Objectives This study aimed to assess oral health-related quality of life (OHRQoL) related to dental status. Material and methods One thousand four hundred sixty-two Chinese subjects over 40 years, dentate in both jaws, were categorized in a hierarchical functional classification system with and without tooth replacements. OHIP-14CN scores were used to assess OHRQoL and analyzed using multivariable logistic regression including five dental conditions (‘≥10 teeth in each jaw’; ‘complete anterior regions’; ‘sufficient premolar regions’ (≥3 posterior occluding pairs (POPs)); ‘sufficient molar regions’ (bilaterally ≥1 POP); and tooth replacement) after adjustment for five background variables. Likelihood ratios for impaired OHRQoL (OHIP total score ≥5) were assessed at each level of the classification system. Results In the hierarchical scheme, OHIP-14CN total scores were highest in branch ‘<10 teeth in each jaw’ (8.5 ± 9.5 to 12.3 ± 13.2). In branch ‘≥10 teeth’ scores ranged from 6.2 ± 7.7 to 8.3 ± 9.3. The most important dental condition discriminating for impact on OHRQoL was ‘≥10 teeth in each jaw’ (Likelihood ratio 1.59). In this branch subsequent levels were discriminative for impaired OHRQoL (Likelihoods 1.29–1.69), in the branch ‘<10 teeth in each jaw’ they were not (Likelihoods 0.99–1.04). Tooth replacements were perceived poorer as their natural counterparts (odd ratios, 1.30 for fixed and 1.47 for removable appliances). Conclusions OHRQoL was strongly associated with the presence of at least 10 teeth in each jaw. The hierarchical classification system predicted approximately 60 % of subjects correctly with respect to impaired OHRQoL. Clinical relevance From an OHRQoL perspective, natural teeth were preferred over artificial teeth.