A healthier, fuller smile may be linked to a longer life, according to a large new study examining the relationship between dental health and mortality in older adults.
Research published in BMC Oral Health found that people with more healthy or restored teeth had a lower risk of death from all causes, while those with more missing or decayed teeth faced a higher mortality risk.
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The findings add to growing evidence that oral health reflects broader physical well-being, extending far beyond cosmetic concerns.
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The study was conducted by researchers from the University of Osaka in Japan, who analyzed dental and medical records from 190,282 adults aged 75 and older. Participants were assessed based on the number and condition of their teeth, excluding wisdom teeth, for a maximum count of 28.
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Teeth were classified as sound, filled, or decayed. Researchers also accounted for factors such as age, body mass index (BMI), smoking status, and existing health conditions including diabetes, high blood pressure, heart disease, high cholesterol, and dementia.
The researchers aimed to determine the most accurate way to count teeth when predicting all-cause mortality, a measure of the likelihood of dying earlier than expected from any cause.
They found that the total number of sound and filled teeth was a stronger predictor of mortality than counting sound teeth alone or including decayed teeth in the total.
“The total number of sound and filled teeth predicted all-cause mortality more accurately,” the researchers wrote, suggesting that tooth condition plays a clinically important role in assessing health risks among older adults.
The team noted that decayed or missing teeth may signal chronic inflammation, which can spread throughout the body and contribute to systemic diseases. Poor oral health has previously been linked to cardiovascular problems such as heart attacks and strokes, as well as cognitive decline associated with conditions like Alzheimer’s disease.
Fewer teeth can also impair chewing ability, making it harder to maintain a balanced and nutritious diet, which may further affect overall health.
“Decayed teeth may indicate an increased risk of all-cause mortality due to functional impairment or as a potential source of chronic inflammation,” the researchers said.
The study also acknowledged several limitations. Poor dental health can be associated with lower socioeconomic status, which may influence access to dental care and overall life expectancy.
Despite these limitations, the researchers called for further large-scale studies to explore how both the number and condition of teeth affect long-term health outcomes.
“The mechanism underlying the association between the number of decayed and filled teeth and all-cause mortality should be carefully investigated,” they concluded.
The findings follow earlier research warning that poor oral hygiene, including cavities and gum disease, could raise the risk of ischemic stroke by as much as 86 percent. Ischemic strokes occur when blood flow to the brain is blocked, depriving it of oxygen and nutrients.
Together, the evidence suggests that maintaining good dental health and addressing oral problems promptly may play a role in protecting against serious disease and premature death.