Oral health problems and risk of incident disability in two studies of older adults in the United Kingdom and the United States

Abstract

Background Preventing oral health problems can be crucial for maintaining physical independence in older adults. We aimed to examine the associations of a range of oral health problems with incidence of disability in older adults. Methods We used prospective data from the British Regional Health Study (BRHS) (N = 2147, 71–92 years), and the Health, Aging and Body Composition (HABC) study (USA) (N = 3075, 71–80 years). Oral health measures included tooth loss, periodontal disease, self‐rated oral health, and self‐reported dry mouth. Participants were followed for onset of disability over a follow‐up period of 3 years. Onset of disability was assessed through new cases of mobility limitations, activities of daily living (ADL), and instrumental activities of daily living (IADL). Logistic regression was performed to calculate the odds of incident disability. Results In the BRHS, tooth loss was associated with greater odds of mobility limitations and ADL difficulties. Periodontal disease was associated with greater incidence of mobility limitations. Self‐report of ≥3 dry mouth symptoms was associated with increased odds of incident mobility limitations and ADL difficulties (OR = 2.08, 95% CI 1.27–3.42; OR = 1.73, 95% CI 1.03–2.90). Fair/poor self‐rated oral health was associated with greater incidence of IADL difficulties. In the HABC study, complete tooth loss was associated with greater incidence of mobility limitations (OR = 1.86, 95% CI 1.13–3.06), and fair/poor self‐rated oral health was associated with increased odds of incident ADL difficulties (OR = 1.42, 95% CI 1.04–1.94). Conclusions Oral health problems in older adults, particularly tooth loss, self‐reported dry mouth and self‐rated oral health were associated with greater incidence of disability. Poor oral health plays a potentially important role in the development of disability in older populations, which in turn is an essential part of quality of life and healthy aging.

Factors associated with the use of dental services in diabetic people

“…Regarding physical disability, in our study there was no association between its types and access to dental services. Our results differ from those of Kotronia et al [30] who showed that disability was related to a high incidence of caries and thus to a great loss of teeth compared to the general population. Therefore, preventive oral care in people with a disability should be reinforced since it is part of their quality of life and healthy aging.…”

Estimation of Oral Disease Burden among Older Adults in LTC: A Scoping Review

“…One example of this type of contention is around the definition of ‘periodontal disease’ in this population who are likely to have both gingival pockets and attachment loss. Studies only looking at combined attachment loss (distance from the cementoenamel junction to the bottom of the pocket) are likely to overestimate the presence of active periodontal disease [ 65 , 66 ] as a proportion of the attachment loss might be due to recession that might be an expected part of normal aging rather than an actively inflamed gingival pocket [ 70 ]. By contrast, using only indicator teeth to screen for the presence of bony defects in periodontal supporting tissues using the CPITN may underestimate the level of disease present [ 28 ].…”

An Overview of Systemic Health Factors Related to Rapid Oral Health Deterioration among Older People

“…Tooth loss, for instance, may lead to disabilities such as limitations in activities of daily living, instrumental activities of daily living, and mobility [ 80 , 81 , 82 , 83 , 84 ]. Conversely, disability may be associated with chronic illnesses, weak oral health, and reduced quality of life among older people [ 85 ]. The World Health Organization defines disability as an impairment that may be physical, cognitive, mental, sensory, emotional, developmental, or a combination of these, and which may occur during a person’s lifetime or from birth.…”