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. 2025 Oct 22;37(7-9):69. doi: 10.1007/s44445-025-00080-5

Prevalence and sociodemographic factors associated with tooth loss patterns: A cross-sectional study in Makkah, Saudi Arabia

Rayan Sharka 1, Hassan Abed 2,✉, Wael Ibraheem 3, Ammar Almarghalani 4, Ali Alghamdi 4
PMCID: PMC12545980  PMID: 41123856

Abstract

Tooth loss is a prevalent oral health issue with significant implications for individuals’ quality of life, nutrition, and psychosocial well-being. Despite advancements in preventive dentistry, disparities in tooth loss persist, particularly among socioeconomically disadvantaged populations. This study aimed to examine the association between socio-demographic factors and patterns of tooth loss specifically the number and location of missing teeth among adult patients seeking prosthodontic treatment in Makkah, Saudi Arabia. A cross-sectional study was conducted among 307 adult patients attending prosthodontic clinics. Data were collected through clinical examination combined with short interviews to capture socio-demographic variables (age, gender, education level, income, and nationality) and teeth loss status. Pearson chi-square and fisher exact probability tests were used to assess associations between these variables and both the number and location of missing teeth. Data were analyzed using SPSS 29. Nearly half of the participants (48.9%) had more than two missing teeth, with posterior tooth loss being the most common (76.2%). Age, education level, and income were significantly associated with the number of missing teeth (p < 0.05), while gender and age were significantly associated with the location of missing teeth (p < 0.05). Lower education and income levels were linked to higher rates of tooth loss, and older adults were more likely to have missing teeth in both anterior and posterior regions. This study underscores the need for policymakers to prioritize disadvantaged populations by developing inclusive, cost-effective oral health strategies that address social determinants and support community-based prevention in Makkah and similar regions.

Keywords: Teeth loss, Sociodemographic, Prosthodontics, Oral health, Health disparities, Missing teeth

Introduction

Tooth loss remains a significant public health concern globally (Aida 2021). It negatively affects individuals’ quality of life, nutrition, speech, and mental well-being (Aida 2021). Despite progress in dental prevention and increased public awareness, tooth loss disproportionately affects populations with lower socioeconomic status (Buchwald et al. 2013; Gomes Filho et al. 2019). The World Health Organization (WHO) recognizes oral health as a vital component of general health and overall quality of life (WHO 2024). Prolonged neglect of tooth loss can lead to functional impairments, aesthetic concerns, and social stigma, impacting daily activities and self-esteem (Anbarserri et al. 2020; Sharka et al. 2019; Tan et al. 2016). Also,untreated tooth loss may necessitate complex restorative or prosthodontic interventions due to drifting or overeruption of adjacent teeth (Craddock 2010).

There are various causes of tooth loss, with dental caries and periodontal disease being the most frequently reported etiological factors (Carvalho et al. 2021; Ling and Tao 2016). Additional contributors include dental trauma, systemic conditions, and extractions related to orthodontic treatment (Dardengo et al. 2016; Levin and Zadik 2012). The pattern of tooth loss, including the number of teeth lost and their location in the dental arch, may provide necessary insights into risk factors and the potential impact on oral function. These patterns also help clinicians assess the need for prosthodontic intervention. For instance, anterior tooth loss often affects aesthetics and psychosocial well-being, while posterior tooth loss can impair mastication and influence dietary habits (Sharka 2024).

Previous studies showed that sociodemographic factors such as age, gender, education level, and income have an impact on oral health outcomes (Barbato and Peres 2015; Gabiec et al. 2022; Moussa et al. 2020). These factors may affect health behaviors, access to dental care, dietary habits, and health literacy (Barbato and Peres 2015; Gabiec et al. 2022; Moussa et al. 2020). People with lower incomes often face barriers to preventive and restorative dental services, resulting in delayed treatment and increased tooth extractions (Seerig et al. 2015). Oral health literacy can affect hygiene practices and the likelihood of seeking regular dental care (Li et al. 2025). In healthcare systems where dental services are not fully funded, financial limitations further contribute to disparities in oral health outcomes (Sharka et al. 2025).

These global challenges are also reflected in Saudi Arabia, where oral diseases including tooth loss are increasingly recognized as pressing public health concerns (Alshehri et al. 2021; Gad et al. 2020). The rapid economic growth of the country has influenced the lifestyle and dietary patterns of the public, which contributes to the prevalence of dental caries and periodontal disease (Alsharari et al. 2025; Orfali et al. 2023). Despite the notable efforts to improve healthcare infrastructure, disparities in oral health persist across different regions and population groups.

