Oral health in elderly Chileans improving, but disparities remain

Feb 25 2013

By Joanna Lyford, Senior medwireNews Reporter

Oral health makes a significant contribution to the general wellbeing of older people, a survey of Chilean over-60s has found.

The research also uncovered evidence of inequalities in oral health across locations, levels of education, and income.

"These results may give planners and providers a better understanding of the oral health status of older adults which in turn need to be met with different health strategies," write Rodrigo Marino (University of Melbourne, Victoria, Australia) and co-authors in the Archives of Gerontology and Geriatrics.

Marino's team analyzed data on 4766 community-dwelling adults aged 60 years and older (mean age 72.3 years). They were participating in a larger study that included a detailed questionnaire addressing demographic, socioeconomic, medical, and oral health issues.

When asked to rate their perceived quality of life, 55.8% of respondents said "excellent" or "very good," 37.5% said "average," and 6.6% said "bad" or "very bad."

Nearly one in four of the respondents was entirely healthy while 29.5% reported having one medical condition, 27.1% had two medical conditions, 14.0% had three, and the remainder had between four and seven conditions.

With regard to oral health, 21.7% of participants had none of their natural teeth and 43.1% were missing the majority of their natural teeth. A further 29.9% had some missing teeth and just 5.3% had all their natural teeth.

As expected, the prevalence of edentulous participants increased with advancing age, and women were more likely to be edentulous than men. Edentulism was also associated with location of residence and with greater comorbidity.

Notably, 36.5% of participants reported experiencing difficulties with chewing, and this in turn had a significant effect on their self-reported quality of life. People who indicated that their quality of life was "average" or "bad" were more than twice as likely to have chewing difficulties as those who self-reported their quality of life as "good" or "excellent."

In logistic regression analysis, six variables were significantly associated with difficulties chewing: having fewer natural teeth left, advancing age, lack of private insurance, lower levels of education, not needing dental prosthetics, and living in northern regions of the country.

In a separate analysis, five variables predicted being edentulous: advancing age, higher number of comorbidities, lower levels of education, female gender, and living in an urban region.

Noting that their study "represents one of the largest data collections on health among older adults in Chile," Marino and co-authors say that the results "add to the evidence that Chile is in the midst of an epidemiological transition in oral health, moving from high rates of edentulism and tooth loss toward lower rates."

They conclude: "Additional information is needed on clinical outcomes, as well as socio-behavioral risk factors. Thus, understanding these health beliefs is fundamental in framing appropriate oral health policies and in the development of effective oral health services and policies to address and redress inequalities in oral health among older adults."

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