Oral Health Impact Among US Adults With Disabilities: NHANES 2013-2018

Objectives: The objective of our study was to assess the relationship between disability status and self-reported pain, lost productivity, and embarrassment attributable to oral health status among US adults.
Methods: We obtained data from the 2013-2014, 2015-2016, and 2017-2018 National Health and Nutrition Examination Surveys (NHANES). The final analytic sample included 17,057 respondents aged ≥20 years.

We assessed 3 oral health problems using answers to these questions 1) “How often during the last year have you had painful aching anywhere in your mouth? 2) How often during last year have you (or family member) had difficulty doing usual jobs or attending school because of problems with your teeth, mouth or dentures? 3) How often during the last year have you been self-conscious or embarrassed because of your teeth, mouth or dentures? The response options included “very often”, “fairly often”, “occasionally”, and “hardly ever” or “never”. Respondents was classified as (yes) if they selected any of the first three response options.

Disability status included: (1) serious difficulty hearing, (2) serious difficulty seeing even when wearing glasses, (3) serious difficulty concentrating, (4) serious difficulty walking, (5) difficulty dressing/bathing, and (6) difficulty doing errands alone.
Results: Compared to adults with no disabilities, adjusted odds ratios (AORs) and 95% confidence intervals showed patterns of increasing likelihood of pain, inability to do usual jobs, and embarrassment as number of disabilities increased: one disability AOR 1.6 (1.4-1.9); two disabilities AOR 2.3 (1.9-2.8) and 3 or more disabilities AOR 3.2 (2.7-3.9). Among types of disability, the strongest pattern was observed for “difficulty dressing/bathing”.
Conclusions: US adults with disabilities are more likely to experience consequences related to poor oral health. Pain, embarrassment, and the ability to perform daily activities are important dimensions of well-being. The findings highlight the disparities in well-being experienced by persons with disabilities attributable to oral health.