Oral diseases disproportionately affect poorer and disadvantaged groups of society. Despite this, there is scarce evidence regarding the monitoring of the structural determinants of health and their impact on oral health status. Thus, this systematic review addresses the question: Is oral health-related quality of life (OHRQoL) of elderly persons (aged ≥ 60 years) associated with structural determinants of health? The present systematic review of observational studies applied the following inclusion and exclusion criteria; inclusion criteria: participants living in the community aged ≥ 60 years, reporting OHRQoL using Oral Health Impact Profile (OHIP), Geriatric Oral Health Assessment Index (GOHAI) or Oral Impact Daily Profile (OIDP). Exclusion criteria: studies reporting outcomes of participants aged < 60 years and residing in long-term care facilities. Three electronic databases (i.e., Embase, MEDLINE via Pubmed and Scopus) were screened (last searched on 23rd August 2024). Quality assessment of the included studies was performed using the tailored quality assessment tool developed by the National Heart, Lung and Blood Institute for observational cohort and cross-sectional studies. Meta-analysis; the overall sum score of OHIP, GOHAI and OIDP were transformed on a scale of 0-100. Sub-group analyses were performed for OHRQoL sum scores stratified by the following variables: Country-level income, Gini index, unemployment rate, Human Development Index (HDI), out-of-pocket health expenditure, health expenditure per capita, prevalence of dental caries, edentulism and periodontal disease. The search identified 910 records. After deduplication, title, abstract and full-text review, 45 papers were included for data extraction. The highest OHRQoL sum scores were recorded in studies from countries with high-middle to high income (77.9, 95% CI 70.2–85.6), low Gini index (91.3, 95% CI 90.0-92.6), high to very high HDI (78.4, 95% CI 71.1–85.8) and lowest out-of-pocket expenditure (83.9, 95% CI 75.2–92.6). Countries with low dental caries prevalence reported higher OHRQoL compared to countries with high dental caries prevalence (81.5, 95% CI 76.5–86.6). Limitations include the fair quality of > 50% of the studies included and the high inter- study heterogeneity. Structural determinants of health contribute to a good quality of life related to oral health. Upstream interventions are essential for improving oral health conditions and quality of life among older adults. The review protocol was registered (CRD42024573590) with the International Prospective Register of Systematic Reviews (PROSPERO) system.

Objective: To evaluate oral health conditions and oral health-related quality of life in community-dwellers aged ≥ 45 years in the Canton of Bern, Switzerland. Materials and Methods: One hundred subjects (63% males; mean age: 73 years), selected randomly using a cluster procedure within the Canton of Bern, underwent a clinical oral examination after completing questionnaires on socio-economic level, medical history, oral health behaviour, and Geriatric Oral Health Assessment Index (GOHAI). Descriptive analyses and multinomial regression models were applied to investigate the association between oral health diseases (dental caries and periodontitis) and specific participant characteristics. Results: The mean number of decayed, missing, and filled teeth (DMFT) was 0.30, 4.20, and 8.75, respectively; the mean DMFT score = 13.35. Dental caries prevalence (ICDAS > 0) was 15% and periodontitis prevalence was 46%. Logistic regression models revealed that living in an urban area was associated with lower odds (OR 0.03, _95%CI 0.00–0.36) of having periodontal disease. Male gender was associated with lower odds for dental caries (OR 0.31, _95%CI 0.09–1.01) and total lack of professional tooth cleaning was associated with higher odds for dental caries (OR 41.99, _95%CI 0.01–0.38). Ordinal logistic regression revealed that both the presence of dental caries (RR 12.80, _95%CI 1.47–111.20) and periodontal disease (RR 6.91, _95%CI 1.16–84.00) were statistically significantly associated with rheumatoid arthritis. Conclusion: Within the study limitations, untreated dental caries and periodontal disease are prevalent in the Swiss population, despite the high level of self-performed oral hygiene and access to the dental care system.

Objective: The study aims to describe and analyze the oral health-related quality of life (OHRQoL) of persons aged ≥45 years in the canton of Bern, Switzerland. Material and Methods: Community dwellers were recruited by random sampling from the canton of Bern. Data were collected by a questionnaire (demographic factors, medical history, oral health behavior, dental patient-reported outcomes [dPROs]) and a clinical examination (dental caries, periodontal disease, oral hygiene, mastication). dPROs were evaluated using the OHRQoL-questionnaire Geriatric Oral Health Assessment Index with items related to four domains: functional limitations, pain and discomfort, psychological impact, behavioral impact. χ2 tests, Cochrane Armitage trend tests and binary logistic regression were performed with P < 0.05 statistical significance. Results: The highest prevalence (199/44%, n [total] = 275 participants) of reported problems was observed in the psychological impact domain. Binary logistic regression shows that participants with rheumatoid arthritis (odds ratio [OR] = 4.86, 95% confidence interval [CI] = 1.70–13.87) and chewing deficiencies (OR 28.43, 95% CI = 2.11–382.68) had higher odds of having functional limitations, while participants with bleeding gums (OR = 1.69, 95% CI = 1.02–2.81) had higher odds of experiencing pain and discomfort. Participants with depression had higher odds of having pain and discomfort (OR = 2.44, 95% CI = 1.03–5.81), suffering a behavioral impact (OR 5.89, 95% CI = 1.57–22.20) and a low OHRQoL (OR = 2.33, 95% CI = 0.09–0.58). Conclusions: The study shows that poor oral hygiene, high DMFT, chewing deficiency, rheumatoid arthritis, and depression are associated with low OHRQoL.