Social isolation during the pandemic could leave older people with fewer teeth

NEW YORK — Pandemic isolation has affected the mental health of millions, and it may also be affecting your teeth. Researchers from New York University find that older adults in social isolation are more likely to have missing teeth. These individuals also tend to lose their teeth at a faster rate than people who regularly connect with others.

“Our study suggests that maintaining and improving social connections may benefit the oral health of older adults,” says first study author Xiang Qi, a PhD student at NYU Meyers, in a university release. “The findings align with previous studies demonstrating that structural indicators of social disconnection can have powerful effects on indicators of health and well-being.”

Social isolation contributes to a litany of health issues in older adults. From an increased risk of dementia and heart disease to premature death, studies show that spending an extended amount of time alone is detrimental to overall health and well-being. Unfortunately, prior to 2020, the World Health Organization estimated that as many as one in three older adults experience loneliness. Considering how the COVID-19 pandemic has increased isolation across the board over the past two years, those statistics are likely even worse today.

Is isolation and loneliness the same thing?

Researchers say it’s important to explain the distinction between loneliness and social isolation. While loneliness is a feeling stemming from a lack of contact with others, social isolation is an objective term that means having minimal social relationships and nearly no social contact with others at all.

“While social isolation and loneliness often go hand in hand, it’s possible to live alone and be socially isolated but to not feel lonely, or to be surrounded by people but still feel lonely,” explains senior study author Bei Wu, Dean’s Professor in Global Health at NYU Meyers.

Older adults are also more likely to lose teeth than their younger counterparts. Take China for example. The study notes that older Chinese adults (ages 65-74), on average, have less than 23 teeth. A healthy adult should have 32 teeth (or 28 if they’ve had their wisdom teeth removed). Moreover, 4.5 percent of all older Chinese adults have lost all of their teeth. Typical oral miscues, such as failing to regularly brush or floss and smoking, increase one’s risk of tooth loss.

Isolation could cost you 2 teeth

To get a better idea of the relationship between social isolation and oral health, researchers used data provided by the Chinese Longitudinal Healthy Longevity Survey to analyze 4,268 adults over 65. Each senior had filled out a survey on three occasions: once in 2011-2012, again in 2014, and a final survey in 2018. The questionnaires asked about social habits, isolation, oral health, and any lost teeth.

Overall, over a quarter of participants (27.5%) reported social isolation, while another 26.5 percent reported loneliness. More social isolation displayed a connection to a greater risk of having fewer teeth and losing teeth quickly — even after study authors accounted for other potentially influential factors. On average, socially isolated older adults had 2.1 fewer natural teeth and a 1.4 times faster rate of losing their teeth than others with a more active social life.

“Socially isolated older adults tend to be less engaged in social and health-promoting behaviors like physical activity, which could have a negative impact on their overall functioning and oral hygiene, as well as increase their risk for systemic inflammation,” Wu notes. “This functional impairment seems to be a major pathway linking social isolation to tooth loss.”

On the other hand, loneliness was not specifically associated with tooth loss.

“While social isolation can result in a lack of support that can affect health behaviors, for older adults who feel lonely, it’s possible that their social networks are still in place and can help them to keep up healthy behaviors,” Qi concludes.

The study is published in the journal Community Dentistry And Oral Epidemiology.

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