Chewing function impacts oral health-related quality of life among institutionalized and community-dwelling Korean elders

Abstract

Objective: The aim of this study was to assess the association of chewing ability to oral health-related quality of life (OHRQoL) measured by the Oral Health Impact Profile-14 (OHIP-14) controlling for clinical oral health status, self-reported health status, demographic factors, and socioeconomic conditions among community-dwelling and institutionalized Korean elders.

Methods: This cross-sectional study comprised a sample of 307 community-dwelling and 102 institutionalized people over the age of 60, using a cluster sampling procedure. A questionnaire was implemented and a clinical oral examination was completed for each subject. The outcome variable of interest was the OHIP-14 score, and its associations with chewing ability, objective oral health status, self-reported health status, demographic factors, and socioeconomic conditions were assessed. Because of highly-skewed distribution of the OHIP-14 scores, nonparametric analytic methods were used. The final model was developed using a multivariable two-level logistic regression model for a dichotomized OHIP-14 score to account for the cluster sampling method applied to this study.

Results: The mean age of the participants was 75.4 years, with 67.7% being women. The median OHIP-14 score was 7. Negative oral health impacts were experienced fairly often or very often by a total of 36.4% of elderly. In the final model, elders who could chew none to three and four to six foods among seven indicator foods were 3.4 (P = 0.010) and 2.0 (P = 0.040) times more likely, respectively, to have worse OHRQoL compared with elders who could chew all seven food types. Also significant associations with worse OHRQoL were shown for being concerned about oral health [Odds Ratio (OR) = 4.9, P = 0.002], fair or better self-reported oral health (OR = 0.12, P = 0.002), very good/good self-reported general health (OR = 0.38, P = 0.008), being married (OR = 2.0, P = 0.054), and having a favourable economic status (OR = 0.43, P = 0.042).

Conclusions: This study showed highly significant association between chewing ability and OHRQoL measured by the OHIP-14 score after controlling for related factors. Amelioration of chewing ability might independently contribute to improving the OHRQoL of elders.