Association between tooth loss-related speech and psychosocial impairment with cognitive function: A pilot study in Hong Kong's older population

Background: Tooth loss has been associated with cognitive decline, but the underlying mechanisms involving speech and psychosocial impairment remain unclear. Objectives: To investigate the impact of tooth loss-related speech and psychosocial impairment on cognitive function in Hong Kong's older population. Methods: Seventy-six Cantonese-speaking participants between the ages of 51–92 were classified into three groups: patients with complete dentures (CD), partially edentulous patients with less than 10 occluding tooth pairs (OU <10), and at least 10 occluding tooth pairs (OU ≥10). Cognitive function was assessed using the Montreal Cognitive Assessment Hong Kong Version, One-minute Verbal Fluency Task and Hayling Sentence Completion Test. Objective and subjective speech assessments were carried out using artificial intelligence speech recognition algorithm and a self-designed speech questionnaire. The impact of tooth loss on psychosocial condition was evaluated by the Reading the Mind in the Eyes Test and a self-designed questionnaire. Statistical analyses (one-way ANOVA, ANCOVA, Kruskal–Wallis test, Spearman correlation test) were performed. Results: Tooth loss was significantly associated with lower cognitive function (p =.008), speech accuracy (p =.018) and verbal fluency (p =.001). Correlations were found between cognitive function and speech accuracy (p <.0001). No significant difference in tooth loss-related psychosocial impact was found between the three groups. Conclusion: While warranting larger sample sizes, this pilot study highlights the need for further research on the role of speech in the association between tooth loss and cognitive function. The potential cognitive impact of tooth retention, together with its known biological and proprioceptive benefits, supports the preservation of the natural dentition.