Makkah City, one of the largest and most culturally significant cities in the country, has a unique demographic with varying socioeconomic backgrounds. Yet, there is a considerable lack of localized data examining the patterns of tooth loss and their association with sociodemographic factors in this region. Previous studies have reported that residents of Makkah perceive a need for enhanced healthcare services, including dental care (Alharbi et al. 2023; Sharka et al. 2025).

Previous research in different parts of Saudi Arabia has shown different rates of tooth loss, often underlining the influences of age and education (Almusallam and AlRafee 2020; Fayad et al. 2016; Gad et al. 2020). A study conducted in Riyadh investigated the prevalence of complete and partial edentulism among adults, focusing on gender, age, and education level (Almusallam and AlRafee 2020). However, it did not account for patients’ economic status or nationality, which are important determinants of oral health. Moreover, the study was limited to private dental centers, potentially affecting the representativeness of the findings (Almusallam and AlRafee 2020). Another study conducted in the northern region investigated the prevalence and patterns of partial edentulism among adult patients attending a dental school. However, the study did not examine the association between these patterns and socio-demographic factors (Fayad et al. 2016). Understanding these associations is essential for designing targeted public health interventions and allocating resources effectively. It also helps identify high-risk groups who may benefit from preventive strategies and early dental care. Therefore, this study aimed to address this gap by analyzing the number and location of missing teeth and their relationship with sociodemographic status among partially dentate adults in Makkah.

Materials and methods

Ethical considerations

This cross sectional study received an ethical approval from Umm Al-Qura University No. HAPO-02-K-012–2023-09–1705.

Study setting and sampling

The study included patients who attended the prosthodontics dental clinical at teaching dental hospital of Umm Al-Qura University, Makkah, Saudi Arabia, from February to September 2024. The sample size was determined using G*Power software (version 3.1.9.7). The analysis assumed a medium effect size (Cohen’s w = 0.3), a significance level (α) of 0.05, and a statistical power of 0.95, reflecting a high probability of detecting a true effect if one exists. These parameters were guided by findings from prior studies with comparable methodologies and populations (Almusallam and AlRafee 2020; Fayad et al. 2016; Gad et al. 2020). The minimum required sample size was estimated to be 220 participants. To account for potential missing data and low responses, the sample size was increased to 334 invitations. A consecutive sampling technique was employed, where all eligible patients attending the dental clinics during the data collection period were invited to participate in the study.

Participants recruitment

The inclusion criteria comprised partially dentate adult patients aged 18 years or older who were capable of providing informed consent and had at least one missing tooth. Patient screening was performed by two trained dental interns, who performed oral examinations in the dental triage clinic to assess the location and number of missing teeth before referring the patients to prosthodontics clinics. At the end of the clinical examination, the participants were asked to answer closed-ended questions related to their sociodemographic: gender, age, monthly income, nationality and level of education.

Statistical analysis

Descriptive statistics, including frequencies and percentages, were used to summarize the characteristics of the study variables. The gender, age, nationality and level of education variables were binary categorized. The monthly income was classified into three categories: low income < 6000 SAR, middle income 6000–12,000 SAR, and high income > 12000 SAR based on Saudi General Authority for Statistics (http://www.stats.gov.sa/). To assess associations between categorical variables, the Pearson chi-square test was applied. In cases where expected cell counts were too low to meet chi-square assumptions, the Fisher’s Exact Test was used and both p-values and 95% confidence intervals were reported. A p-value less than 0.05 was considered statistical significance. All data were analyzed using IBM SPSS Statistics version 29 for Windows.

Results

Participants characteristics

A total of 307 participants agreed and were included in the study, yielding a response rate of 91.9%. The majority of participants were female 189 (61.6%), while male participants accounted for 118 (38.4%). In terms of age distribution, 118 participants (38.4%) were between 19 and 39 years, and 189 participants (61.6%) were aged 40 years and above. Figure 1 illustrates the demographics of the participants.

Fig. 1.

