OP67 The influence of area-level socioenvironmental deprivation on deterioration of oral health in older age: results from a longitudinal investigation over an 8-year period

Background

There are marked socioeconomic inequalities in oral health. However, the influence of socioenvironmental circumstances of where individuals, particularly older adults, live remains underexplored. This study examined the influence of area-level socioenvironmental deprivation (objective and perceived) on changes in oral health of older adults over an 8-year period.

Methods

This study employed the British Regional Heart Study data comprising a socially and geographically representative cohort of 7735 British men initially examined in 1978–80. Surviving participants were followed-up from 2010–12 (baseline for this analysis; aged 71–92 years; n=1722) to 2018–19 (aged 78–98 years; n=667), through a physical examination including, dental assessments. Dental measures included dentition (tooth loss), self-rated oral health, and dry mouth symptoms. Changes in oral health (from baseline to follow-up) were dichotomised as sustained good/improved and sustained poor/deteriorated. Neighbourhood deprivation based on the Index of Multiple Deprivation (IMD) comprised income, employment, housing, and access to services. A cumulative index based on perceived neighbourhood factors included local area services, safety, and environment. Individual-level socioeconomic position was based on longest-held occupational social class. Multilevel and multivariate logistic regression models were undertaken for IMD and perceived neighbourhood quality, respectively.

Results

The risk of poor/deterioration of dentition (i.e., loss of teeth) increased from IMD quintile 1 (least deprived) to IMD quintile 5 (most deprived); P for trend: <0.001. The increased risk in IMD quintile 3 [OR:1.74 (95%CI: 1.06–2.83)] and IMD quintile 5 [OR:2.32 (95%CI: 1.09–4.89)], compared with IMD quintile 1, remained statistically significant on full adjustment for individual social class, smoking, alcohol consumption, history of cardiovascular disease and diabetes. Perceived neighbourhood quality index was associated with the risk of poor/deterioration of dentition (i.e., loss of teeth) and deterioration of dry mouth, with risks increasing from quintile 1 (least deprived) to quintile 5 (most deprived), P for trend: 0.001 and 0.0005, respectively. Increased risks of poor/deterioration of dentition remained significant in quintile 4 [OR:1.70 (95%CI: 1.01–2.89)] and quintile 5 [OR:1.89 (95%CI: 1.00–3.57)] on full adjustment. Risk of deterioration of dry mouth was higher in quintile 5 [OR:2.09 (95%CI: 1.15–3.78)] compared with quintile 1 of perceived neighbourhood quality after full adjustment.

Conclusion

Socioenvironmental deprivation (objective and perceived) of area of residence potentially contributes to deterioration of oral health in older adults, independent of their individual social class. The generalisability of these findings needs to be tested in studies of older non-White and female populations. Further research is warranted on socioenvironmental factors to tackle oral health inequalities in older age.