The association between social determinants of health (SDoH) and dental conditions that result in reduced food intake in long-term patients living at home. 

Authors: Stephanie M. Hernandez, DMD, Richard B. Aguilar, MD, Marlow B. Hernandez, DO, MBA, FACP 

INTRODUCTION: Lack of dental care is well-documented in assisted living facilities and nursing homes, with untreated dental decay rates from 49% to 78%. No data exists on the relationship between SDoH and dental conditions affecting food intake in long-term care (LTC) pts living at home. Our objective was to evaluate this relationship using four self-reported Specialized Health Assessment Surveys (SHAS); SDoH, Nutrition, Fall Risk, and ER visits/hospital admissions (ER/HA). 

METHODS: Our APRNs conducted four SHAS on LTC patients in S Florida living at home, focusing on food intake related to dental or medical issues, ER/HA rates, and their relationship with SDoH characteristics. Significance for all study findings was set at p < 0.05. 

RESULTS: N= 796 pts, x̄ age 80.3, x̄ BMI 27.2, F 71%. Patients living alone at least half of the day were 3.6 times more likely to have dental issues affecting food intake. Living alone increased the risk by 4.8 times, not feeling safe at home by 4.1 times, and missing clinical appointments due to the inability to get to the clinician increased the risk by 4.5 times. Decreased food intake due to dental conditions was associated with a 40% higher prevalence of moderate to severe dementia, a 43% prevalence of being bedridden, and an increased ER/HA rate. 

CONCLUSION: Our data suggests that there exists a correlation between specific SDoH characteristics and dental conditions impacting food intake. Decreased food intake is associated with increased ER/HA and poor clinical outcomes. Addressing specific SDoH issues and dental conditions in at-risk patients may substantially improve clinical outcomes, quality of life, while reducing the cost of care.