Association between oral health care behaviors and subjective oral health status among Korean older adults: a national study using community health survey data.

BACKGROUND: Oral health is an essential component of overall health in older adults. However, evidence on the association between oral health behaviors and subjective oral health status using large-scale population-based data remains limited. METHODS: This study analyzed data from 210,212 Korean adults aged ≥60 years using the 2022-2023 Community Health Survey. Ordinal logistic regression analysis was conducted, and the proportional odds assumption was evaluated using the Brant test. For variables violating this assumption, a partial proportional odds model (PPOM) was applied. RESULTS: Several sociodemographic, behavioral, and oral health-related factors were significantly associated with subjective oral health status. Women were more likely to report better oral health than men (OR = 1.261, 95% CI = 1.236-1.287), while individuals aged ≥70 years were less likely than those in their 60s (OR = 0.748, 95% CI = 0.734-0.763). Higher education was strongly associated with better oral health (high school: OR = 1.711, 95% CI = 1.672-1.752; ≥college: OR = 2.235, 95% CI = 2.171-2.301). Among health behaviors, toothbrushing after dinner or before sleep showed a strong positive association (OR = 1.482, 95% CI = 1.431-1.535), and walking ≥5 days per week was also associated with better oral health (OR = 1.307, 95% CI = 1.278-1.336). Lower perceived stress was one of the strongest factors (low: OR = 1.733, 95% CI = 1.687-1.779; moderate: OR = 1.401, 95% CI = 1.367-1.437). In contrast, smoking (OR = 0.621, 95% CI = 0.603-0.639), low income (OR = 0.825, 95% CI = 0.741-0.918), and unmet dental care needs (OR = 0.231, 95% CI = 0.223-0.239) were associated with lower odds of being in a better oral health category. The PPOM results further indicated that the effects of several variables varied across levels of oral health status. CONCLUSION: Subjective oral health among Korean older adults is influenced by multiple interrelated factors, including sociodemographic characteristics, health behaviors, and access to dental care. These findings highlight the need for comprehensive and stage-specific public health strategies to promote oral health and reduce disparities in aging populations.