A Clinic Based Survey Investigating Self-Reported Oral Health-Related Quality of Life, Number of Natural Teeth, and Oral Hygiene Habits Among Elderly Singaporeans

Abstract

Background: Global aging poses various challenges for both developing and developed countries. The proportion of older adults in developed countries is currently much higher than in developing countries. Health authorities are now confronting increasing public health problems, including a growing burden of oral diseases among older people. Although the percentage of older adults who have retained their natural teeth has increased steadily during the past decades, the number of natural teeth might still contribute vastly to older people’s quality of life. As little research has been conducted in the Southeast Asia area, this study aims to 1) investigate the association of number of natural teeth and oral pain with oral health-related quality of life; 2) discover ethnic disparities in regards to number of natural teeth and oral health-related quality of life; and 3) examine factors related to number of natural teeth retained among elderly Singaporeans. Methods: The study was carried out in a dental clinic conducting a questionnaire survey on patients who visited the clinic. Geriatric Oral Health Assessment Index (GOHAI) was used and the GOHAI total score (ranged from 12 - 60) was measured to describe participants’ oral health-related quality of life from three perspectives: physical, social, and mental health components. Participants’ dental records were linked to the questionnaire survey and data on their dental parameters were also collected. Linear regression analysis was conducted as the main method towards all the three study aims, whereas logistic regression analysis was performed as supplementary evidence especially for Aim 1. Non-parametric statistical tests were also used in cased of normality assumption requirements throughout the analytical process. Results: The mean GOHAI total score of the study subjects was 47.72 (SD = 7.45). The mean number of natural teeth was 18.27 (SD = 8.15). A positive association between number of natural teeth and GOHAI total score was found by the linear regression analysis (Coefficient = 0.20, 95%CI: 0.17, 0.44) and a Spearman correlation test (rho=0.22, P < 0.01). A negative association between oral pain and GOHAI total score was detected by the linear regression (Coefficient = -5.88, 95%CI: -7.86, -3.91) and a Spearman correlation test (rho = -0.40, p < 0.001) as well. In terms of factors associated with number of natural teeth, older people with more number natural teeth were found to be associated with younger age, higher educational level, and flossing at least once a day. Ethnic disparities were observed with Malays exhibited the lowest number of natural teeth and GOHAI total score, compared to Chinese and Indians. Conclusions: The oral health-related quality of life of the investigated population was generally fair. Ethnic disparities existed in oral health-related quality of life and number of natural teeth among older adults in Singapore that Malays had adverse oral health status compared to Chinese and Indians. With more number of natural teeth retained and less oral pain, a person was more likely to have better oral health-related quality of life. Flossing at least once a day might contribute to the retention of more natural teeth.