What contributes to self-rated oral health among community-dwelling older adults? Findings from the eldersmile program

Objectives: As part of ongoing efforts by the Columbia University College of Dental Medicine to devise community-based models of health promotion and care for local residents, we sought to answer the following query: "What contributes to self-rated oral health among community-dwelling older adults?" Methods: The present study is cross sectional in design and centrally concerned with baseline data collected during community-based screenings of adults aged 50 years and older who agreed to participate in the ElderSmile program in northern Manhattan, New York City. The primary outcome measure of interest is self-rated oral health, which was assessed as follows: "Overall, how would you rate the health of your teeth and gums - excellent, good, fair, or poor?" Results: More than a quarter (28.5 percent) of ElderSmile participants aged 50 years and older reported that their oral health was poor. After adjustment for age (in years), place of birth, educational level, and dental insurance status in a logistic regression model, recent visits to the dentist (within the past year versus more than a year ago) contributed to better self-rated oral health and non-Hispanic Black race/ethnicity, dentate (versus edentulous) status, tooth decay as measured by decayed missing filled teeth, and severe periodontal inflammation contributed to worse self-rated oral health in this population. Conclusions: Recent dental care contributed to better self-rated oral health among community-dwelling older adults living in northern Manhattan. Significant gradients were evident in the caries experience and periodontal inflammation of dentate adults by self-rated oral health, suggesting that untreated oral disease contributes to poor self-rated oral health.