Prevalence and associated factors of denture use among older adults living in rural and urban areas of China: a national cross-sectional study.

Abstract

Backgrounds: Tooth loss, often considered as an inevitable result of ageing, is one of the most frequently stated problems with older adults worldwide, which entails a negative impact on physical and mental health, as well as quality of life. However, there is urban-rural gap among older adults in both oral health condition and dental service utilization. The study focused on the urban-rural gap in Chinese older population, aiming to describe their tooth loss and denture use status, and explore the associated factors, hoping to provide insights into improving the oral healthcare system in China and other developing countries.

Methods: This cross-sectional study used data collected from May to September in 2020. A stratified, multi-stage cluster sampling design was used to produce nationally representative samples of 2709 adults aged 60 years and older. The dependent variable was denture use of the participant. Determinants included demographic characteristics, health status, social support, oral health knowledge and health service utilization. Descriptive analysis was conducted to describe the sample characteristics, and Generalized Linear Mixed Model was used to identify independent factors associated with denture use among older adults in rural and urban China respectively.

Results: There were significant urban-rural differences in tooth loss, denture use and health service utilization among Chinese older adults. Urban participants' denture use was associated with oral health knowledge (OR = 1.29, 95%CI = 1.07-1.56). Rural participants' denture use was associated with oral health knowledge (OR = 1.23, 95%CI = 1.02-1.47), dental checkup in the last six months (OR = 1.19, 95%CI = 1.00-1.40), and social support (OR = 1.22, 95%CI = 1.03-1.44).

Conclusions: Greater efforts should be made to enhance oral health education and emphasize the importance of regular dental checkups among older population. Targeted focus on different aspects of oral health based on the characteristics of different populations is suggested. Policymakers should be aware of the urban-rural disparity in distribution and utilization of oral health services.