Reports & Studies

Social participation in society even without teeth?

PD Dr. Kristina Bertl, PhD MSc MBA

The population in Europe is ageing. In 2022, around 21% of the population was aged 65 or over, and this figure is estimated to reach approx. 30% in 2050. It is therefore all the more important that in the older segment of the population too, as many people as possible stay in good physical and mental health for as long as possible. Active social participation in society even in old age has numerous positive effects:

  • Greater life expectancy
  • Slower cognitive decline
  • Improved sense of wellbeing
  • Greater independence and autonomy
  • etc.
Social participation in society even without teeth?
Social participation in society even without teeth?

An earlier report (“No teeth, no quality of life?”) showed that tooth loss leads to a deterioration in quality of life in terms of oral health, but also that the replacement of missing teeth can in turn lead to a significant improvement. Teeth are undoubtedly an important part of our life – for eating, talking, laughing and facial expressions – in short, for positive interactions with one another.

However, does tooth loss in old age really result in people withdrawing and losing the confidence to participate in society? This question was investigated by a team of researchers from Japan and England. They examined an extremely large data pool from Japan (Cooray et al. 2023). The team analysed in detail the data from nearly 25,000 Japanese men and women over a period of six years; all participants were aged 65 or over. The results showed that the following factors had a negative impact on regular social participation in society:

  • Older age
  • Male sex
  • Lower income
  • Low educational attainment
  • Self-perceived poor health

Taking these factors into account, the study showed that tooth loss or retaining only a few natural teeth led to significantly less regular social participation in society. By contrast, maintaining at least 20 teeth led to a significant improvement in social participation.

This data is based on Japanese citizens, so there are likely to be differences compared with Europe and even within European countries in terms of social participation in society. Nevertheless, this data confirms yet again that teeth are an important part of our body and that their loss can have numerous consequences, of both a physical and mental nature.


  1. U. Cooray, G. Tsakos, A. Heilmann, R.G. Watt, K. Takeuchi, K. Kondo, K. Osaka, J. Aida. Impact of Teeth on Social Participation: Modified Treatment Policy Approach. Journal of Dental Research 2023, Vol. 102(8) 887–894.