Oral Health Comparisons in East, Middle and Western Tennessee and Factors Associated with Unfavorable Oral Health Outcome in the Tennessean Elderly

• Main Authors: Omoike, Ogbebor, Adamu, Abdullahi Musa, Liu, Ying
• Format: Others
• Published: Digital Commons @ East Tennessee State University 2020
• Subjects: oral health; Tennessee; Elderly; Healthcare
• Online Access: https://dc.etsu.edu/asrf/2020/presentations/44; https://dc.etsu.edu/cgi/viewcontent.cgi?article=1690&context=asrf

Introduction: About one in four seniors have periodontal disease and significant disparities have been shown to exist between some population groups. This study aimed to ascertain if differences exist in oral health conditions among statistical zones in Tennessee divided into east, middle and western zones. We also sought to explore factors predicting poor oral health outcomes in these zones. We postulated that oral health would differ between at least two zones in Tennessee and socio-demographic and socio-economic factors would predict oral health outcome. Methods: We combined data from the Behavioral Risk Surveillance System using Data from years 2010, 2012, 2014, 2016 (n= 5181). Outcome variable was number of permanent teeth removed which was ordered as- none, one to five, six or more but not all and all. Zones were divided into East Tennessee comprising- Kingsport-Bristol-Bristol Tennessee-Virginia metropolitan statistical area, Knoxville, Tennessee Metropolitan Statistical Area. Middle/Central Tennessee comprising Chattanooga, Tennessee-Georgia, Metropolitan Statistical Area, Nashville-Davidson-Murfreesboro-Franklin, Tennessee Metropolitan Statistical Area and West Tennessee including Memphis, Tennessee-Memphis-Arizona, Metropolitan Statistical Area. Other independent variables included in our models were general health, could not see a doctor because of cost, history of diabetes, smoked at least 100 cigarettes, use of smokeless tobacco products, adults who had visited a dentist and poor physical health. Covariates were income level, education level, employment status, race/ethnicity, year and marital status. Descriptive statistics and initial univariate analysis were done. Variables significant at alpha level of 0.05 were included in the final adjusted Ordinal Logistic regression model with logit link function. Results: From our sample, 37.1% were males and 67.9% were females. Most (43.4%) were married, most had a high school level of education (34%), most were retired (73.5%) and a higher percentage (12.4%) earned less than 25,000 per annum from all sources. A higher number were White (62.7%), and smokers (51.4%) and 31% had at least one permanent tooth removed. All variables and covariates except poor physical and mental health were significantly associated with the outcome variable (P<0.05). On adjusting for covariates, sex, income, employment status and zone of residence in Tennessee were significantly associated with a difference in the number of permanent teeth removed. The observed difference between the Eastern part of Tennessee and the Western part of Tennessee was significantly. Conclusion: Zone of residence, sex, employment status and income predict oral health outcomes in Tennessee. People in East Tennessee are more likely to have increased permanent teeth removed compared to those in the west.