Ecological Model Factors and Retention of at Least 20 Functional Permanent Teeth among Older Adults in Bangrak Subdistrict, Mueang District, Trang Province

Abstract

Introduction: Tooth loss has a profound impact on overall health and quality of life in older adults. Objective: This study aimed to investigate the prevalence of having at least 20 functional permanent teeth, analyze factors within the ecological model, and explore the relationship between these ecological factors and the retention of at least 20 functional permanent teeth in older adults in Bangrak Subdistrict, Mueang District, Trang Province. Methods: An analytical cross-sectional study was conducted among 270 older adults. Data was collected through interviews and oral health assessments. Results: Of the participants, 37.41% had at least 20 functional permanent teeth, with an average of 15.17 teeth per person (SD=9.03). Significant individual-level factors associated with having at least 20 functional permanent teeth included age and perceived oral health problems. Participants aged 60-74 years were 2.08 times more likely to have at least 20 functional permanent teeth than those aged 75 and above (95% CI: 1.12-3.85). Those who did not perceive difficulties in eating or chewing were 2.19 times more likely to have at least 20 functional teeth (95% CI: 1.28-3.73), while those who did not report speech or pronunciation problems were 4.14 times more likely to have 20 or more teeth (95% CI: 1.55-11.06). After adjusting for potential confounding factors, only age remained significantly associated; participants aged 60-74 years were still more likely to have at least 20 functional permanent teeth than those aged 75 and above, with an adjusted odds ratio of 1.93 (95% CI: 1.01-3.71) Conclusion: Only 37.41% of older adults had at least 20 functional permanent teeth, with an average of 15.17 permanent teeth per person. Significant individual-level factors associated with having at least 20 functional permanent teeth included age and perceived oral health problems, particularly difficulties in chewing and speaking. Age was a key predictor of functional permanent tooth retention, while awareness of oral health issues played an important role in preventing or delaying tooth loss. Tooth loss clearly impacts daily quality of life, especially in terms of eating and communication. Therefore, promoting awareness of the consequences of tooth loss and improving access to proactive dental care services are essential to sustainably maintain oral health and overall quality of life among older adults.