Abstract
BackgroundThere is poor knowledge about the extent to which psychological distress influences oral health in older people in Norway. The aim of this study was two-fold: i) to describe the oral health of Norwegian elderly and their levels of psychological distress; and ii) to examine the relationship of psychological distress with self-rated oral health, while controlling for oral status and socio-demographic characteristics, in Norwegian elderly.MethodsData were retrieved from a national cross-sectional survey conducted by Statistics Norway in 2012 and included information about self-rated oral health, psychological distress (measured using the Hopkins Symptom Checklist 25; HSCL-25), gender, age, civil status, smoking, self-reported number of teeth present and dental attendance for 949 non-institutionalised adults aged 65 years or older. Logistic regression was used to establish whether psychological distress predicts self-rated oral health, controlling for socio-demographic characteristics and oral status.ResultsAround 27% of the elderly reported having poor oral health, and 8 % had a HSCL-25 mean score ≥ 1.75, which indicates higher levels of psychological distress. Among the symptoms listed in the HSCL-25, the most frequently reported problems were lack of energy (1.7 ± 0.8) and difficulties falling and staying asleep (1.6 ± 0.7). The likelihood of reporting poor oral health was independently associated with having a mean HSCL-25 score ≥ 1.75 (OR = 1.89; 95% CI = 1.14–3.15), even when smoking (OR = 1.83; 95% CI = 1.17, 2.87) and having fewer than 20 teeth (OR = 3.49; 95% CI = 2.56, 4.76) were taken into account.ConclusionMost of the Norwegian elderly in our sample perceived themselves to have good oral health and reported relatively low levels of psychological distress. Higher levels of psychological distress can influence the oral health of the elderly independently of other factors such as smoking and having reduced number of teeth. Dental care professionals should consider screening their elderly patients for psychological distress and individualise the information about dental care for this specific population.
Highlights
IntroductionAs in other European countries, in Norway an increasing decline in fertility rates and increased life expectancy are resulting in an increase of the proportion of older people which represent a potential burden to society and a challenge to public health institutions [1](WHO)
There is poor knowledge about the extent to which psychological distress influences oral health in older people in Norway
Among the symptoms listed in the Hopkins Symptoms Checklist − 25 (HSCL-25), the most frequently reported problems were lack of energy and difficulties falling and remaining asleep
Summary
As in other European countries, in Norway an increasing decline in fertility rates and increased life expectancy are resulting in an increase of the proportion of older people which represent a potential burden to society and a challenge to public health institutions [1](WHO). A reduction in the prevalence of edentulousness and the prevalence and incidence of tooth loss has occurred in many countries [11, 12] Despite these observed declining trends in edentulousness, the mean number of lost teeth increases with increasing age and a substantial proportion of the current older generations experience tooth loss [11, 13]. Studies have confirmed the expected positive associations between tooth loss and reduced perceived oral health [13, 14]
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