Social relationships and oral health among adults aged 60 years or older

Georgios Tsakos, Wael Sabbah, Tarani Chandola, Tim Newton, Ichiro Kawachi, Jun Aida, Aubrey Sheiham, Michael G. Marmot, Richard G. Watt

Research output: Contribution to journalArticlepeer-review

58 Citations (Scopus)


OBJECTIVE: This study assessed associations between social relationships and oral health outcomes and whether these associations were explained by demographic, socioeconomic, and behavioral factors, and physical health. METHODS: We used the National Health and Nutrition Examination Survey (1999-2004) data on 4014 adults aged 60 years or older. Oral health outcomes were edentulism, number of decayed teeth, root decay, number of sound or filled teeth, and self-rated oral health. Social relationships referred to social networks (marital status, number of close friends) and social support (emotional support need, provision of financial support). Analyses consisted of regression models sequentially adjusting for demographic, socioeconomic, behavioral, and physical health confounders. RESULTS: In fully adjusted models, widowed or divorced/separated individuals had fewer sound or filled teeth than those married or living with a partner: rate ratio (95% confidence interval) = 0.89 (0.82 to 0.97) and 0.90 (0.83 to 0.97), respectively. People with four to six close friends had fewer decayed teeth and lower probability for root decay than those with fewer friends. Emotional support need was associated with 1.41 (1.05 to 1.90) higher odds for root decay and 1.18 (1.04 to 1.35) higher odds for poorer self-rated oral health. Lack of financial support was associated with more decayed teeth. Edentulism was not related to any social network and social support markers. CONCLUSIONS: Social relationships are associated with clinical measures of current disease, markers of good oral function, and subjective oral health, but not with clinical measures of a lifetime history of oral disease among older Americans.

Original languageEnglish
Pages (from-to)178-186
Number of pages9
JournalPsychosomatic medicine
Issue number2
Publication statusPublished - 2013


  • geriatric dentistry
  • gerontology
  • older adults
  • psychosocial factors
  • social networks
  • social support

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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