Oral-Systemic Health Burden and Dry Mouth as an Intermediary Factor: A Cross-Sectional Study in Singapore Nursing...

This cross-sectional study aimed to assess the prevalence of oral and systemic health conditions among older adults in nursing homes (NHs) in Singapore and investigate associations between dry mouth and oral-systemic health factors.

Participants were selected through a stratified cluster sampling method across 8 NHs. Inclusion criteria included age ≥60 years and physical/cognitive ability to undergo oral screening. Data on systemic health (care dependence, malnutrition, multimorbidity, and polypharmacy) and oral health (dry mouth, oral hygiene, dentition, gingival and periodontal condition, and denture quality) were collected in 2024. Bivariate analyses (Mann-Whitney U test and chi-square test) were used to assess associations between dry mouth and other health parameters. Logistic regression models were conducted to examine independent associations with dry mouth. Statistical significance was set at P < .05.

A total of 173 NH residents completed oral assessments (mean age: 75.0 ± 9.1 years; 38% female). Systemic health concerns were prevalent: 75.7% were care-dependent, 80.9% were malnourished or at risk, and 84.1% had multimorbidity. Cardio-cerebrovascular diseases (CVD) were the most common disease category (76.4%). Oral health problems were also widespread: 63.6% showed clinical symptoms of dry mouth, 46.6% had poor oral hygiene, 50.8% had at least one untreated coronal and/or root caries, and 89.2% showed gingival inflammation. Multivariate analysis identified CVD (OR = 3.99) as a systemic factor significantly associated with dry mouth. Greater plaque accumulation (OR = 5.09) and root caries (OR = 1.93) were also independently associated with dry mouth.

This study provides the first comprehensive report on oral-systemic health burden in NH residents in Singapore. Dry mouth emerged as a potential intermediary factor linking systemic health conditions and dental deterioration. These findings underscore the importance of interprofessional care strategies to address dry mouth and its consequences in this vulnerable population. (292 words).