Self-reported and clinical oral health in users of VA health care

Background This article describes the oral health of users of Veterans Admi nistration (VA) health care using both clinical and self-report measures, a nd models relationships between these measures and self-perceived oral heal th. Methods. We conducted a cross-sectional study of 538 male users of VA outpa tient care in the Boston area. Questionnaires assessed self-reported oral h ealth, oral-specific health-related quality of life, health behaviors, and sociodemographic information. Clinical data were collected on oral mucosa s tatus, number of teeth and root tips, dental caries, and periodontal treatm ent need. We report clinical and self-reported oral health status by age gr oup (era of military service). We regressed models of self-perceived oral h ealth on clinical indices and self-reported measures of the impact of oral health on daily life, adjusting for sociodemographic characteristics and he alth behavior. Results. Among those participants aged 65 to 91 years old, 2.8%, 18.7%, and 41.5% rated their oral health as excellent, very good, or good, respective ly. Among 50- to 64-year-old men, the corresponding values were 1.4%, 18.5% , and 40.4%, while among those aged 22 to 49 years old, the values were 2.3 %, 17%, and 34.1%. Tooth loss was common among users of VA care; 34% of tho se aged 65-90 years, 28% of those aged 50-64 years, and 28% of those aged 2 5-49 years had no teeth. Periodontal treatment needs were uniformly high am ong persons with teeth; mild mucosal change was common, and 10% had root ti ps. Regression models showed self-perceived oral health was better in perso ns with more teeth and recent dental treatment, and worse with tooth mobili ty, coronal decay, and more medical problems. Measures of the impact of ora l conditions on daily life added significantly to the amount of explained v ariance in self-perceived oral health. Conclusions. Clinical conditions and the impact of oral health on daily life are important determinants of self -perceived oral health.