Oral Multimorbidity Patterns and Determinants Among Chinese Older Adults: A Latent Class Analysis

This study aims to identify distinct oral multimorbidity subtypes among Chinese older adults and to examine the structural and intermediary social determinants associated with subtype membership.

This cross-sectional study analyzed 423 adults aged 65-74 years recruited from 39 communities at 13 disease surveillance sites in Guangdong Province, China, within the 2021 key population oral health surveillance project. Oral health indicators, including caries, periodontal status, and tooth loss, were subjected to latent class analysis (LCA). The Bolck-Croon-Hagenaars (BCH) three-step approach was employed to examine associations between latent class membership and covariates organized within Solar and Irwin's social determinants of health framework (SDH).

Three subtypes were identified: Class 1 (lower disease burden, 23.9%), preserved dentition with moderate periodontal involvement; Class 2 (periodontal-dominant subtype, 41.6%), severe periodontal destruction, substantial tooth loss, and high rates of unrestored missing teeth; and Class 3 (caries-tooth loss dominant subtype, 34.5%), elevated crown caries burden and tooth loss but relatively preserved periodontal status. Compared with Class 1, Class 2 was significantly associated with older age, smoking, and dental visit. Class 3 was significantly associated with older age, females, urban residence, and dental visit.

Oral multimorbidity among Chinese older adults is heterogeneous. These findings may support the design of, subtype-specific rather than uniform oral health management strategies for older adults. Longitudinal validation and replication in other Chinese populations are required before wider generalization.