Work Stress and Oral Health Among Older Adults in England

Objectives: To explore: 1) whether exposure to stressful working conditions was associated with subsequent poor oral health among older working adults, and 2) whether this association was explained by selected covariates.
Methods: Secondary data analysis from the third (2006–2007) and fifth (2010–2011) waves of the English Longitudinal Study of Ageing (ELSA). The sample comprised of 1,542 adults aged 50-65 years who were in the workforce at the time of wave 3. Work stress was assessed by the effort-reward imbalance model (no imbalance vs. medium or high imbalance). Oral health outcomes were assessed using self-reported edentulousness (dentate vs. edentate), self-rated oral health (good vs. poor) and oral health-related quality of life (OHRQoL) represented by a short version of the Oral Impacts on Daily Performances (OIDP) questionnaire (no oral impacts vs. one or more oral impact). Logistic regression models were used to estimate the odds ratio of poor oral health outcomes at wave 5 in relation to work stress exposure at wave 3, sequentially adjusted for age, gender, marital status, education, income, work contract type and smoking status.
Results: When compared to those without, participants with effort-reward imbalance had higher odds of poor self-rated oral health (OR 1.64; 95% CI: 1.16-2.30) and poor OHRQoL (OR 1.63; 95% CI: 1.06-2.50) four years later. After adjusting for demographic, socio-economic and behavioural factors, the association between effort-reward imbalance with poor self-rated oral health and poor OHRQoL remained statistically significant (OR 1.43; 95% CI: 1.01-2.04 and OR 1.43; 95% CI: 1.01-2.04, respectively).
Conclusions: There was evidence of longitudinal associations between effort-reward imbalance with oral health and OHRQoL. Given the increasing proportion of older adults in the population overall and the workforce in particular, there is a need to consider the role of work stress as a broader determinant of oral health in ageing populations.