The longevity habit that most people overlook: Keeping the teeth you already have

Keeping your own teeth is less about luck than about habits, maintenance, and the quality of care you get along the way. (Irina Bg / Shutterstock.com)Gum disease can have a bigger impact on your overall health than most people imagine. In December 2025, the American Heart Association published an updated scientific statement on periodontal disease and atherosclerotic cardiovascular disease, pointing to epidemiological associations with heart attack, stroke, atrial fibrillation, and heart failure. It described periodontal disease as a chronic inflammatory condition affecting more than 40% of American adults.

Dual board-certified periodontist Dr. Alina Krivitsky told me that dental implants are a great replacement of teeth you're already missing. However, she cautioned, "They are not better than your existing teeth. All effort should be made to save a tooth prior to removing it and replacing it with a dental implant.". I interviewed her about what a natural tooth does that an implant can't, the warning signs that are worth acting on immediately, the daily habits that cause significant damage, and the single change she tells patients to make.

About Our Expert: Alina Krivitsky, DDS, is a dual board-certified periodontist in Brentwood, California. She's a Diplomate of the American Board of Periodontology and the American Board of Oral Implantology and Implant Dentistry, and she also serves as a clinical assistant professor at the Herman Ostrow School of Dentistry of the University of Southern California.

Dental implant model illustrating titanium post insertion into jawbone and crown placement. A natural tooth sits in a ligament with nerve supply. An implant fuses directly to bone.

The differences between a natural tooth and a dental implant are largely structural. Krivitsky explained, "A natural tooth is 'alive.' It has a ligament, nerve and a pulp that provide mobility, feedback and 'proprioception', a fine feeling sensation, which an implant can't provide."

That feedback system is measurable. Research published in Medicina noted that extracting a tooth removes the proprioceptors housed in the periodontal ligament, and that while implant wearers develop a compensating sensitivity known as osseoperception, tactile sensibility with an implant prosthesis remains somewhat reduced compared with natural dentition.

Gum disease now appears in cardiology literature, including a 2025 American Heart Association scientific statement.

"Both heart disease and cognitive decline such as Alzheimer's have been linked to the presence of specific aggressive periodontal pathogens and specifically related to the toxins and the byproducts of the pathogens that will affect the healthy organs. We have today as well, a new hypothesis linking pancreatic cancer to periodontal disease," Krivitsky noted.

A study in Science Advances identified the gum disease pathogen Porphyromonas gingivalis in the brains of Alzheimer's patients and traced the damage to toxic enzymes it secretes, called gingipains, which were found alongside tau tangles. On the cancer question, a 2025 cohort study of 122,000 people published in JAMA Oncology identified three oral periodontal pathogens plus additional bacteria and fungi that together were associated with a more than threefold increase in pancreatic cancer risk. It's important to note, however, that association is not causation, and the AHA statement is explicit that gaps remain.

Bone loss begins as soon as a tooth is removed, which is why grafting at the time of extraction is recommended.

When a tooth is pulled, a lot of people have no idea that it will impact the bone. Krivitsky pointed out, "The only purpose of the jawbone is to hold onto a tooth. Once a tooth is removed, the bone loss starts, that is why we highly recommend a bone graft to be placed in the socket at the time of the extraction, especially if an implant is planned to be placed in the future."

The pace of that loss is well-documented. A systematic review indexed on PubMed found horizontal bone loss of 29% to 63% and vertical bone loss of 11% to 22% within six months of an extraction, with the steepest decline in the first three. The European Federation of Periodontology puts the average at 3.79 mm of horizontal shrinkage and 1.24 mm vertically over that same window.

"Treat your gums with respect and care. The gums, also known scientifically as periodontium, are a live organ that needs to be respected and treated as such," Krivitsky said.

On the question of when to respond to the first symptoms, she stressed, "Immediately, the sooner we act, the easier, the more reversible and predictable the treatment will be, that means less pain and less money as well."

The CDC lists the signals to watch for, including red or tender gums, bleeding, gums pulling away from the teeth, loose or sensitive teeth, painful chewing, and any change in how the teeth fit together when biting. The agency also notes that gum disease frequently becomes serious before a person notices symptoms at all.

Soft bristles twice a day, floss once a day, and a gentler touch than most people use.

"There is a fine line between excellence in home care and overdoing it. We recommend in general that our patients use a soft brush twice a day, floss once a day. and supplement with the mouthwash of their choice," Krivitsky advised.

That lines up with advice from the American Dental Association, which recommends brushing twice daily with a soft-bristled brush, cleaning between the teeth once a day, and replacing a toothbrush every three to four months or sooner once the bristles fray.

A narrative review in the National Library of Medicine database is blunt about the consequences of getting it wrong. It reports that medium or hard bristles, highly abrasive toothpaste, brushing forces above 3 N, and incorrect technique can produce cervical abrasion or gum recession, which in turn can lead to sensitivity.

Implants need the same maintenance natural teeth do, and roughly one in five patients develops peri-implantitis.

"It is never too late to protect your remaining dentition and improve their condition. Good oral hygiene habits will carry on the implants maintenance and improve their long term outcome," Krivitsky offered. "Tooth loss is not age dependent; it is habit dependent."

Federal data points the same direction. The CDC reports that complete tooth loss among adults 65 and older fell from roughly 29% at the turn of the century to about 13% by 2015 to 2018, a shift driven by care and prevention rather than by any change in how people age.

One annual periodontal evaluation is the habit she recommends above all others.

"Visit your periodontist at least once per year to get a general oral health condition evaluation," Krivitsky urged. The CDC makes the same point, noting that a yearly dental checkup allows for early detection and treatment of gum disease; that way, you'll catch problems when they are still reversible.

Dr. Alina Krivitsky, DDS, dual board-certified periodontist and clinical assistant professor at the Herman Ostrow School of Dentistry of USC.

Dr. Alina Krivitsky graduated with a BS in dental hygiene, a DDS, and a certificate in advanced periodontics from the USC School of Dentistry. She is a Diplomate of the American Board of Periodontology and a Diplomate of the American Board of Oral Implantology and Implant Dentistry, a Fellow of the International College of Dentists, and a Fellow of the American Academy of Esthetic Dentistry. The Society of Periodontology and the USC Research Committee recognized her for outstanding achievement and contribution to the field of periodontics. She is a clinical assistant professor at the Herman Ostrow School of Dentistry of USC in the Department of Advanced Periodontics and a lecturer for the dental hygiene program, and she serves on the committee for Friends of Dentistry and the Board of Councilors. She also serves as an expert advisor for Surviving Beautifully, a book and online resource dedicated to helping people manage beauty-related challenges during and after cancer treatment. Dr. Krivitsky maintains a private practice limited to periodontics and reconstructive implant dentistry in Brentwood, California, and she lectures nationally and internationally.

Please Note: This article is here to make your next dental appointment a more informed one, not to replace personalized advice from a licensed dentist, periodontist, or physician. Every mouth is different, and only a hands-on exam with radiographs can determine whether a specific tooth can be saved. If you're noticing bleeding gums, looseness, or pain, please reach out to a qualified dental professional rather than waiting to see whether it resolves on its own.

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