Measuring the impact of oral health in old age: a qualitative reaction to some quantitative views

Abstract

Investigations into the oral health-related beliefs and behaviour of old people are complex and fraught with methodological difficulties. They have employed to a large extent structured interviews or questionnaires based on the Sickness Impact Profile to explain the impact of oral disorder in old age. However, despite sophisticated statistical techniques, the results have failed to explain much of the variance in the responses of the elderly subjects. This paper reviews the results of several investigations conducted in a structured and quantitative manner, and contrasts them with an alternative method of inductive investigation using a more qualitative interpretation of open-ended interviews. The alternative method of exploration with a small but intensely involved group of elderly participants revealed a view of oral health that reflects a willingness of elders to adapt constructively to changes in the mouth with advancing age. Moreover, the construction of a framework of oral health-related beliefs and behaviours that emerged from the qualitative analysis of open-ended interviews, has widened our understanding of the significance of the mouth in old age beyond the framework of biophysical, functional and disabling variables that dominated previous research on this field.