Oral Health Disparities in Community-Dwelling Older Adults

Objectives: Determine the associations between oral health indicators and sociodemographic characteristics among community-dwelling older adults (≥65 years).

Methods: Cross-sectional analysis of NHANES 2005-2008 data. Descriptive analyses were used to characterize the study sample. Bivariate and multivariate analyses were used to determine the association between two oral health indicators and sociodemographic characteristics.

Oral health indicators: self-rated oral health (based on 5-point Likert scale) and potential chewing difficulty (defined as ≤20 teeth). Demographic measures include family income to poverty threshold ratio, race/ethnicity and gender. We controlled for education, marital status and clinically significant depression (PHQ-9 score ≥10).

Results: Two-thousand seven hundred forty-five subjects were identified: female 1,387 (50.5%), non-white 1,010 (36.8%), ≥high school education 1,684 (61.6%), married 1,431 (52.2%), depression 107 (4.7%), mean income:poverty ratio 2.37 ± 0.03, excellent/very good oral health 463 (30.0%), potential chewing difficulty 1,633 (63.0%). Table 1 shows the multivariate regression model for self-rated oral health and sociodemographic characteristics. Interestingly, living in poverty was associated with ~5% increase in mean self-rated oral health score, after controlling for demographic characteristics and depression. Living in poverty was associated with ~42% increased odds for potential chewing difficulty in the multivariate logistic regression model including race, education, gender, marital status and depression.

Table 1. Multivariate regression model for self-rated oral health.

Conclusion: Community-dwelling older adults living in poverty are more likely to experience potential chewing difficulty. Difficulty chewing may impact nutrition, functional status and quality of life. Attention should be directed toward addressing oral health disparities in older adults living in poverty.