Exploring the National Health and Nutrition Examination Survey Data: Oral Health and Activities of Daily Living

Research Objectives: To investigate the relationship between three measures of oral health and performance in activities of daily living (ADLs) among adults in the United States.

Design: Secondary data analysis using repeated cross-sectional, nationally representative NHANES data from 1999 through 2018. The NHANES is a publicly available dataset from the National Center for Health Statistics.

Setting: Not applicable.

Participants: Adults 20 years of age or older. 8,518 total cases without missing data.

Interventions: Not applicable.

Main Outcome Measures: Oral health outcomes measured as time since last dental visit, self-reported oral health, and oral health examination. ADL outcomes measured using self-reported difficulty with eating, using utensils, and drinking from a cup, and dressing.

Results: Chi-squared testing indicated variables sex (p = 0.022), age (p = 0.000), education (p = 0.000), income (p = 0.000), marital status (p = 0.000), nativity (p = 0.000), and citizenship (p = 0.000) were significantly associated with ADL difficulty. Logistic regression model indicated significant predictors of ADL difficulty. Poorer self-reported oral health is significantly associated with increased odds of ADL difficulty. However, time of last dentist visit and presence of root caries were not associated with ADL difficulty. As income level and education levels increase, odds of ADL difficulty decrease. As age increases, odds of ADL difficulty increase as well. Non-Hispanic Asians face increased odds of ADL difficulty (p = 0.015) as do Mexicans (p = 0.00). Model included additional controls including data collection year.

Conclusions: Healthcare personnel (HCPs) should educate patients on the importance of oral health and provide active intervention for oral care to ensure patients are able to participate in this vital ADL. HCPs should talk with patients about their self-rated oral health to identify patients who may be at risk of decreased ADL performance. This research suggests HCPs should be aware that certain demographic groups, such as older adults, non-Hispanic Asians, and Mexicans, may be at higher risk of ADL difficulty.

Author(s) Disclosures: None.