Bidirectional longitudinal associations between subjective oral health and subjective well-being

Objective: This study investigated the bidirectional longitudinal association between subjective oral health (SOH) and subjective well-being (SWB) over time. Methods: This cohort study was based on a four-wave surveys conducted by the English Longitudinal Study of Aging. SOH was measured by oral impacts on daily performance (OIDP), self-rated oral health (SROH), and SWB was measured by the Center for Epidemiologic Studies-Depression (CES-D) scale, Control, Autonomy, Self-Realization, and Pleasure (CASP-19), and satisfaction with life scale (SWLS). To evaluate the bidirectional associations between SOH and SWB, separate models were created using SOH and SWB as the outcome and exposure, respectively. Additionally, the synchronous and lagged effects of exposure on outcomes were checked by employing exposures measured at different time points. A generalized estimating equation model was fitted, including the exposure variables, outcome variables in the previous wave, and baseline covariates. Results: Among 4,510 participants (mean age=61.7 years [1SD=7.9], men=43.1 %), 8.1 %, 18.2 %, 14.3 %, 30.5 %, and 25.0 % had poor SOH and SWB as measured by OIDP, SROH, CES-D, CASP-19, and SWLS at baseline, respectively. The results of the regression models with all combinations of SOH and SWB measures showed that poor conditions of SOH or SWB were significantly associated with poor conditions of the other measures (all p < 0.05). In almost all combinations of SOH and SWB measures, the synchronous effect was stronger than the lagged effect. Conclusion: SOH and SWB are closely linked, and comprehensive care that considers oral health could contribute to well-being later in life.