Fig. 1

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The demographic distribution of participants

Pattern of tooth loss

In terms of dental status, 83 (27.0%) participants had one missing tooth, 74 (24.1%) had two missing teeth, and 150 (48.9%) had more than two missing teeth. The location of missing teeth was predominantly in the posterior region 234 (76.2%), while 12 (3.9%) participants had missing anterior teeth only, and 61 (19.9%) had missing teeth in both anterior and posterior regions.

Associations between sociodemographic variables and number of missing teeth

Age was significantly associated with the number of missing teeth (χ2(2) = 11.167, p = 0.004). Participants aged 40 years and above were more likely to have more than two missing teeth (56.1%) compared to those aged 19–39 years (37.3%), (Table 1). The odds of having more than two missing teeth were significantly higher in the older age group (OR = 2.15, 95% CI: [1.34, 3.44]).

Table 1.

The association between socio-demographic variables and number of missing teeth

Number of missing teeth 1 missing tooth
N (%)		 2 missing teeth
N (%)		 More than 2 missing teeth
N (%)		 Total
N (%)		 P value
Gender
  Male 38 (32.2) 28 (23.7) 52 (44.1) 118 (38.4) 0.246
  Female 45 (23.8) 46 (24.3) 98 (51.9) 189 (61.6)
Age
  19–39 years old 42 (35.6) 32 (27.1) 44 (37.3) 118 (38.4) 0.004*
  40 and above 41 (21.7) 42 (22.2) 106 (56.1) 189 (61.6)
Level of education
  School level/below 20 (17.2) 31 (26.7) 65 (56.0) 116 (37.8) 0.011*
  University degree/above 63 (33.0) 43 (22.5) 85 (44.5) 191 (62.2)
Monthly income
  Low 35 (24.1) 33 (22.8) 77 (53.1) 145 (47.2)  < 0.001*
  Middle 8 (12.5) 23 (35.9) 33 (51.6) 64 (20.8)
  High 40 (40.8) 18 (18.4) 40 (40.8) 98 (31.9)
Nationality
  Saudi 68 (28.9) 51 (21.7) 116 (49.4) 235 (76.5) 0.150
  Non-Saudi 15 (20.8) 23 (31.9) 34 (47.2) 72 (23.5)
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*P < 0.05

Education level also showed a significant association (χ2(2) = 9.111, p = 0.011); individuals with a school-level education or below had a higher prevalence of multiple missing teeth (56%) than those with a university-level education or higher (44.5%), (Table 1). The odds of having more than two missing teeth were higher among those with lower education (OR = 1.59, 95% CI: [1.00, 2.53]).

Similarly, monthly income was significantly associated with the number of missing teeth (χ2(4) = 19.428, p < 0.001), with lower-income participants more likely to report more than two missing teeth (53.1%) compared to those with high income (40.8%), (Table 1). The odds of having more than two missing teeth were also higher among low-income individuals (OR = 1.64, 95% CI: [0.98, 2.76]).

In contrast, gender and nationality variables were not significantly associated with the number of missing teeth (p = 0.246 and p = 0.150, respectively) (Table 1).

Associations between sociodemographic variables and location of missing teeth

Regarding the location of missing teeth, gender was significantly associated (χ2(2) = 9.164, p = 0.010). Among males, 66.9% had missing posterior teeth, 5.1% had missing anterior teeth, and 28.0% had missing teeth in both regions. In comparison, 82.0% of females had missing posterior teeth, 3.2% had anterior tooth loss, and 14.8% had missing teeth in both regions (Table 2). The odds of males having posterior versus both-region tooth loss were significantly lower than those of females (OR = 0.43, 95% CI: [0.24, 0.77]).

Table 2.

The association between socio-demographic variables and location of missing teeth

Location of missing teeth Posterior teeth
N (%)		 Anterior teeth
N (%)		 Both
N (%)		 Total
N (%)		 P value
Gender
  Male 79 (66.9) 6 (5.1) 33 (28.0) 118 (38.4) 0.010
  Female 155 (82) 6 (3.2) 28 (14.8) 189 (61.6)
Age
  19–39 years old 103 (87.3) 3 (2.5) 12 (10.2) 118 (38.4)  < 0.001*
  40 and above 131 (69.3) 9 (4.8) 49 (25.9) 189 (61.6)
Level of education
  School level/below 85 (73.3) 2 (1.7) 29 (25) 116 (37.8) 0.084
  University degree/above 149 (78.0) 10 (5.2) 32 (16.8) 191 (62.2)
Monthly income
  Low 110 (75.9) 4 (2.8) 31 (21.4) 145 (47.2) 0.700
  Middle 51 (79.7) 2 (3.1) 11 (17.2) 64 (20.8)
  High 73 (74.5) 6 (6.1) 19 (19.4) 98 (31.9)
Nationality
  Saudi 173 (73.6) 12 (5.1) 50 (21.3) 235 (76.5) 0.062
  Non-Saudi 61 (84.7) 0 (0.0) 11 (15.3) 72 (23.5)
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*P < 0.05

