Oral Health May Put Older Chinese-Americans’ Mental Health at Risk

Two new studies review the impact of poor oral health on the psychological well-being and overall health of older Chinese-Americans. The studies examined the relationship between poor oral health and cognitive decline and the effects of perceived stress and social support.

Traditionally, poor oral health is associated with decreased quality of life, depression, hypertension, and cognitive decline.

The Rutgers studies, co-authored by Darina Petrovsky, Bei Wu, and Weiyu Mao, assessed the health of more than 2,700 Chinese-Americans aged 60 and older. The researchers discovered that nearly 50 percent of study participants reported experiencing tooth symptoms, and 25.5 percent reported dry mouth.

In the first study, those who reported tooth symptoms experienced declines in cognition and episodic memory, often precursors to dementia. In the second study, the researchers found that stress increased symptoms of dry mouth, leading to poorer overall oral health.

“Racial and ethnic minorities are particularly vulnerable to the negative consequences of poor oral health,” said XinQi Dong, M.D., director of Rutgers University’s Institute for Health, Health Care Policy and Aging Research.

“Minorities have less access to preventive dental care that is further exacerbated by language barriers and low socioeconomic status. Older Chinese-Americans are at particular risk for experiencing oral health symptoms due to lack of dental insurance or not visiting a dental clinic regularly.”

According to Dong, the increasing oral health disease burdens among older Chinese immigrants point to the need for investigations of psychosocial factors due to the current emphasis on physical diseases and health behaviors in oral health.

“Efforts must be made to increase social support to alleviate stress and the resulting dry mouth issues reported by our study participants,” Dong continued. “These efforts can help preserve older adults’ health and well-being and limit cognitive decline.”

Key findings:

• 47.8 percent of older Chinese-Americans reported having teeth symptoms; participants who reported teeth symptoms at baseline experienced their global cognition and episodic memory decline
• 18.9 percent of older Chinese-Americans reported gum symptoms.
• 15.6 percent of older Chinese-Americans reported teeth and gum symptoms.
• 25.5 percent of older Chinese-Americans reported dry mouth.
• More perceived stress was associated with higher odds of dry mouth.

“These studies demonstrate the importance of examining immigrant oral health outcomes later in life to understand the specific type of outcomes of different cultural groups,” said Dong.

“The studies further serve as a call to action for policymakers to develop programs aimed at improving oral health preventative and dental care services in this high-risk population.”

First author Darina Petrovsky, Ph.D., added, “Examining current oral health practices among older Chinese-Americans is crucial for developing culturally-tailored interventions to promote oral health and ultimately mitigate cognitive decline.”

“Poor oral health is a top concern among older Chinese-Americans. In our study, the prevalence rate of dry mouth is followed by diabetes and heart disease. Our findings demonstrate the importance of studying the linkage between stress and dry mouth in this vulnerable population.” said author Weiyu Mao, Ph.D., assistant professor, University of Nevada, Reno.

“Support from family and friends could be protective against dry mouth symptoms in relation to stress; however, the potential overload of such support could be detrimental to oral health outcomes among older Chinese-Americans,” Mao continued.

“Intervention strategies need to expand beyond the common risk factors, such as health conditions and health behaviors, and account for the psychosocial determinants, including stress and social support, to better promote oral health and reduce oral health disparities in this population.”

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