Do postponed dental visits for financial reasons reduce quality of life? Evidence from the Survey of Health, Ageing and Retirement in Europe

Oral health and quality of life: findings from the Survey of Health, Ageing and Retirement in Europe

BACKGROUND

The aim of this study was to clarify the link between oral health and quality of life among older adults in Europe.

METHODS

Cross-sectional data from wave 5 (n = 59,048 observations) were used from the representative Survey of Health, Ageing and Retirement in Europe. Oral health was quantified by three questions: presence of all natural teeth (yes; no); among individuals with missing natural teeth, the number of missing teeth and the extent of replaced natural teeth were quantified. Quality of life was quantified using the widely used CASP-12. Multiple linear regressions were used to determine the association between oral health and quality of life, adjusting for various potential confounders.

RESULTS

Multiple linear regressions showed that higher quality of life was associated with (1) the presence of all natural teeth and among individuals with missing natural teeth, with (2) a lower number of missing natural teeth and (3) completely replaced natural teeth. Additionally, quality of life was positively associated with younger age, being female, being married or in a partnership, higher income, higher educational level, not currently smoking, a lower number of functional impairments, better self-rated health, a lower number of depressive symptoms and a lower number of chronic diseases.

CONCLUSION

Study findings showed an association between oral health and quality of life among older adults in Europe. Thus, the importance of good oral health for successful ageing was stressed. Future research is required to clarify the underlying mechanisms. Moreover, longitudinal studies are required to confirm our current findings.

Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review

Background: A systematic review synthesizing studies examining the determinants of dental service use drawing on the (extended) Andersen model is lacking. Hence, our purpose was to fill this knowledge gap; Methods: Three established electronic databases (PubMed, PsycInfo, as well as CINAHL) were searched. Observational studies focusing on the determinants of dental service use drawing on the Andersen model were included; Results: In sum, 41 studies have been included (ten studies investigating children/adolescents and 31 studies investigating adults). Among children, particularly higher age (predisposing characteristic), higher income (enabling resource) and more oral health problems (need factor) were associated with increased dental service use. Among adults, findings are, in general, less consistent. However, it should be noted that one half of the studies found an association between increased education (predisposing characteristic) and increased dental service. In general, study quality was rather high. However, it should be noted that most studies did not report how they dealt with missing data; Conclusions: Our systematic review revealed that all components (i.e., predisposing characteristics, enabling resources and need factors) of the Andersen model tend to be associated with dental service use among children, whereas the findings are more mixed among adults. In conclusion, beyond need factors, dental service use also tend to be driven by other factors. This may indicate over—or, more likely—underuse of dental services and could enrich the inequality discussion in dental services research.

Postponed Dental Visits during the COVID-19 Pandemic and their Correlates. Evidence from the Nationally Representative COVID-19 Snapshot Monitoring in Germany (COSMO)

(1) Background: The COVID-19 pandemic is accompanied by various societal and economic challenges. Furthermore, it is associated with major health challenges. Oral health is a key component of health. Therefore, both curative and preventive dental visits are important during pandemics. Since there is a lack of nationally representative studies focusing on postponed dental visits and their correlates during the COVID-19 pandemic, we aimed to fill this gap in knowledge; (2) Methods: Cross-sectional data (wave 17) were collected from a nationally representative online-survey (COVID-19 Snapshot Monitoring in Germany (COSMO)) conducted in July 2020. The analytical sample consisted of 974 individuals (average age was 45.9 years (SD: 16.5, from 18 to 74 years)). The outcome measure was postponed dental visits since March 2020 (yes; no) due to the COVID-19 pandemic. Furthermore, the type of postponed dental visits was recorded (check-up/regular dental examination; pain/dental complaints; planned therapy); (3) Results: 22% of participants reported to have postponed dental visits due to the COVID-19 pandemic since March 2020, whereas 78% of individuals did not report postponed visits (“no, attended as planned”: 29.2%; “no, examining pending”: 44.9%; “no, other reasons”: 3.9%). Among individuals who reported postponed dental visits, 72% postponed a “check-up/regular dental examination”, whereas 8.4% postponed a dental visit despite “pain/dental complaints” and 19.6% postponed “planned therapy”. Furthermore, multiple logistic regressions showed that the likelihood of postponed dental visits was positively associated with being younger (aged 65 and older, OR: 0.43, 95% CI: 0.22–0.85; compared to individuals 18 to 29 years), and higher affect regarding COVID-19 (OR: 1.36, 95% CI: 1.13–1.64); (4) Conclusions: Our study showed that more than one out of five individuals postponed a dental visit—particularly check-ups and regular dental examination—due to the COVID-19 pandemic since March 2020. Several correlates of these postponed visits have been identified. This may help identify and address individuals at risk for deterioration of oral health amplified by postponed dental visits.