Association Between Oral Health and Multidimensional Flourishing: A Cross-sectional Study from Japan Gerontological Evaluation Study (JAGES)

Purpose: Human flourishing is a multidimensional concept that encompasses happiness and life satisfaction (happiness), mental and physical health (health), meaning and purpose (purpose), character and virtue (character), and close social relationships (social), which are characterized by comprehensive well-being. This cross-sectional study investigated the association of oral health, number of remaining teeth, and prosthesis use with multidimensional flourishing.

Methods: Data was sourced from the 2022 wave of the Japan Gerontological Evaluation Study, a population-based survey of independent individuals aged 65 years or older. This study utilized multilevel linear regression with multiple imputations. The covariates included sex, age, income, education, marital status, smoking status, diabetes history, instrumental activities of daily living, and depressive symptoms.

Results: This study included 87,201 participants with a mean age of 74.87 years [standard deviation (SD)=6.30], and mean±SD composite flourishing index of 6.77±1.64. Multilevel multivariable regression showed that individuals with dental prostheses or more teeth had a higher flourishing index. Among individuals without dental prostheses, those with >20 teeth showed a composite flourishing index of 0.34 units higher (95% confidence interval (95% CI): 0.26-0.42, P < 0.001) than those with 0-9 teeth. Among those with 0-9 teeth, individuals with dental prostheses showed 0.21 (95% CI: 0.12-0.29, P < 0.001) higher units compared to those without prostheses. The interaction analysis showed that dental prosthesis use was significantly associated with higher indices, especially among those with fewer teeth.

Conclusions: Teeth and prostheses were independently associated with multidimensional flourishing. Using dental prostheses may enhance multidimensional flourishing among individuals with fewer remaining teeth.