Dietary implications of oral health decrements among African-American and White older adults

Objective. Older African-Americans are at disproportionate risk of chronic, nutritionally-related diseases. To begin to understand factors that may contribute to the disproportionate prevalence of life-threatening illnesses among African-Americans, this study investigates ethnic differences in the prevalence of oral health decrements. Design. The Florida Dental Care Study (FDCS), a longitudinal study of changes in the oral health of 873 subjects age 45+, was used to explore a broad range of oral health status differences between African-American and White adults in the United States. The FDCS consists of clinical and self-reported measures of oral health, sociodemographic information, and other indicators of oral functional status. Results. The prevalence of oral health decrements in this sample using a broad range of clinical and self-reported measures was substantial. African-American elders were at a heightened risk of poor oral health profiles, including having fewer teeth and being more likely to have a carious surface, fractured cusp or incisal edge, severely mobile teeth and severe periodontal levels than their White counterparts. Furthermore, the African-American respondents in our sample were significantly more likely to report a lower self-rated oral health and functioning than their White counterparts. These findings persist regardless of poverty status or educational level, two factors commonly thought to confound racial differences in health outcomes. Conclusion. Our study provides evidence that the widespread prevalence of oral health decrements and accompanying functional disability among this sample of dentate older adults impacts their daily lives. Of particular concern is the oral health status of older African-Americans who may be nutritionally vulnerable due, in part, to these oral health decrements and disabilities. We suggest enhancing the access of health services in order to prevent those oral health decrements that presumably undermine adequate dietary intake.