Tooth Loss may Decrease the Capacity to Perform Everyday Tasks

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Older adults with more natural teeth are better able to perform everyday tasks such as cooking a meal, making a telephone call or going shopping, according to a new study. 

The study, conducted by researchers from UCL and the Tokyo Medical and Dental University, was published in the Journal of American Geriatrics Society, The researchers analysed data from 5631 adults from the English Longitudinal Study of Ageing (ELSA) with ages between 50 and 70 years old.

Previous research had established a link between tooth loss and various reductions in capacity, such as cognitive decline. However, such research could not tease out any kind of causal link: did the tooth loss cause the decline, or did the decline result in tooth loss?

In this study the research team wanted to investigate the causal effect of tooth loss on someone’s ability to carry out daily activities. After controlling for factors such as participants’ socioeconomic status and health status, they nevertheless found evidence of an independent link between tooth loss and the ability to carry out everyday tasks.

The participants in the study were asked how many natural teeth they had, with older adults usually having up to 32 natural teeth that are lost over time. Using data gathered in 2014-2015, the researchers measured how tooth loss affected people’s ability to carry out key instrumental activities of daily living (IADL). The activities included preparing a hot meal, shopping for groceries, making telephone calls, taking medications, doing work around the house or garden, or managing money.

Senior author Georgios Tsakos, professor at UCL Institute of Epidemiology and Health, explained: “We know from previous studies that tooth loss is associated with reduced functional capacity, but this study is the first to provide evidence about the causal effect of tooth loss on the instrumental activities of daily living (IADL) among older adults in England. And this effect is considerable.

“For example, older adults with 10 natural teeth are 30% more likely to have difficulties with key activities of daily living such as shopping for groceries or working around the house or garden compared to those with 20 natural teeth.

“Even after taking in factors such as participant’s education qualification, self-rated health and their parent’s education level for example, we still found a positive association between the number of natural teeth a person had and their functional ability.”

The researchers had a number of possible explanations for this relationship, noting that having more natural teeth is linked to delaying the onset of disability and death and that tooth loss can also hamper social interactions, which is also linked to poorer quality of life. Tooth loss could be linked to having a poorer diet with less nutrients, they suggested.

However the researchers cautioned that the results should be considered carefully due to the study’s complex design. Further studies are needed to investigate the causal relationship between tooth loss and functional ability.

First author, Dr Yusuke Matsuyama, at Tokyo Medical and Dental University, said: “Preventing tooth loss is important for maintaining functional capacity among older adults in England. Given the high prevalence of tooth loss, this effect is considerable and maintaining good oral health throughout the life course could be one strategy to prevent or delay loss of functional competence.

“The health gain from retaining natural teeth may not be limited to oral health outcomes but have wider relevance for promoting functional capacity and improving overall quality of life.”

Source: University College London

Journal information: Yusuke Matsuyama et al, Causal Effect of Tooth Loss on Functional Capacity in Older Adults in England: A Natural Experiment, Journal of the American Geriatrics Society (2021). DOI: 10.1111/jgs.17021