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The leading cause of tooth loss is periodontal (gum) disease. There are a number of other causes that also contribute to the development of periodontal disease in individuals. These include tooth decay, cavities (caries) and oral injury.

Risk factors

A number of risk factors for tooth loss have been identified in studies conducted by dental experts in recent years. The number of risk factors identified by each study depended on and was limited by the parameters set by researchers, when information was documented about individual patients. For example, some studies collected data about dietary habits while others did not. That’s why we have combined the results of several studies to include as many key factors as possible in order to compile the lists below.

Why is risk assessment important?

Risk assessment studies are useful to assist individuals in understanding their risk for tooth loss (or any other medical condition) in the future, whether or not they have experienced the condition in the past.

In some cases, a risk factor cannot be changed due to physical or biological reasons, such as age or gender. Having these risk factors doesn’t automatically mean that you will lose your teeth. As long as you maintain your oral health with proper oral care and regular preventative dental visits, you can help avoid gum disease and other causes of tooth loss. On the other hand, behavioural and lifestyle risk factors can be modified and/or eliminated which can significantly reduce your risk of tooth loss.

The more risk factors you have, the higher your chances of experiencing tooth loss, and vice-versa. You can use the list below to assess your modifiable risk factors, and if you work to manage and keep them as low as possible, then you can help avoid gum disease and increase your chances of keeping more of your natural teeth longer.

Physical and biological risk factors for tooth loss

  • Age – over 35 years
  • Male gender
  • Anterior (front) teeth are more susceptible to gum disease than molars (back teeth)
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      Modifiable risk factors that can be modified, treated or managed:

    • Lack of professional oral care and maintenance by a dentist
    • Inadequate home oral care (e.g. never using a toothbrush)
    • Long-term plaque, calculus and gingivitis
    • Attachment loss (i.e. degeneration of tooth support tissues and ligaments)
    • Tooth grinding (Bruxism)
    • Consumption of sweets
    • Poor nutrition
    • Certain medical conditions (including hypertension/high blood pressure, diabetes and rheumatoid arthritis)
    • Systemic and marginal bone loss
    • Smoking
    • Lower income and education level



    Al-Shammari, K. F., Al-Khabbaz, A. K., Al-Ansari, J. M., Neiva, R., & Wang, H. (2005). Risk Indicators for Tooth Loss Due to Periodontal Disease. Journal of Periodontology, 76(11), 1910-1918. doi:10.1902/jop.2005.76.11.1910
    Atieh, M. A. (2008). Tooth loss among Saudi adolescents: social and behavioural risk factors. International Dental Journal, 58(2), 103-108. doi:10.1111/j.1875-595x.2008.tb00184.x
    Bahrami, G., Vaeth, M., Kirkevang, L., Wenzel, A., & Isidor, F. (2008). Risk factors for tooth loss in an adult population: a radiographic study. Journal of Clinical Periodontology, 35(12), 1059-1065. doi:10.1111/j.1600-051x.2008.01328.x
    Botero, J. E., Yepes, F. L., Roldán, N., Castrillón, C. A., Hincapie, J. P., Ochoa, S. P., … Contreras, A. (2012). Tooth and Periodontal Clinical Attachment Loss Are Associated With Hyperglycemia in Patients With Diabetes. Journal of Periodontology, 83(10), 1245-1250. doi:10.1902/jop.2012.110681
    Burt, B., Ismail, A., Morrison, E., & Beltran, E. (1990). Risk Factors for Tooth Loss Over a 28-year Period. Journal of Dental Research, 69(5), 1126-1130. doi:10.1177/00220345900690050201
    Hirotomi, T., Yoshihara, A., Ogawa, H., & Miyazaki, H. (2011). Tooth-related risk factors for tooth loss in community-dwelling elderly people. Community Dentistry and Oral Epidemiology, 40(2), 154-163. doi:10.1111/j.1600-0528.2011.00648.x
    Locker, D., Ford, J., & Leake, J. (1996). Incidence of and Risk Factors for Tooth Loss in a Population of Older Canadians. Journal of Dental Research, 75(2), 783-789. doi:10.1177/00220345960750020801