Background and Objectives: This study aimed to investigate the relationship between lower urinary tract symptoms (LUTS) and tooth loss due to chronic periodontitis. Materials and Methods: A total of 232 patients aged 40 years or older with LUTS were evaluated. The number of remaining teeth and the severity of LUTS were assessed using the overactive bladder symptom score, international prostate symptom score, and urodynamic tests. Statistical analyses, including multivariate and propensity score matching, were conducted to determine the relationship between tooth loss and overactive bladder (OAB). Results: Compared with the non-OAB group, the OAB group had significantly fewer remaining teeth (p < 0.001). A negative correlation was observed between the number of remaining teeth and the severity of LUTS, with symptoms such as urgency, frequency, and nocturia being more severe in patients with fewer teeth (all p < 0.001). Objective measures, including bladder capacity and maximum flow rate, were also significantly lower in patients with fewer teeth. Additionally, having fewer than 21 teeth was identified as a significant risk factor for LUTS. Multivariate analysis confirmed that tooth loss was an independent risk factor for OAB, even after adjusting for age and comorbidities (p < 0.001). Propensity score matching further validated the association between the number of remaining teeth and OAB (p = 0.022), highlighting a clear connection between dental health and urinary function. Conclusions: Tooth loss due to chronic periodontitis is strongly associated with the severity of LUTS, including storage and voiding symptoms. Maintaining good oral health may help reduce the risk of OAB and related urinary symptoms. This study underscores the importance of dental care in managing and preventing LUTS, suggesting that improving oral health could play a key role in mitigating these conditions.
