The population of the world is growing and people are living longer. Today 32 % of the population is over the age of 60 and 46.8 million people worldwide have cognitive impairment or dementia [1]. This is a serious challenge in healthcare. Reducing risk factors for developing dementia is crucial and recent studies have identified that tooth loss and mastication or chewing dysfunction have been associated with cognitive decline [1]. Research has demonstrated that effective chewing maintains hippocampus-dependent cognitive function by increasing cerebral cortical blood flow necessary for learning, memory, and for hippocampal cell neurogenesis [2,3]. Tooth loss is also a source of chronic stress and involves the hypothalamic-pituitary-adrenal (HPA) axis that increases circulating corticosterone associated with spatial learning deficits [4]. Additionally, tooth loss affects the trigeminal sensory pathway that is linked to learning and memory [4]. The following is a discussion of tooth loss and its effect on cognition. These are important and surprising findings that present as modifiable risk factors that can impact the quality of life for the geriatric population.