Self-perceived oral health and orofacial appearance in older adults – an 18-year follow-up study in Karlskrona, Sweden
DOI:
https://doi.org/10.2340/aos.v83.40574Keywords:
Older adults, oral health, orofacial appearance, self-perceptionAbstract
Objectives: To analyze whether self-perceived oral health and orofacial appearance change with increasing age.
Methods: This longitudinal study is based on data from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprises 160 participants 60 years of age at baseline 2001–2003. The same participants were re-examined at 66-, 72-, and 78 years of age. To analyze whether perceptions of oral health and orofacial appearance changed with increasing age, Cochran’s Q test was conducted. Statistical significance was considered at p ≤ 0.05, and the calculated value Q must be equal to or greater than the critical chi-square value (Q ≥ 7.82). Significance values have been adjusted for the Bonferroni correction for multiple tests.
Results: Self-perceived mouth dryness, both day (Q = 7.94) and night (Q = 23.41), increased over the 18-year follow-up. When divided by gender, significant differences were only seen for mouth dryness at nighttime. A decrease in sensitive teeth was perceived with increasing age, and an increase in self-perceived satisfaction with dental appearance, and a decrease in self-perceived problems with dental gaps between the ages of 60 and 78. These changes were, however, not statistically significant. Men experienced a higher proportion of discomfort with discolored teeth at age 78 than at 60 (Q = 9.09).
Conclusions: Self-perceived oral health and orofacial appearance were relatively stable, with few changes over an 18-year follow-up.
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Griffin SO, Jones JA, Brunson D, et al. Burden of oral disease among older adults and implications for public health priorities. Am J Public Health. 2012;102(3):411–418. https://doi.org/2105/AJPH.2011.300362. DOI: https://doi.org/10.2105/AJPH.2011.300362
Müller F, Shimazaki Y, Kahabuka F, et al. Oral health for an ageing population: the importance of a natural dentition in older adults. Int Dent J. 2017;67(2):7–13. https://doi.org/10.1111/idj.12329. DOI: https://doi.org/10.1111/idj.12329
United Nations, Department of Economics and Social Affairs, Population Division. World population ageing 2019. New York, NY: UN; 2020.
Statistics Sweden. After age 60 – a description of older people in Sweden 2020. [Internet]. [cited 20-08-2022]. Available from: http://www.statistikdatabasen.scb.se/
Chang AY, Skirbekk VF, Tyrovolas S, et al. Measuring population ageing: an analysis of the Global Burden of Disease Study 2017. Lancet Public Health. 2019;4(3):e159–e167. https://doi.org/10.1016/S2468-2667(19)30019-2. DOI: https://doi.org/10.1016/S2468-2667(19)30019-2
Ettinger RL, Marchini L. Cohort differences among aging populations: an update. J Am Dent Assoc. 2020;151(7):519–526. https://doi.org/10.1016/j.adaj.2020.04.001. DOI: https://doi.org/10.1016/j.adaj.2020.04.001
Abrams AP, Thompson LA. Physiology of aging of older adults: systemic and oral health considerations. Dent Clin North Am. 2014;58(4):729–738. https://doi.org/10.1016/j.cden.2014.06.002. DOI: https://doi.org/10.1016/j.cden.2014.06.002
Critén S, Andersson P, Renvert S, et al. Oral health status among 60-year-old individuals born in 1941–1943 and 1954–1955 and 81-year-old individuals born in 1922–1924 and 1933–1934, respectively: a cross-sectional study. Clin Oral Investig. 2022;26(11):6733–6742. https://doi.org/10.1007/s00784-022-04632-5. DOI: https://doi.org/10.1007/s00784-022-04632-5
Stock C, Jürges H, Shen J, et al. A comparison of tooth retention and replacement across 15 countries in the over-50s. Community Dent Oral Epidemiol. 2016;44(3):223–231. https://doi.org/10.1111/cdoe.12209. DOI: https://doi.org/10.1111/cdoe.12209
Atanda AJ, Livinski AA, London SD, et al. Tooth retention, health, and quality of life in older adults: a scoping review. BMC Oral Health. 2022;22(1):185. https://doi.org/10.1186/s12903-022-02210-5. DOI: https://doi.org/10.1186/s12903-022-02210-5
McKenna G, Tsakos G, Burke F, et al. Managing an ageing population: challenging oral epidemiology. Prim Dent J. 2020;9(3):14–17. https://doi.org/10.1177/2050168420943063. DOI: https://doi.org/10.1177/2050168420943063
Schneider C, Zemp E, Zitzmann NU. Oral health improvements in Switzerland over 20 years. Eur J Oral Sci. 2017;125(1):55–62. https://doi.org/10.1111/eos.12327. DOI: https://doi.org/10.1111/eos.12327
Grönbeck Lindén I, Hägglin C, Gahnberg L, et al. Factors affecting older persons’ ability to manage oral hygiene: a qualitative study. JDR Clin Trans Res. 2017;2(3):223–232. https://doi.org/10.1177/2380084417709267. DOI: https://doi.org/10.1177/2380084417709267
Dayanidhi S, Valero-Cuevas FJ. Dexterous manipulation is poorer at older ages and is dissociated from decline of hand strength. J Gerontol A Biol Sci Med Sci. 2014;69(9):1139–1145. https://doi.org/10.1093/gerona/glu025. DOI: https://doi.org/10.1093/gerona/glu025
Lamster IB. Geriatric periodontology: how the need to care for the aging population can influence the future of the dental profession. Periodontol 2000. 2016;72(1):7–12. https://doi.org/10.1111/prd.12157. DOI: https://doi.org/10.1111/prd.12157
Ship JA. The influence of aging on oral health and consequences for taste and smell. Physiol Behav. 1999;66(2):209–215. https://doi.org/10.1016/S0031-9384(98)00267-4. DOI: https://doi.org/10.1016/S0031-9384(98)00267-4
An G. Normal aging of teeth. Geriatr Aging. 2009;12:513–517.
