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Updated: Sep 20, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Association between level of education and oral health status in 35-, 50-, 65- and 75-year-olds
J Paulander1, P Axelsson, J Lindhe
1Department of Periodontology, Faculty of Odontology, The Sahlgrenska Academy of Göteborg University, Sweden. jorgen.paulander@liv.se
Aim:
The aim of the present study was to evaluate the association between educational level and dental disease, treatment needs and oral hygiene habits.
Material And Methods:
Randomized samples of 35-, 50-, 65- and 75-year-olds, classified according to the educational level: [low (LE): elementary school or higher (HE)], were identified. In 1091 subjects, a number of characteristics such as (i) number of teeth, (ii) periodontal attachment levels (PAL), (iii) caries and (iv) occlusal function were recorded. Educational level, oral hygiene and dietary habits were self-reported. Non-parametric variables were analyzed by chi2, Mann-Whitney U-Wilcoxon's rank sum tests, and parametric variables by Student's t-test (level of significance 95%). A two-way anova was performed on decayed, missing and filled surfaces to investigate the interaction between age and educational level. All statistical procedures were performed in the SPSS statistical package.
Results:
The number of remaining teeth was similar for LE and HE in the 35-year olds (25.8 versus 26.6), but in the older age groups LE had significantly a larger number of missing teeth. The LE groups (except in 65-year olds) exhibited significantly more PAL loss. LE had significantly fewer healthy gingival units in all but the 75-year age group. In all age groups, LE had fewer intact tooth surfaces and a significantly poorer occlusal function. The frequency of tooth cleaning measures and dietary habits did not differ between LE and HE.
Conclusion:
Educational level was shown to influence the oral conditions and should be considered in assessing risk, and in planning appropriate preventive measures.
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