What Is Oral Health-Related Quality of Life?
Oral health-related quality of life (OHRQOL) is the impact that a patient’s oral health has on their daily functioning.3
Oral health problems are rarely acutely life-threatening. However, poor oral health can cause serious social, economic, and psychological problems.3
Pain and loss of function due to dental problems can affect many daily activities that are integral to a patient’s well-being, such as:3
- Eating
- Talking
- Smiling
Tooth loss can significantly impact one’s quality of life.4 Tooth loss can even be used to predict life expectancy. A study of adults who lived past the age of 100 found lower rates of edentulism at ages 65 to 75 compared to others who did not live to 100.5
Risk Factors for Poor Oral Health
The risk factors for having poor oral health include:6
- High consumption of sugar
- Alcohol use
- Tobacco use
- Poverty
Patients at risk for poor oral health may also be at risk for other chronic conditions, such as cardiovascular disease, cancer, diabetes, and respiratory disease, which share these risk factors.6
How Does Poor Oral Health Affect OHRQOL?
Poor oral health can make daily activities more difficult or less enjoyable, decreasing a patient’s quality of life.1
Eating
Patients with poor oral health may have difficulty eating. The mouth is the beginning of the digestive tract, and loss of function can significantly affect how patients eat and their nutrition status. Tooth loss can decrease the efficiency of chewing. Even if patients have dentures, chewing may be up to 40% less efficient than chewing with natural teeth.2
A reduced ability to chew efficiently encourages patients to choose foods that are softer and easier to chew. This may encourage food choices that are more unhealthy, such as foods high in saturated fat and cholesterol. Tooth loss in older adults has been associated with both weight loss and obesity.2
A study of more than 2,500 adults over the age of 60 found that participants without teeth or who wore dentures ate fewer fruits and vegetables than those with teeth.7
Social Interaction
Individuals with poor oral health and tooth loss can have difficulty with social interaction for various reasons.2
Teeth are important for speech and communication. Tooth loss may affect how an individual pronounces words or make it harder to communicate with facial expressions, such as smiling.1 Additionally, tooth loss can affect one’s appearance, leading to self-consciousness and lower self-esteem.2
Pain
Oral disease can cause significant pain that will not improve without proper treatment. It is well-documented that chronic pain can decrease an individual’s quality of life.8 Pain from oral diseases such as caries, ulcers, or periodontitis can negatively impact several daily activities and sleep.2
Benefits of Good Oral Health
In addition to reduced risk of oral disease that can lead to tooth loss, good oral health is linked to systemic health benefits. Several studies have found benefits to overall health with enhanced oral hygiene and treatment of dental diseases.
A 2010 Cochrane review found that glycemic control in patients with type 2 diabetes improved after receiving treatment for periodontal disease.9
A population-based survey of more than 11,000 people in Scotland found that participants who self-reported frequent teeth brushing had a lower risk of cardiovascular disease.10
Two different systematic reviews found good oral hygiene in older adults living in nursing homes or other institutions may prevent respiratory infections such as aspiration pneumonia.
Improving Oral Health
It is clear that good oral health can have a significant impact on a patient’s overall health and quality of life. Poor oral health is often preventable.2
Preventative care is one of the most important aspects of preventing poor oral health. However, accessing dental care can be challenging for those at risk of dental problems, such as older adults. Fluorides applied to teeth with toothpaste or in the dentist's office can decrease the incidence of caries.2
Community programs and education are important to improving patient’s oral health and, therefore, their overall health and quality of life.
References:
- Block C, König HH, Hajek A. Oral health and quality of life: findings from the Survey of Health, Ageing and Retirement in Europe. BMC Oral Health. 2022 Dec 15;22(1):606. doi: 10.1186/s12903-022-02599-z. PMID: 36517821; PMCID: PMC9753255.
- Griffin SO, Jones JA, Brunson D, Griffin PM, Bailey WD. Burden of oral disease among older adults and implications for public health priorities. Am J Public Health. 2012 Mar;102(3):411-418. doi: 10.2105/AJPH.2011.300362. Epub 2012 Jan 19. PMID: 22390504; PMCID: PMC3487659.
- Baiju RM, Peter E, Varghese NO, Sivaram R. Oral Health and Quality of Life: Current Concepts. J Clin Diagn Res. 2017 Jun;11(6):ZE21-ZE26. doi: 10.7860/JCDR/2017/25866.10110. Epub 2017 Jun 1. PMID: 28764312; PMCID: PMC5535498.
- Liang LY, Tsai MC, Shih KC, et al. Tooth life expectancy and burden of tooth loss: Two cross-sectional studies in Taiwan. J Dent Sci. 2022 Jul;17(3):1364-1370. doi: 10.1016/j.jds.2022.05.002. Epub 2022 May 21. PMID: 35784138; PMCID: PMC9236957.
- Friedman PK, Lamster IB. Tooth loss as a predictor of shortened longevity: exploring the hypothesis. Periodontol 2000. 2016 Oct;72(1):142-152. doi: 10.1111/prd.12128. PMID: 27501497.
- World Health Organization. Oral Health. Updated March 14, 2023. Accessed November 22, 2023. https://www.who.int/news-room/fact-sheets/detail/oral-health#:
- Ervin RB, Dye BA. The effect of functional dentition on Healthy Eating Index scores and nutrient intakes in a nationally representative sample of older adults. J Public Health Dent. 2009 Fall;69(4):207-216. doi: 10.1111/j.1752-7325.2009.00124.x. PMID: 19453869.
- Pandelani FF, Nyalunga SLN, Mogotsi MM, Mkhatshwa VB. Chronic pain: its impact on the quality of life and gender. Front Pain Res (Lausanne). 2023 Sep 13;4:1253460. doi: 10.3389/fpain.2023.1253460. PMID: 37781217; PMCID: PMC10534032.
- Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, Stevenson B, Furness S, Iheozor-Ejiofor Z. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2015 Nov 6;2015(11):CD004714. doi: 10.1002/14651858.CD004714.pub3. Update in: Cochrane Database Syst Rev. 2022 Apr 14;4:CD004714. PMID: 26545069; PMCID: PMC6486035.
- de Oliveira C, Watt R, Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey. BMJ. 2010 May 27;340:c2451. doi: 10.1136/bmj.c2451. PMID: 20508025; PMCID: PMC2877809.