Algarni AA, Ungar PS, Lippert F, et al. Trend-analysis of dental hard-tissue conditions as function of tooth age. J Dent. 2018;74:107–112. https://doi.org/10.1016/j.jdent.2018.05.011. DOI: https://doi.org/10.1016/j.jdent.2018.05.011
Lamster IB, Asadourian L, Del Carmen T, et al. The aging mouth: differentiating normal aging from disease. Periodontol 2000. 2016;72(1):96–107. https://doi.org/10.1111/prd.12131. DOI: https://doi.org/10.1111/prd.12131
Watts A, Addy M. Tooth discolouration and staining: a review of the literature. Br Dent J. 2001;190(6):309–316. https://doi.org/10.1038/sj.bdj.4800959a. DOI: https://doi.org/10.1038/sj.bdj.4800959a
National Board of Health and Welfare. The state and development in health care and dental care – situation report 2020. National Board of Health and Welfare; Sweden, 2020.
Yahya F, Johannsen A, Östman C, et al. Self-perceived oral health of elderly people living independently in Stockholm, Sweden: a questionnaire study. EAS J Dent Oral Med. 2021;3(6):176–183.
Locker D, Clarke M, Payne B. Self-perceived oral health status, psychological well-being, and life satisfaction in an older adult population. J Dent Res. 2000;79(4):970–975. https://doi.org/10.1177/00220345000790041301. DOI: https://doi.org/10.1177/00220345000790041301
Glick M, Williams DM, Kleinman DV, et al. A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health. J Am Dent Assoc. 2016;147(12):915–917. https://doi.org/10.1016/j.adaj.2016.10.001. DOI: https://doi.org/10.1016/j.adaj.2016.10.001
Henricsson S, Bengtsson Wallin V, Renvert S, et al. Self-perceived oral health and orofacial appearance in an adult population. Int J Dent Hygiene. 2023. Epub ahead of print. https://doi.org/10.1111/idh.12711. DOI: https://doi.org/10.1111/idh.12711
Lysberg F, Innstrand ST, Cvancarova Småstuen M, et al. Age groups changes in self-rated health: a prospective longitudinal study over a 20-year period using Health Survey of North Trøndelag data. Scand J Public Health. 2020;49(8):845–850. https://doi.org/10.1177/1403494820904626. DOI: https://doi.org/10.1177/1403494820904626
Jankowski GS, Diedrichs PC, Williamson H, et al. Looking age-appropriate while growing old gracefully: a qualitative study of ageing and body image among older adults. J Health Psychol. 2014;21(4):550–561. https://doi.org/10.1177/1359105314531468. DOI: https://doi.org/10.1177/1359105314531468
Sánchez-Cabrero R, León-Mejía AC, Arigita-García A, et al. Improvement of body satisfaction in older people: an experimental study. Front Psychol. 2019;10:1–11. https://doi.org/10.3389/fpsyg.2019.02823. DOI: https://doi.org/10.3389/fpsyg.2019.02823
World Medical Association (WMA). Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. https://doi.org/10.1001/jama.2013.281053. DOI: https://doi.org/10.1001/jama.2013.281053
Lagergren M, Fratiglioni L, Hallberg IR, et al. A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care (SNAC). Aging Clin Exp Res. 2004;16(2):158–168. https://doi.org/10.1007/BF03324546. DOI: https://doi.org/10.1007/BF03324546
Atchison KA, Dolan TA. Development of the geriatric oral health assessment index. J Dent Educ. 1990;54(11):680–687. https://doi.org/10.1002/j.0022-0337.1990.54.11.tb02481.x. DOI: https://doi.org/10.1002/j.0022-0337.1990.54.11.tb02481.x
Unell L, Söderfeldt B, Halling A, et al. Equality in satisfaction, perceived need, and utilization of dental care in a 50-year old Swedish population. Community Dent Oral Epidemiol. 1996;24(3):191–195. https://doi.org/10.1111/j.1600-0528.1996.tb00840.x. DOI: https://doi.org/10.1111/j.1600-0528.1996.tb00840.x
Sheskin DJ. Handbook of parametric and nonparametric statistical procedures. New York, NY: Chapman & Hall/CRC Press; 2000.