Age was also significantly associated with the location of missing teeth (χ2(2) = 13.072, p < 0.001). Participants aged 19–39 years predominantly exhibited posterior tooth loss (87.3%), while those aged 40 and above had a higher proportion of missing teeth in both anterior and posterior regions (25.9%). The odds of younger participants (19–39 years) having posterior versus both-region tooth loss were significantly higher than those aged 40 and above (OR = 3.21, 95% CI: [1.62, 6.35]). However, education level, monthly income, and nationality were not significantly associated with the location of missing teeth (p > 0.05) (Table 2).

Discussion

This study examined the association between tooth loss and sociodemographic characteristics among partially dentate adult patients seeking prosthodontic treatment. The participants of this study had a high proportion of tooth loss, with nearly half reporting more than two missing teeth. This high prevalence probably reflects the cumulative impact of oral health challenges over time. Factors such as limited access to dental services, suboptimal oral hygiene practices, and delayed treatment-seeking behaviors may contribute to such high percentages (Bersell 2017; Sharka et al. 2025). Additionally, the distribution of tooth loss was also common which supports findings from previous studies that highlight the persistent burden of tooth loss in adult populations, particularly in settings where preventive dental care is underutilized or inaccessible (Davis et al. 2022).

Also, the findings showed that the majority of missing teeth were found in the posterior region. This pattern of teeth loss is consistent with the functional role of posterior teeth, which might be more susceptible to caries and functional wear due to their natural involvement in mastication. However, the lower prevalence of anterior tooth loss may also highlight that patients seek treatment when they lose posterior teeth and do not prioritize aesthetic concerns for anterior teeth. This finding in line with a previous study conducted in the Eastern Province of Saudi Arabia, which reported that most patients seeking removable partial dentures presented with Kennedy class I classification (Gad et al. 2020).

Age was significantly associated with the number and location of missing teeth, with participants aged 40 years and older more likely to have lost multiple teeth. This finding is consistent with the well-established relationship between aging and cumulative oral health deterioration (Holm-Pedersen et al. 2008; Renvert et al. 2013) The increased prevalence of tooth loss in older adults may be attributed to the long-term effects of dental caries, periodontal disease, and reduced access to preventive care earlier in life. These results are in line with the global trends, where both biological and behavioral factors such as declining oral hygiene, chronic disease burden, and reduced dental service utilization contribute to increased tooth loss with age (Lee et al. 2022).

Moreover, socioeconomic factors, particularly education level and monthly income, also appeared as significant predictors of tooth loss. Participants with lower educational attainment and income levels were more likely to have multiple missing teeth. These results agree with previous studies that reported that such socioeconomic factors lead to discrepancies in access to dental care, oral health literacy, and the ability to afford preventive and restorative treatments (Nazer and Sabbah 2018). These findings fortify the theory of a social gradient in oral health, where individuals from underprivileged backgrounds experience a disproportionate burden of disease (Steele et al. 2015). Also, gender was significantly associated with the location of missing teeth. Males were more likely to have missing teeth in both anterior and posterior regions, whereas females mainly had posterior tooth loss. Previous studies have shown that men are more likely to delay dental visits and have higher rates of untreated dental conditions compared to women (Lipsky et al. 2021; Su et al. 2022).

In the present study, gender and nationality were not found to be significantly associated with the number of missing teeth, suggesting that these variables may not be strong predictors of tooth loss within this population. This finding aligns with previous research conducted in Riyadh, which similarly reported no significant differences in tooth loss based on gender or nationality (Almusallam and AlRafee 2020). Moreover, Although education level, monthly income, and nationality were not significantly associated with the location of missing teeth, it is still important to consider the observed trends. Individuals with a school-level education or below had a slightly higher proportion of missing teeth in both anterior and posterior regions compared to those with a university-level education or higher. This pattern may reflect underlying disparities in oral health awareness, access to preventive care, or utilization of dental services (Gomes et al. 2015).

