Tooth loss: does it affect dietary intake and nutritional status?

A Mediterranean diet high in fruits, vegetables, fish and wholegrains has been associated with decreased depression. Is there a key ingredient?

Mastication is a key function of teeth and tooth loss reduces masticatory function and chewing ability. This can lead to a reduction of food choice and variation in the diet.   A good diet is important for a health life and studies have been conducted on the interrelationship between tooth loss, diet and nutritional status.

The aim of this review was to assess the longitudinal evidence on whether tooth loss affects dietary intake and nutritional status among adults.


Searches were conducted in the Medline, Embase, LILACS, OpenGrey and Google Scholar databases. Longitudinal studies of population-based or clinical samples of adults exploring the effect of tooth loss on food/dietary/nutrient intake and/or nutritional status were considered.  Two reviewers independently selected studies abstracted data and assessed study quality using the Newcastle-Ottawa Scale for cohort studies.Meta-analysis was not carried out because of the high level of heterogeneity a narrative summary was presented.


  • 10 reports of 8 cohort studies were included.
  • 5 studies were subsets of population –based cohorts.
  • Sample sizes ranged from 134 to 59,467 and age varied from 30 to 65+ years.
  • 7 studies were considered to be of poor quality, 1 of fair quality.
  • There was considerable variation across the studies in terms of both the exposure and outcomes
  • 5 studies reported the association between tooth loss and nutrient intake, 4 showed some significant associations, although results were inconsistent across measures of tooth loss and food intake.
  • 4 studies reported the association between tooth retention and nutritional status, 3 studies showed some significant associations. However, results were contradictory.


The authors concluded: –

This systematic review indicates there is weak evidence on the association of tooth loss with nutrient intake and nutritional status. Inconsistent findings were reported across the 8 longitudinal studies identified. The only consistent association, as reported in two studies, was for greater self-reported tooth loss and small decreases in dietary cholesterol. Additional high-quality longitudinal studies should address the limitations of previous studies identified in this review.


The authors have searched a number of databases and only including prospective studies which in theory would provide good observational evidence. However, the   included studies were of low quality in part due to the marked variability in the way in which both exposures and outcomes were measured.  This means that while the review helpfully summarises the available data the findings are weak and inconsistent and further high quality studies are needed.


Primary paper

Gaewkhiew P, Sabbah W, Bernabé E. Does Tooth Loss affect Dietary Intake and Nutritional Status? A Systematic Review of Longitudinal Studies. J Dent. 2017 Oct 30. pii: S0300-5712(17)30264-6. doi: 10.1016/j.jdent.2017.10.012. [Epub ahead of print] Review. PubMed PMID: 29097121.

Other references

Original review protocol on PROSPERO








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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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