1. Impact of Oral Health on Quality of Life in the Elderly
Author: Emily Lamb
Word Count in Body of Text: 1059
Journal Referencing Format: Clinical Interventions in Aging

2. ABSRACT
Purpose: Evidence suggests an association between oral health and the quality of life an elderly
individual experiences. The purpose of this paper is to examine the current research pertaining to this
association; specifically, the impact that oral health has on the process of aging and individual
perceptions of well-being among the elderly.
Methods: I utilized an online search engine to find information related to the search terms “oral health
elderly” and “cognitive decline and well-being”. From these searches I found articles from databases
such as PubMed and Wiley Online Library. These resources offered articles that afforded me the
opportunity to compare and corroborate information, which further allowed me to establish a general
sense of the validity of the research and analyses I was reading.
Results: Poor oral health has been associated with many adverse health effects including systemic
diseases, cognitive decline, social anxiety and depression. There is also research that suggests that
socioeconomic status plays a role in an individual’s oral health status, as well as their perception of well-
being. Understanding the relationship between an individual’s oral health and their perception of well-
being is a developing aspect of health in the field of geriatrics.
Conclusions: Among the research I reviewed, there exists a concern for the impact that oral health has
on other health outcomes within the elderly population. Additional research may clarify understanding
and solidify associations between well-being and oral health.

3. INTRODUCTION
The degree to which oral health impacts both an individual’s perception of well-being and their
true state of health is of growing interest in the field of geriatrics. Oral infections, such as periodontitis,
have been associated with systemic diseases, while other oral health problems are antecedent to
malnutrition and depression.[1] Instruments, such as the Health- and Oral Health-Related Quality of Life
(OHRQoL), have been created to measure the impact of health on an individual’s ability to function and
their perception of well-being.[1] Additionally, exams such as the Modified Mini-Mental State
Examination (3MS) have been utilized in the process of investigating the relationship between
periodontal disease and cognitive decline. Cognitive decline has been associated with diminished well-
being, specifically in areas of purpose in life that involve behavioral regulation.[4]
Factors that influence an individual’s oral health consist of genetics and lifestyle,[3] both of
which are affected by an individual’s socioeconomic status.[1,5] Education remains the most important
preventative measure for assuring oral health over a lifetime, but socioeconomic status and the lack of
affordable dental care in the U.S. makes accessing care difficult for many Americans. For many
individual’s, primary oral health care measures, such as brushing and flossing one’s teeth, will not
eliminate the development of dental caries or periodontitis, which, when left uncared for, can result in
edentulism. This loss of teeth has been directly correlated to malnutrition, as mastication becomes more
difficult, and to social anxiety and depression, as one’s self esteem is impacted by their absence of
teeth.[1] Additionally, edentulism has been proposed as a good predictor of mortality.[1]
METHODS
I utilized the Portland State University Library search engine for databases and articles. Using the
search terms “oral health elderly” I was able to find peer-reviewed articles from journals such as the
Journal of the American Geriatrics Society. From these resources I was able to compare and corroborate

4. information which allowed me to establish a general sense of the validity of the research and analyses I
was reading. In addition, I conducted a separate search in the same search engine for the terms
“cognitive decline and well-being” to better understand the associations described by articles from my
previous search between well-being and oral health as specific oral infections and diseases were
suggested to result in cognitive decline.
RESULTS
Oral health is mediated by many factors including behavioral, nutritional, and lifestyle. Like
many aspects of health, determining a causal relationship can be difficult as many factors are
compounding. An individual’s perception of well-being and quality of life is an example of this. As a
result, considerations for the roles that other influences, besides oral health, play in an individual’s life
have been made by the people employing these subjective instruments; such as the OHRQoL.[1] After
controlling for factors such as general health, income and marital status, it has been discovered that oral
problems affecting older populations (e.g. dry mouth, edentulism, and problems with mastication) are
correlated with a worsened quality of life.[1] The OHRQoL is a subjective measurement that considers
an individual’s perception of well-being. The OHRQoL has been used to measure the effectiveness of
treatments in dental research and clinical practices of dentistry by comparing participant’s OHRQoL
scores before and after interventions.[1]
Edentulism the loss of teeth, often due to caries and periodontitis that have been left untreated.
Periodontitis is a type of gum infection that causes damage to the soft tissue and bone that supports the
teeth. Antibodies to common periodontal pathogens are associated with an increased risk of
atherosclerosis, heart attack and stroke. There is even research developing on the relationship between
periodontal disease and cognitive decline.[2] Cognitive decline in the elderly is associated with various
health issues from disability to death. Efforts have been made to better understand the effect that

5. cognitive decline has on an individual’s well-being.[4] A 2013 study that conducted annual clinical
evaluations on its participants for an average of five to six years, observed that, among other things,
lower levels of cognitive function and increased rates of cognitive decline resulted in lower levels of
well-being.[4]
Access to dental care and the use of preventative oral health care measures has been shown to
affect the self-reported oral health status of an individual and suggests a correlation with socioeconomic
status.[5] In an analyses of data from two cohort studies, associations were found between the level of
prestige of a man’s occupation (women were not mentioned as the cohort consisted only of men) and
the number of teeth they had. Men who made less than $40,000 annually had an average of 19.5 teeth
and rated their oral health more poorly than did men making more money annually (compare at an
average of 21.9 teeth).[5] From this same analyses, men that had a preventative visit in the past year
had an average of 22.4 teeth compared to 16.1 teeth for those who had not had a preventative visit in
the past year. 88% of men with higher income had gone for a preventative visit in the past year
compared to 75% of men from lower income jobs.[5]
DISCUSSION
Oral health influences aspects of an individual’s health including their physical, mental and social
health. Even when confounders have been controlled, poor oral health status and the existence of
adverse oral health characteristics have been correlated with aggravating quality of life. Instruments
such as the OHRQoL have been used in studies that seek to better understand this correlation. While the
OHRQoL has been used as an effective instrument in dental research and clinical practice, it is important
to remember that due to its subjective nature, data rendered from it should be interpreted with care.
For purposes of better understanding associations and establishing relationships between well-being

6. and oral health, it would be advantageous for well-being to become clinically defined, making it easier to
objectively measure.
The possible role of socioeconomic status in the oral health status and outcomes of an individual
is an area in need of further exploration. The implications of such an interaction would be indicative of a
need for public health outreach in the form of education and dental health care services to low-income
and under-served populations. Additionally, better understanding limitations that elderly populations
may face when accessing dental care in terms of transportation, making appointments and
remembering directives from dentist, would be necessary for implementing effective preventative oral
health care measures.

7. REFERENCES
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304-313. doi: 10.1037/a0031196
5 Huntington, N. L., Krall, E. A., Garcia, R. I. and Spiro, A. (1999), SES and Oral Health Status in
an Elderly Population. Annals of the New York Academy of Sciences, 896: 451–454.
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