includes self-reported oral health measures and chronic disease outcomes, as well as comprehensive sociodemographic and biological variables, making it very well-suited to our research questions. Q What were your main findings? NG: As hypothesized, we found individuals with poor oral health to have multiple chronic conditions, or what the Public Health Agency of Canada collectively defines as multimorbidity. Previous research has linked individual chronic diseases—such as diabetes, cardiovascular diseases, chronic respiratory diseases and mental illnesses—to oral health conditions, but we didn’t know much about the relationship of multiple chronic diseases, or multimorbidity, to oral health. We also found the risk for multimorbidity to be greater in those who have not been able to see the dentist in the past year, and those who reported cost barriers to accessing oral health care due to financial constraints or lack of dental insurance. These findings really underscore how deeply oral health and general well-being are connected, and they shine a light on the need for policies that make oral health care more accessible for older adults with chronic diseases. Q Could you talk more about why you study access to dental care for seniors? NG: Many seniors face unique challenges. As people age, they are likely to develop more chronic conditions like diabetes and cardiovascular diseases, which we know are linked to oral health. Also, many seniors no longer have dental benefits upon retirement, making oral health care harder to afford. Yet, older adulthood is generally when oral health needs are higher, because aging physiologically affects oral tissues. In 1971, Julian Tudor Hart proposed the “inverse care law,” which states that the availability of good medical care is inversely related to the need for it in a population. This is an example of this concept; access to quality oral health care for our seniors is very important, which is why we wanted to look at how it impacts seniors’ health and well-being. Provincial dental care programs for seniors and, more recently, the Canadian Dental Care Plan are good initiatives in this area, and we’re hoping to see the impacts of these targeted interventions for this population. Q What outcomes from this study surprised you? NG: Previous studies on oral health inequalities made us expect to find connections between suboptimal oral health and multiple chronic diseases. What was interesting was that this was further exacerbated by the lack of access to oral health care and that it was particularly evident in older adults. On top of these findings, we conducted a subsequent study to investigate whether there were differences between men and women in the impact of access to oral health care on the chronic disease burden. Men are generally more likely to have poor oral health, but we were surprised to find older women to be more affected by issues of lack of access to oral health care than men. When you think about it, it makes sense because women generally face more socioeconomic barriers and are more likely to have lower and fixed incomes in older age, which impacts their access to oral health care. Q What further research questions did this study bring up for you? NG: So far, our research has been able to indicate associations quite well. We want to further understand whether there are causal links between oral and overall health. Importantly, we want to “break the cycle” by determining the impact of oral health interventions. My team has recently received a catalyst grant from the Canadian Institutes of Health Research that will enable us to further establish the longer-term impacts of improved access to oral health care on the oral and overall health of older Canadians and look at the broader structural and geographic determinants of health. This is work in progress, and we look forward to sharing our results soon. Reference: 1. Limo L, Nicholson K, Stranges S, Gomaa N. Suboptimal oral health, multimorbidity, and access to dental care. JDR Clinical & Translational Research. 2024;9(1_suppl):13S-22S. Men are generally more likely to have poor oral health, but we were surprised to find older women to be more affected by issues of lack of access to oral health care than men. 19 Issue 1 | 2025 | Issues and People
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