Oral Health Problems in Individuals Living With Spinal Cord Injuries and Disorders

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Abstract:

Objective

To identify factors associated with oral health problems in individuals with spinal cord injuries and disorders (SCI/D).

Design

Cross-sectional survey conducted in 2024-2025.

Setting/Participants

Veterans and civilians with SCI/D from Veterans Health Administration and private sector organizations.

Main Outcomes Measures

Oral health problems, chronic conditions, secondary complications, and psychosocial health.

Results

The sample (n=370) had a mean age of 58 years (18-91y; SD, 15); 71% were men, 57% had paraplegia, and the mean injury duration was 12 years (1-64y; SD, 13). Oral health problems were reported by 26%. Unadjusted analyses showed that a greater proportion of those with oral health problems (vs those without) were not employed (92% vs 83%; P=.04) and lived alone (30% vs 18%; P=.02), and had a higher age at injury onset (50y vs 44y; P=.01), sleep problems (62% vs 49%; P=.04), high blood pressure (49% vs 37%; P=.04), heart problems (16% vs 8%; P=.04), musculoskeletal pain (88% vs 83%; P=.004), and respiratory problems (46% vs 26%; P=.0004). A greater proportion with oral health problems experienced depression (58% vs 37%; P=.0005), anxiety (53% vs 36%; P=.003), frequent mental distress (37% vs 24%; P=.01), posttraumatic stress (41% vs 34%; P=.002), and loneliness (32% vs 22%; P=.05). Multivariable regression showed that variables independently associated with oral health problems included living alone (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.1-4.5; P=.03), musculoskeletal pain (OR, 2.7; 95% CI, 1.1-6.7; P=.03), and respiratory conditions (OR, 2.0; 95% CI, 1.1 - 4.5; P=.04).

Conclusions

Oral health problems were more common among people who lived alone and had physical and psychosocial health concerns. Future studies should identify barriers to oral health in this population, especially for those who live alone and experience musculoskeletal pain, as each of these may contribute to oral hygiene difficulties and challenges accessing preventive services. Given the compromised respiratory function in many people with SCI/D, efforts to alleviate oral health problems that could be contributing to respiratory conditions should be addressed.

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