Reports & Studies

No teeth, no quality of life?

PD Dr. Kristina Bertl, PhD MSc MBA

Stage IV periodontitis is, by definition, associated with tooth loss and/or the need for extensive rehabilitation. Tooth loss and periodontitis each lead to a deterioration in quality of life in terms of oral health. It can also lead to problems with food intake, speaking, sunken cheeks and/or loss of vertical face height. It is therefore pertinent to ask whether this loss of quality of life can be compensated for with appropriate treatment and rehabilitation.

No teeth, no quality of life?
No teeth, no quality of life?

An Italian-Croatian research group recently examined this (Gennai et al. 2022). The group considered the following question in detail: Can rehabilitation and replacement of missing teeth in patients with some or all of their teeth missing and stage IV periodontitis improve quality of life in relation to oral and/or general health?

The authors identified 59 publications with around 6,700 patients on this subject, but these did not specifically relate to patients with stage IV periodontitis. This, in turn, means that the following conclusions relate more generally to patients with some or all of their teeth missing:

  • Replacement of missing teeth leads to a significant improvement in quality of life relating to oral health.
  • This improvement is largely independent of the number and location of the teeth missing or in need of replacement, and also of the prosthetic treatment selected.
  • Patients with no prosthetic treatment tend to have a worse cognitive status, increased consumption of medication and higher level of frailty.
  • There is a need for studies specifically relating to patients with stage IV periodontitis.

This systematic review therefore shows that our patients can benefit from having their missing teeth replaced for a number of reasons. In light of this, patients suffering from multiple tooth loss should therefore definitely be given a recommendation for rehabilitation of their teeth. In this regard, however, it is also very interesting to know that it doesn’t necessarily have to be a fixed solution, because there was no difference between fixed and non-fixed treatment options when compared as regards improved quality of life relating to oral health.


  1. Gennai, S., Izzetti, R., Pioli, M. C., Music, L., & Graziani, F. (2022). Impact of rehabilitation versus edentulism on systemic health and quality of life in patients affected by periodontitis: A systematic review and meta-analysis. Journal of Clinical Periodontology, 49(Suppl. 24), 328–358.