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All subjects completed cognitive function assessments both in 1996\u20131998 and 2004\u20132006, and the same subjects received a dental examination at the initial visit. Cognitive assessment consisted of delayed word recall (<jats:styled-content style=\"fixed-case\">DWR<\/jats:styled-content>), digit symbol substitution (<jats:styled-content style=\"fixed-case\">DSS<\/jats:styled-content>), and word fluency (<jats:styled-content style=\"fixed-case\">WF<\/jats:styled-content>) tests. In the analysis, cognitive function for 911 dentally screened participants was evaluated, and 558 of 785 dentate participants received comprehensive oral examinations, including periodontal probing. Measures of oral health included dental status, number of teeth, and periodontal disease classified by the biofilm\u2013gingival interface (<jats:styled-content style=\"fixed-case\">BGI<\/jats:styled-content>) index. The generalized estimating equations (<jats:styled-content style=\"fixed-case\">GEE<\/jats:styled-content>) method was used to analyze repeated measures of cognitive scores with adjustment for socio\u2010demographic characteristics and cardiovascular risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 911 study participants, 13.8% were edentulous. About 13% of dentally examined participants had periodontal pockets (\u22654\u00a0mm) with severe bleeding. At the follow\u2010up visit, <jats:styled-content style=\"fixed-case\">DWR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">WF<\/jats:styled-content> scores were lower in edentulous compared to dentate people, whereas other oral health measures were not associated with cognitive function. Mean values declined over time for all three cognitive measures, although poor oral health conditions were not associated with greater degree of decline in cognitive function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In these late middle\u2010aged adults, complete tooth loss was significantly associated with lower cognitive performance. 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