Abstract
OBJECTIVES: To compare oral health status according to ethnicity and socioeconomic status in African-American, American-Indian, and white dentate and edentulous community-dwelling older adults. DESIGN: Cross-sectional study; data from self-reports and oral examinations. PARTICIPANTS: A multistage cluster sampling design was used to recruit 635 participants aged 60 and older from rural North Carolina counties with substantial African-American and American-Indian populations. MEASUREMENTS: Participants completed in-home interviews and oral examinations. Self-reported data included sociodemographic indicators; self-rated oral health status; presence or absence of periodontal disease, bleeding gums, oral pain, dry mouth; and fit of prostheses. Oral examination data included number of teeth and numbers of anterior and posterior functional occlusal units. RESULTS: African Americans and American Indians had significantly lower incomes and educational attainment than whites. Self-rated oral health was significantly better in whites than in African Americans and American Indians. Prevalence of self-reported periodontal disease and bleeding gums was lower in whites. Of dentate participants, African Americans were significantly more likely than whites to have 11 to 20 teeth and one or two posterior occlusal contacts. Oral health deficits remained associated with ethnicity when adjusted for socioeconomic variables. CONCLUSION: Oral health disparities in older adults in a multiethnic rural area were largely associated with ethnicity and not socioeconomic status. Clinicians should be aware of these health disparities in oral health status and their possible role in disparities in chronic disease. Further research is necessary to understand whether these oral health disparities reflect current or lifetime access to care, diet, or attitudes toward oral health care.