This cross-sectional study evaluated whether histories of systemic disease among community-dwelling older adults were associated with self-reported subjective oral status and oral health behaviours. The authors note that inadequate oral hygiene and management affect oral health and have been linked to systemic disease, but relationships between systemic disease history and oral perceptions or behaviours remain insufficiently examined. The stated purpose was to investigate associations between systemic disease history and three oral-related variables: concerns about oral condition, use of interdental cleaning aids, and prior receipt of oral hygiene instruction.
Data were drawn from 979 individuals aged 65–85 years who participated in a 2018 group examination in Higashiura-cho, Aichi Prefecture, Japan. Participants completed a self-administered questionnaire that included items on oral status, oral health behaviours, and histories of systemic diseases. The mean age of the sample was 73.0 ± 5.2 years, and 52.4% of participants were female. The analysis is explicitly cross-sectional and observational.
Oral-related variables assessed were:
Systemic disease histories collected by self-report included: cancer, myocardial infarction, stroke, hypertension, diabetes, liver disease, lung disease, mental illness, and bone disease.
The investigators used multivariable logistic regression to assess associations between each oral-related variable and histories of the specified systemic diseases. The regression models adjusted for covariates as appropriate for the analysis (details of covariates were reported in the source). Odds ratios (ORs) with 95% confidence intervals (CIs) were reported for associations between oral variables and disease histories.
The analytic sample included 979 older adults (mean age 73.0 ± 5.2 years; 52.4% female). Primary outcomes of the regression analyses were:
No other statistically significant relationships between the oral-related variables and the other systemic diseases listed (cancer, myocardial infarction, stroke, diabetes, liver disease, lung disease, mental illness, bone disease) were reported as significant in the source.
The observed positive association between receiving oral hygiene instruction and a history of hypertension indicates participants with hypertension were more likely to report having received instruction on oral hygiene. The source does not establish causality or directionality; possible interpretations include greater dental-care engagement among people with hypertension, differential counseling by dental professionals for patients with known hypertension, or reporting differences. The lack of association for self-reported concerns about oral condition and the use of interdental brushes and dental floss suggests these subjective perceptions and self-reported behaviours were not linked to the systemic disease histories measured in this sample.
The authors emphasized that all disease histories and oral-health measures were self-reported. Self-report introduces potential measurement error, recall bias, and misclassification. The cross-sectional design precludes determination of temporal sequence or causation between systemic disease history and oral-health behaviours or perceptions. The study was conducted in a single municipality in Japan and the sample comprised volunteers attending a group examination, which may affect generalizability. These limitations were noted as reasons for interpreting the findings cautiously.
Based on the observed association, the authors recommend that dental hygienists consider patients’ systemic health status—particularly hypertension—when providing oral hygiene instruction. The finding suggests that patients with a history of hypertension were more likely to have received instruction, but because of reliance on self-report and the cross-sectional design, this should not be interpreted as evidence that instruction affects hypertension or vice versa. Dental professionals should integrate awareness of systemic disease histories into oral-health education and tailor communication and instructional strategies accordingly.
In this study of 979 community-dwelling older adults aged 65–85, no associations were found between self-reported oral concerns or interdental cleaning use and histories of systemic disease. Receiving oral hygiene instruction was positively associated with a self-reported history of hypertension (OR 1.4; 95% CI 1.0–2.0). Results derive from self-reported, cross-sectional data, and the authors advise cautious interpretation. The study highlights the importance of considering systemic health, especially hypertension, in oral hygiene counseling for older adults.