooth loss conferring greater risk. Prosthodontic rehabilitation may mitigate this association, suggesting a potential role for oral health in supporting cognitive ageing.