SOCIAL DETERMINANTS OF ORAL HEALTH AMONG OLDER ADULTS: RURALITY MATTERS

Abstract

Abstract Oral health is often viewed as a predictor of emotional well-being. Older age and any tobacco use are among the strongest predictors of poor oral health. We sought to examine the roles of age, tobacco use, and dental health in relation to emotional well-being. Moreover, we identified unique predictors of oral health. Data were provided by 197,786 adults completing the 2020 BRFSS (mean age = 54.3 yrs; 46% men; 80% white; 15% rural; 41% had ever regularly used tobacco). Although 53.6% reported no loss of natural teeth, 29.5% reported losing between 1 and 5 teeth and 17% reported having lost 6 or more natural teeth. Hierarchical linear regression analyses revealed that younger adults, smokers, urban-dwellers, and those with more tooth loss experienced more poor mental health days, F (4, 359016) = 4307.6, p < .001, R^2= .05. Tooth loss uniquely contributed to the variance explained, above and beyond the other predictors (Step 2: F (1, 359016) = 3722.01, p, .001). We also conducted a multinomial logistic regression to test whether age, tobacco use, and rurality could differentiate among levels of tooth loss. These equations were significant, with odds ratios showing that rurality was the strongest predictor of tooth loss. Our results suggest that rurality is a strong predictor of oral health, even beyond the influence of age and tobacco use. Future interventions used to improve the oral health of people, including older adults, must consider the greater needs present to rural-dwelling Americans