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J Public Health Dent. 2018 Sep 17. doi: 10.1111/jphd.12288. [Epub ahead of print]

Oral health and access to dental care among older homeless adults: results from the HOPE HOME study.

Author information

1
Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, USA.
2
Division of General Internal Medicine, Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, USA.
3
Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA.

Abstract

OBJECTIVES:

To describe the prevalence of and factors associated with oral health measures in a sample of older homeless adults in Oakland, CA.

METHODS:

We conducted a cross-sectional analysis of data from a population-based study of 350 homeless adults aged ≥50 in which trained researchers conducted structured interviews using validated questions regarding sociodemographics, health-related behaviors, healthcare utilization, and health status. We assessed self-reported tooth loss, oral pain, and unmet need for dental care. We used multivariable logistic regression to examine factors associated with missing half or more teeth.

RESULTS:

Over half 201/350 (57.4 percent) of participants were missing at least half of their teeth. Half 191/350 (54.6 percent) reported oral pain in the past 6 months; 101/350 (28.9 percent) reported that oral pain prevented them from eating and 73/350 (20.9 percent) reported that pain prevented sleeping. Almost half, 141/350 (40.3 percent), had not seen a dentist in over 5 years, and over half 190/350 (54.3 percent) reported being unable to obtain needed dental care. In multivariate models, increased age (AOR = 1.09, 95 percent CI 1.04-1.14), moderate-to-high risk alcohol use (AOR = 2.17, CI = 1.23-3.84), moderate-to-high risk cocaine use (AOR = 1.72, CI = 1.03-2.88), and ever smoking (AOR = 2.87, CI = 1.59-5.18) were associated with an increased odds of having lost half or more teeth.

CONCLUSIONS:

Tooth loss and oral pain are highly prevalent in older homeless adults. Increasing age, alcohol, drug, and tobacco use are associated with tooth loss.

KEYWORDS:

aging; dental care; homeless persons; oral health

PMID:
30295922
DOI:
10.1111/jphd.12288

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