The most immediate downside of a missing tooth to most people is the appearance. Having a gap where a tooth used to be can affect first impressions, resulting in difficulties with everything from dating to landing a job interview.

But beyond the superficial, there are series health complications associated with missing teeth. These can be significantly more severe than many expect.

Here are five surprising health risks of tooth loss.

Increased Risk of Malnutrition

People who are missing all of their teeth and require dentures are at a significantly increased risk of dying prematurely from malnutrition.

Newswire reported in 2012 that elderly patients with less than 22 teeth remaining died ten years earlier on average, largely due to malnutrition.

Removable dentures don’t allow patients to eat regular food. Due to the lack of teeth, the jaw bone itself starts to deteriorate. In 15 years of wearing dentures, a patient’s bite force can decrease by a staggering 97%.

Increased Risk of Further Tooth Loss

Broken teeth beget broken teeth.

When we lose a tooth, it’s natural to start chewing more where there are more teeth. Say you lose a premolar on the left side of your jaw; this may make you chew more on the right side.

Doing this puts extra strain on those teeth, which can lead to them chipping and cracking. This in turn can lead to infection, abscesses — or even needing to remove those teeth.

Increased Risk of Cardiovascular Disease

There is a known, well-documented link between infections in the mouth, and increased risk of cardiovascular teeth.

Periodontal disease in particular is an advanced form of gum disease that attacks the bone around the root of a tooth. This condition, left untreated, can result in the loss of a tooth — and make you more susceptible to having cardiovascular problems.

Loss of Jaw Bone Volume

The roots of our teeth keep our jaw bones “filled” and help them maintain their shape. When teeth are lost, the socket where the roots once sat are left empty. Over time, the jaw bone will collapse into these pockets.

This has many side effects:

•  Shrinking of the jaws

•  Weakening of bite strength

•  Tipping of adjacent teeth into the gap

•  Reshaping of the face, leading to premature aging as the face shrinks

Increased Cancer Risk

As with cardiovascular disease, periodontal disease — the leading cause of tooth loss — also poses an increased risk of certain cancers.

These include:

•  Oral cancer

•  Throat cancer

•  Lung cancer

•  Upper gastrointestinal cancers

•  Pancreatic cancer

Most of these concerns can be prevented through proper oral hygiene and frequent visits to the dentist. Where problems are caused by the loss of a tooth, dental implants are the best bet for replacing the missing teeth.

Dental implants:

•  Preserve bone volume

•  Prevent teeth tipping

•  Preserve bite strength

•  Preserve or improve aesthetics