Similarly, participants with lower income levels exhibited a marginally higher prevalence of missing teeth in both anterior and posterior regions compared to those with higher income. Individuals with limited financial resources may delay or avoid dental visits, leading to more extensive tooth loss that affects multiple regions (Sharka et al. 2025). While the current data do not confirm a statistically significant relationship, the trend suggests that socioeconomic status may influence the extent and distribution of tooth loss.

A noteworthy strength of this study is its focus on a clinical population, which enhances the applicability of the findings to everyday dental practice. By incorporating a broad range of sociodemographic variables, including age, gender, education level, income, and nationality, the study provides a comprehensive overview of potential factors influencing tooth loss. This multidimensional approach allows clinicians to better understand the social determinants of oral health and tailor preventive strategies accordingly. For example, recognizing patterns of tooth loss among specific demographic groups may support more targeted patient education, early intervention, and resource allocation in clinical settings.

Despite these strengths, the study has several limitations. Notably, it did not account for key medical and behavioral risk factors such as diabetes, smoking, and other systemic health conditions, which are known to significantly influence oral health outcomes. Additionally, the presence and severity of periodontal disease, a major contributor to tooth loss, were not assessed, limiting the ability to fully capture the multifactorial nature of tooth loss. Another important limitation is the potential for selection bias, as the study was conducted at a single center and the exact duration of residency of the population in Makkah was not recorded. This may restrict the generalizability of the findings to broader populations, particularly those with different socioeconomic or cultural backgrounds. Future research should aim to include a wider range of clinical and behavioral variables and consider multi-center designs to enhance external validity.

Conclusion

This study underscores the need for targeted oral health strategies that address social determinants of tooth loss. The findings support the development of community-based preventive programs and suggest that integrating sociodemographic screening into routine dental care could help identify high-risk individuals and guide resource allocation in Makkah and similar settings.

Acknowledgements

The authors extend their appreciation to Umm Al-Qura University, Saudi Arabia for funding this research work through grant number: 25UQU4350291GSSR02.

Author contributions

R.S. contributed to the study conception, design, and manuscript drafting. H. A. was responsible for data collection and clinical coordination. W. I. performed statistical analysis and contributed to data interpretation. A. Almarghalani and A. Alghamdi assisted in patient recruitment, clinical procedures, and manuscript revision. All authors reviewed and approved the final version of the manuscript.

Funding

This research project was funded by Umm Al-Qura University, Saudi Arabia under grant number: 25UQU4350291GSSR02.

Data availability

The datasets analyzed during the current study are not publicly available due to participant confidentiality ethical, but are available from the corresponding author on reasonable request.

Declarations

Ethics approval

The study approved from Umm Al-Qura University (clearance No. HAPO-02-K-012–2023-09–1705).

Informed consent

A written consent was obtained from each participant before clinical examination.

Competing interests

The authors declare that they have no competing interests.

