Fewer Teeth in Older Adults Linked to Social Isolation

Older adults who are socially isolated are more likely to have missing teeth and to lose their teeth more quickly over time than those with more social interaction, according to a new study published in Community Dentistry and Oral Epidemiology.

The findings align with previous studies demonstrating that structural indicators of social disconnection can have powerful effects on indicators of health and well-being.

‘Maintaining and improving social connections may benefit the oral health of older adults.’

Social isolation and loneliness in older adults are major public health concerns around the world and are risk factors for heart disease, mental health disorders, cognitive decline, and premature death.

In some countries, including the United States and China, up to one in three older adults are lonely, according to the World Health Organization.

The COVID-19 pandemic has exacerbated these issues among older adults, as many in-person interactions have been interrupted to protect older adults from infection.

Social isolation and loneliness are related but different. Social isolation is an objective measure defined as having few social relationships or infrequent social contact with others, while loneliness is the feeling created by a lack of social connection.

Older adults are also at risk for another health concern of losing teeth. In China, older adults aged 65 to 74 have fewer than 23 teeth on average (adults typically have 32 teeth, or 28 if wisdom teeth have been removed) and 4.5% of this age group has lost all of their teeth.

Gum disease, smoking, lack of access to dental care, and chronic illnesses like diabetes and heart disease increase the risks of tooth loss. Missing teeth can have a significant impact on one's quality of life, affecting nutrition, speech, and self-esteem.

To understand the relationship between social isolation, loneliness, and tooth loss in older adults in China, the researchers used the Chinese Longitudinal Healthy Longevity Survey to analyze data from 4,268 adults aged 65 and up.

The participants completed surveys at three different time points (2011–2012, 2014, and 2018), which captured measures of social isolation and loneliness, how many teeth people had and lost over the 7-year study, and other factors.

More than a quarter (27.5%) of the study participants were socially isolated, and 26.5% reported feeling lonely.

Researchers found that higher levels of social isolation were associated with having fewer teeth and losing teeth more quickly over time, even when controlling for other factors such as oral hygiene, health status, smoking and drinking, and loneliness.

Older adults who were socially isolated had, on average, 2.1 fewer natural teeth and 1.4 times the rate of losing their teeth than those with stronger social ties.

This functional impairment seems to be a major pathway linking social isolation to tooth loss but it was not associated with the number of remaining teeth, nor with the rate of tooth loss.

The findings are relevant to countries beyond China, given that social isolation and tooth loss are global issues. They also highlight the importance of developing interventions to reduce social isolation.

Programs could aim to foster intergenerational support within families and improve older adults' peer and social connections within their local communities.



Source: Medindia