Objective: The present study aimed to investigate the association between baseline moderate-to-severe periodontitis and all-cause mortality over a 23-year follow-up among individuals aged 60 and 66 years.

Materials and methods: This longitudinal study was based on data from the Swedish National Study on Aging and Care in Karlskrona, Blekinge, Sweden. A total of 340 participants aged 60 and 66 years old at baseline (2001–2003) who underwent periodontal and radiographic examination were included. Baseline data on age, sex, number of medications, smoking status, cash margin, and education were collected.

Results: At baseline, 16.2% of participants had moderate-to-severe periodontitis. During the 23-year follow-up, 52.7% of participants with moderate-to-severe periodontitis died. In the adjusted survival analysis, moderate-to-severe periodontitis was associated with an increased risk of all-cause mortality (hazard ratio = 1.56; 95% confidence interval [CI] = 1.00–2.44, p = 0.050).

Conclusions: Over 23-year follow-up, baseline moderate-to-severe periodontitis was associated with a higher risk of all-cause mortality among individuals aged 60 and 66 years. However, although the association was statistically significant, any sex-specific findings should be considered exploratory due to the limited number of events and the resulting wide CIs.