Footnotes

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

  1. Aida J (2021) Tooth Loss, In: Peres MA, Antunes JLF, Watt, RG (eds) Oral Epidemiology. Textbooks in Contemporary Dentistry. 1st edn. Springer International Publishing, Cham, 223–233. 10.1007/978-3-030-50123-5_13
  2. Alharbi KK, Alzahrani AMA, Aldadi MMJ, Basisi AMM, Alshareef AMA, Alghamdi RAM, Aldebane NTS, Zamzami JMS (2023) Assessment of community health needs in Makkah: a qualitative study. Indian J Med Sci 75:174–180. 10.25259/IJMS_82_2023 [Google Scholar]
  3. Almusallam SM, AlRafee MA (2020) The prevalence of partial edentulism and complete edentulism among adults and above population of Riyadh city in Saudi Arabia. J Family Med Prim Care 9:1868–1872. 10.4103/jfmpc.jfmpc_1209_19 [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Alsharari T, Felemban MF, Khattak O, Algahtani FS, Alzahrani A (2025) Periodontal disease in Saudi Arabia: a systematic review of prevalence and associated risk factors. Diagnostics 15:812. 10.3390/diagnostics15070812 [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Alshehri MD, Alqahtani WM, Asiri EM, Asiri MN (2021) Awareness to consequences of teeth missing and prosthodontics treatment options among people of Aseer region, Saudi Arabia. J Fam Med Prim Care 10:307–311. 10.4103/jfmpc.jfmpc_1621_20 [Google Scholar]
  6. Anbarserri NM, Ismail KM, Anbarserri H, Alanazi D, AlSaffan AD, Baseer MA, Shaheen R (2020) Impact of severity of tooth loss on oral-health-related quality of life among dental patients. J Fam Med Prim Care 9:187–191. 10.4103/jfmpc.jfmpc_909_19 [Google Scholar]
  7. Barbato PR, Peres KG (2015) Contextual socioeconomic determinants of tooth loss in adults and elderly: a systematic review. Rev Bras Epidemiol 18:357–371. 10.1590/1980-5497201500020006 [DOI] [PubMed] [Google Scholar]
  8. Bersell CH (2017) Access to oral health care: a national crisis and call for reform. Am Dent Hyg Assoc 91:6–14 [Google Scholar]
  9. Buchwald S, Kocher T, Biffar R, Harb A, Holtfreter B, Meisel P (2013) Tooth loss and periodontitis by socio-economic status and inflammation in a longitudinal population-based study. J Clin Periodontol 40:203–211. 10.1111/jcpe.12056 [DOI] [PubMed] [Google Scholar]
  10. Carvalho R, Botelho J, Machado V, Mascarenhas P, Alcoforado G, Mendes JJ, Chambrone L (2021) Predictors of tooth loss during long-term periodontal maintenance: an updated systematic review. J Clin Periodontol 48:1019–1036. 10.1111/jcpe.13488 [DOI] [PubMed] [Google Scholar]
  11. Craddock HL (2010) Consequences of tooth loss: 2. dentist considerations – restorative problems and implications. Dent Update 37:28–32. 10.12968/denu.2010.37.1.28 [DOI] [PubMed] [Google Scholar]
  12. Dardengo CS, Fernandes LQP, Capelli Júnior J (2016) Frequency of orthodontic extraction. Dent Press J Orthod 21:54–59. 10.1590/2177-6709.21.1.054-059.oar [Google Scholar]
  13. Davis J, Liu M, Kao D, Gu X, Cherry-Peppers G (2022) Using GIS to analyze inequality in access to dental care in the District of Columbia. AMA J Ethics 24:E41–E47. 10.1001/amajethics.2022.41 [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Fayad MI, Baig MN, Alrawaili AM (2016) Prevalence and pattern of partial edentulism among dental patients attending College of Dentistry, Aljouf University, Saudi Arabia. J Int Soc Prev Community Dent 6:S187–S191. 10.4103/2231-0762.197189 [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Gabiec K, Bagińska J, Łaguna W, Rodakowska E, Kamińska I, Stachurska Z, Dubatówka M, Kondraciuk M, Kamiński KA (2022) Factors associated with tooth loss in general population of Bialystok, Poland. Int J Environ Res Public Health 19:2369. 10.3390/ijerph19042369 [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Gad MM, Abualsaud R, Al-Thobity AM, Al-Abidi KS, Khan SQ, Abdel-Halim MS, Al-Harbi FA, El Zayat M, Fouda SM (2020) Prevalence of partial edentulism and RPD design in patients treated at College of Dentistry, Imam Abdulrahman Bin Faisal University, Saudi Arabia. Saudi Dent J 32:74–79. 10.1016/j.sdentj.2019.07.002 [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Gomes AP, Silva E, Gonçalves S, Huhtala M, Martinho F, Gonçalves S, Torres C (2015) Relationship between patient’s education level and knowledge on oral health preventive measures. Int Dent Med J Adv Res 1:1–7. 10.15713/ins.idmjar.6 [Google Scholar]