Patil KD. Cochran’s Q test: exact distribution. J Am Statistic Assoc. 1975;70(349):186–189. https://doi.org/10.1080/01621459.1975.10480285. DOI: https://doi.org/10.1080/01621459.1975.10480285
Armstrong RA. When to use the Bonferroni correction. Ophthalmic Physiol Opt. 2014;34(5):502–508. https://doi.org/10.1111/opo.12131. DOI: https://doi.org/10.1111/opo.12131
Larsson P, Bondemark L, Häggman-Henrikson B. The impact of oro-facial appearance on oral health-related quality of life: a systematic review. J Oral Rehab. 2021;48(3):271–281. https://doi.org/10.1111/joor.12965. DOI: https://doi.org/10.1111/joor.12965
Statistics Sweden. Statistikdatabasen; utbildningsnivå, ålder och kön 2001 [Statistical database; level of education, age and gender 2001] [Internet]. [cited 17-02-2022]. Available from: http://www.statistikdatabasen.scb.se/
Westerhof GJ, Keyes CL. Mental illness and mental health: The two continua model across the lifespan. J Adult Dev. 2010;17(2):110–119. https://doi.org/10.1007/s10804-009-9082-y. DOI: https://doi.org/10.1007/s10804-009-9082-y
Hitchcott PK, Penna MP, Fastame MC. Age trends in well-being and depressive symptoms: the role of social desirability. Psychiatr Q. 2020;91(2):463–473. https://doi.org/10.1007/s11126-020-09711-y. DOI: https://doi.org/10.1007/s11126-020-09711-y
Krause N. Providing emotional support to others, self-esteem, and self-rated health. Arch Gerontol Geriatr. 2016;65:183–191. https://doi.org/10.1016/j.archger.2016.03.014. DOI: https://doi.org/10.1016/j.archger.2016.03.014
Johansson AK, Johansson A, Unell L, et al. Self-reported dry mouth in 50- to 80-year-old Swedes: longitudinal and cross-sectional population studies. J Oral Rehabil. 2020;47(2):246–254. https://doi.org/10.1111/joor.12878 DOI: https://doi.org/10.1111/joor.12878
Åstrøm AN, Lie SA, Ekback G, et al. Self-reported dry mouth among ageing people: a longitudinal, cross-national study. Eur J Oral Sci. 2019;127(2):130–138. https://doi.org/10.1111/eos.12601. DOI: https://doi.org/10.1111/eos.12601
Ship JA, Nolan NE, Puckett SA. Longitudinal analysis of parotid and submandibular salivary flow rates in healthy, different-aged adults. J Gerontol A Biol Sci Med Sci.1995;50(5):M285–M289. https://doi.org/10.1093/gerona/50A.5.M285. DOI: https://doi.org/10.1093/gerona/50A.5.M285
Johansson AK, Omar R, Mastrovito B, et al. Prediction of xerostomia in a 75-year-old population: a 25-year longitudinal study. J Dent. 2022;118:1–7. https://doi.org/10.1016/j.jdent.2022.104056. DOI: https://doi.org/10.1016/j.jdent.2022.104056
Farac RV, Morgental RD, Lima RK, et al. Pulp sensibility test in elderly patients. Gerodontology. 2012;29(2):135–139. https://doi.org/10.1111/j.1741-2358.2012.00623.x. DOI: https://doi.org/10.1111/j.1741-2358.2012.00623.x
Noone JH, Stephens C. Men, masculine identities, and health care utilisation. Sociol Health Illn. 2008;30(5):711–725. https://doi.org/10.1111/j.1467-9566.2008.01095.x. DOI: https://doi.org/10.1111/j.1467-9566.2008.01095.x
Santoni G, Angleman S, Welmer AK, et al. Age-related variation in health status after age 60. PLoS One. 2015;10(3):e0120077. https://doi.org/10.1371/journal.pone.0120077. DOI: https://doi.org/10.1371/journal.pone.0120077
Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet. 2013;381(9868):752–762. https://doi.org/10.1016/S0140-6736(12)62167-9. DOI: https://doi.org/10.1016/S0140-6736(12)62167-9
Grönbeck-Linden I, Hägglin C, Petersson A, et al. Discontinued dental attendance among elderly people in Sweden. J Int Soc Prev Community Dent. 2016;6(3):224–229. https://doi.org/10.4103/2231-0762.183101. DOI: https://doi.org/10.4103/2231-0762.183101
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