Resilience and Self-Perceived Oral Health: A Hierarchical Approach

OBJECTIVES To determine whether positive self-perceived oral health is associated with sociodemographic health variables, with an emphasis on resilience, in community-dwelling older adults in southern Brazil. DESIGN Cross-sectional study nested within a cohort study. SETTING Carlos Barbosa in southern Brazil. PARTICIPANTS Four hundred ninety-six community-dwelling adults aged 64 and older. MEASUREMENTS Sociodemographic information, a health history, and health perceptions were assessed using a structured questionnaire. Resilience was assessed using a resilience scale. For each participant, a brief oral examination was performed to assess number of teeth. Positive self-perceived oral health was the outcome of interest. RESULTS A final, fully adjusted Poisson regression model showed that high resilience potential (prevalence ratio (PR)=1.18, 95% confidence interval (CI)=1.06-1.32), income (PR=1.18, 95% CI=1.07-1.30), and no reported change in diet because of dental problems (PR=1.34, 95% CI=1.13-1.60) were associated with positive self-perceived oral health. Participants living in rural areas were less likely to report positive self-perceived oral health (PR=0.83, 95% CI=0.75-0.93). CONCLUSION Using a hierarchical approach, positive self-perceived oral health was found to be associated with several variables included in the conceptual framework of oral health outcomes, such as resilience. Resilience may act as a potentiating agent in the positive adaptation to tooth loss.