  18. Gomes Filho VV, Gondinho BVC, Silva-Junior MF, Cavalcante DFB, Bulgareli JV, Sousa MLR, Frias AC, Batista MJ, Pereira AC (2019) Tooth loss in adults: factors associated with the position and number of lost teeth. Rev Saúde Pública 53:105. 10.11606/S1518-8787.2019053001318 [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Holm-Pedersen P, Schultz-Larsen K, Christiansen N, Avlund K (2008) Tooth loss and subsequent disability and mortality in old age. J Am Geriatr Soc 56:429–435. 10.1111/j.1532-5415.2007.01602.x [DOI] [PubMed] [Google Scholar]
  20. Lee H, Kim D, Jung A, Chae W (2022) Ethnicity, social, and clinical risk factors to tooth loss among older adults in the U.S., NHANES 2011–2018. Int J Environ Res Public Health 19:2382. 10.3390/ijerph19042382 [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Levin L, Zadik Y (2012) Education on and prevention of dental trauma: it’s time to act! Dent Traumatol 28:49–54. 10.1111/j.1600-9657.2011.01060.x [DOI] [PubMed] [Google Scholar]
  22. Li J, Chen Y, Liu F, Yan W (2025) Oral health literacy and oral health outcomes among older people: a cross-sectional study. BMC Public Health 25:732. 10.1186/s12889-025-21965-4 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Ling Z, Tao H (2016) Dental caries and systemic diseases. In: Xuedong Z (ed) Dental Caries: Principles and Management. Springer, Berlin, Heidelberg, 129–155. 10.1007/978-3-662-47450-1_8
  24. Lipsky MS, Su S, Crespo CJ, Hung M (2021) Men and oral health: a review of sex and gender differences. Am J Mens Health 15:15579883211016360. 10.1177/15579883211016361 [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Moussa A, Ibrahim E, Esmat A, Eissa S, Ramzy M (2020) An overview of oral health status, socio-economic and behavioral risk factors, and the pattern of tooth loss in a sample of Egyptian rural population. Bull Natl Res Cent 44:16. 10.1186/s42269-020-0268-6 [Google Scholar]
  26. Nazer FW, Sabbah W (2018) Do socioeconomic conditions explain ethnic inequalities in tooth loss among US adults? Ethn Dis 28:201–206. 10.18865/ed.28.3.201 [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Orfali SM, Alrumikhan AS, Assal NA, Alrusayes AM, Natto ZS (2023) Prevalence and severity of dental caries in school children in Saudi Arabia: a nationwide cross-sectional study. Saudi Dent J 35:969–974. 10.1016/j.sdentj.2023.09.008 [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Renvert S, Persson RE, Persson GR (2013) Tooth loss and periodontitis in older individuals: results from the Swedish National Study on Aging and Care. J Periodontol 84:1134–1144. 10.1902/jop.2012.120378 [DOI] [PubMed] [Google Scholar]
  29. Seerig LM, Nascimento GG, Peres MA, Horta BL, Demarco FF (2015) Tooth loss in adults and income: systematic review and meta-analysis. J Dent 43:1051–1059. 10.1016/j.jdent.2015.07.004 [DOI] [PubMed] [Google Scholar]
  30. Sharka R (2024) Psychometric properties of the Arabic version of the perceived prosthodontic treatment need scale: exploratory and confirmatory factor analyses. PLoS ONE 19:e0298145. 10.1371/journal.pone.0298145 [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Sharka R, Abed H, Hector M (2019) Oral health-related quality of life and satisfaction of edentulous patients using conventional complete dentures and implant-retained overdentures: an umbrella systematic review. Gerodontology 36:195–204. 10.1111/ger.12399 [DOI] [PubMed] [Google Scholar]
  32. Sharka R, Alghamdi M, Dustakir E, Alghamdi M (2025) Developing and validating a scale to measure perceived barriers to prosthodontics treatments among partially edentulous patients. Front Oral Health. 10.3389/froh.2024.1517574 [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Steele J, Shen J, Tsakos G, Fuller E, Morris S, Watt R, Guarnizo-Herreño C, Wildman J (2015) The interplay between socioeconomic inequalities and clinical oral health. J Dent Res 94:19–26. 10.1177/0022034514553978 [DOI] [PubMed] [Google Scholar]
  34. Su S, Lipsky MS, Licari FW, Hung M (2022) Comparing oral health behaviours of men and women in the United States. J Dent 122:104157. 10.1016/j.jdent.2022.104157 [DOI] [PubMed] [Google Scholar]
  35. Tan H, Peres KG, Peres MA (2016) Retention of teeth and oral health–related quality of life. J Dent Res 95:1350–1357. 10.1177/0022034516657992 [DOI] [PubMed] [Google Scholar]
  36. WHO (2024) Oral health. In: Health topics. Available via https://www.who.int/health-topics/oral-health Accessed 12 August 2025

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The datasets analyzed during the current study are not publicly available due to participant confidentiality ethical, but are available from the corresponding author on reasonable request.

Articles from The Saudi Dental Journal are provided here courtesy of Springer

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