Dental experts are warning that age-based assumptions are denying millions of over-65s a fair conversation about their dental options, with new national data revealing the scale of untreated dental disease in older adults across England.
According to new data, 93% of all dentate adults show at least one sign of periodontal disease, the bacterial gum infection that, left untreated, destroys the bone and tissue supporting the teeth and is one of the leading causes of tooth loss in adults.
Yet despite that scale of need, experts say older patients are still routinely being steered towards dentures without implants ever being raised, often because of their age alone.
The fresh data also reveals that nine in 10 adults over the age of 75 in England still have their own teeth, according to the Adult Oral Health Survey 2023, published by the Office for Health Improvement and Disparities in December 2025. In 1978, more than three quarters (78%) of adults aged 65 and over had lost all of their natural teeth.
By 2023, that figure had fallen to just four per cent among 65 to 74-year-olds and 11% among those aged 75 and over. Half of all adults over the age of 75 now retain at least 21 natural teeth, which is the clinical threshold associated with a functional bite, better nutrition and improved quality of life.
However, those teeth are under significant pressure. Twenty-eight per cent of dentate adults aged 75 and over have extensive obvious tooth decay, and the survey found that periodontal disease, which can develop silently over years without pain, affects the vast majority of adults regardless of age. Left unmanaged, it leads directly to tooth loss.
Yet when that tooth loss occurs, experts warn the conversation about how to restore it is not always being had fairly.
“There is no clinical guideline that sets an upper age limit on dental implants,” says Dr Bhavika Parekh, General Dental Surgeon at Smile n Shine. “What we assess is bone density, general health, lifestyle and medications, the same criteria we apply to any patient. Implants are not right for everyone, and there are absolutely cases where dentures remain the better clinical choice. But that decision should always follow a proper individual assessment, never an assumption about age.”
The problem is compounded by an access crisis already stretching NHS dentistry thin. More than six in 10 adults in England were not seen by an NHS dentist in the two years to June 2025, meaning many older adults are not receiving the routine care that catches periodontal disease and decay before they progress.
“If older patients are struggling to access routine care and then not being given a fair hearing when they need restorative treatment, we are compounding inequality at every stage,” Dr Parekh said. “Every patient deserves a proper conversation about their options. That does not stop at 65.
“Clinical guidance is clear that implant suitability should be determined by bone quality, systemic health, medications and the patient’s own priorities, not their age alone. For any older adult who has been told dentures are their only option, asking whether implants have been properly assessed is a reasonable and informed question to raise.”
