Oral Health Burden and Determinants of Oral Health-Related Quality of Life Among Geriatric Incarcerated Individuals: A Cross-Sectional Analysis

Oral Health Burden and Determinants of Oral Health-Related Quality of Life Among Geriatric Incarcerated Individuals: A Cross-Sectional Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Oral Health Burden and Determinants of Oral Health-Related Quality of Life Among Geriatric Incarcerated Individuals: A Cross-Sectional Analysis Thananya Chongcharoenkit, Patita Bhuridej, Soranun Chantarangsu, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8636082/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 10 You are reading this latest preprint version Abstract Objectives This study aimed to comprehensively assess the oral health status and oral health-related quality of life (OHRQoL) among older Thai prisoners and to identify key determinants influencing these outcomes, particularly within the context of long-term incarceration. Ultimately, we sought to inform targeted interventions to improve the holistic well-being of this vulnerable population. Methods A cross-sectional study was conducted among 141 older prisoners (aged ≥ 60 years) at Bang Kwang Central Prison, Thailand. Data included socio-demographics, physical health, and validated mental health indicators. Clinical oral examinations were conducted to assess oral hygiene, dental caries, periodontal status, and prosthetic needs. Bivariate analyses and multivariate logistic regression identified factors associated with OHRQoL. Results The cohort (mean age: 69.26 years) exhibited severe oral health burdens, including poor oral hygiene (mean Oral Hygiene Index: 3.38), high caries prevalence (mean decayed teeth: 1.72), and limited occluding pairs (mean: 4.91). Multivariate analysis revealed that long-term incarceration (≥ 10 years; Adjusted Odds Ratio (AOR) = 2.58, p = 0.028) and depressive symptoms (AOR = 4.12, p < 0.001) were significant, independent predictors of lower OHRQoL. Conclusion Older incarcerated individuals in Thailand face pervasive poor oral health and diminished OHRQoL. Long-term incarceration and depressive symptoms are critical, modifiable determinants. Clinical Relevance: These findings underscore an urgent need for integrated oral health services and mental health support within correctional facilities, prioritizing this vulnerable geriatric population to mitigate health disparities and improve their overall quality of life during and after incarceration. Dentition Oral health Healthcare access Incarceration Older inmates Prison Introduction Incarcerated populations globally endure substantial health disparities, primarily stemming from restrictive environmental determinants and impeded healthcare access within correctional settings [ 1 ]. This vulnerability is heightened among aging inmates, who demonstrate an elevated prevalence of chronic morbidity and functional impairment relative to age-matched community-dwelling peers [ 2 , 3 ]. Consequently, this demographic trajectory necessitates targeted interventions to address the complex clinical requirements of the aging prison cohort. Oral health is a fundamental determinant of overall well-being, but it remains disproportionately compromised within correctional facilities. Literature consistently indicates a high prevalence of oral pathology among incarcerated individuals, characterized by suboptimal oral hygiene, dental caries, advanced periodontal disease, and edentulism [ 4 – 6 ]. These deficits precipitate substantial unmet treatment needs, particularly among older inmates burdened by multimorbidity. Oral Health-Related Quality of Life (OHRQoL) is a multidimensional measure of the functional and psychological impact of oral conditions. Although the association between OHRQoL and clinical parameters is well-documented in the general population [ 7 , 8 ], the determinants of OHRQoL within prison populations, specifically among older adults, remain under-investigated. Variables such as incarceration duration, restricted healthcare access, and carceral lifestyle factors are hypothesized to significantly modulate OHRQoL in this vulnerable cohort [ 9 – 11 ]. Despite global acknowledgement of these disparities, epidemiological data regarding older inmates in Thailand are limited. Prior Thai studies have examined general prison populations or community-dwelling older adults, thereby neglecting the intersection of aging and incarceration [ 12 – 15 ]. Consequently, this study addresses this gap by evaluating the oral health status and OHRQoL of older Thai inmates and by identifying correlates of these outcomes. Materials and Methods Study Design and Setting This cross-sectional study was conducted at Bang Kwang Central Prison, Nonthaburi, Thailand. Data were collected through structured questionnaires and comprehensive oral examinations performed by experienced dentists. Ethical Considerations and Informed Consent The study protocol was approved by the Ethical Committee at the Faculty of Dentistry, Chulalongkorn University (HREC-DCU 2024-009). Official permission to conduct the study was also obtained from the Director of Bang Kwang Central Prison. Prior to participation, all potential participants received a detailed information sheet outlining the research objectives, procedures, and potential benefits. Written informed consent was obtained from each participant before any data collection commenced. Participants and Sampling Thai inmates aged 60 years and above, residing in Bang Kwang Central Prison during the period of June to December 2024, were eligible for inclusion. Exclusion criteria comprised individuals who declined, were unwilling, or were medically or cognitively unable to provide informed consent, complete questionnaires, or undergo an oral examination. Data Collection Procedures Socio-demographic characteristics and relevant medical history were extracted from the electronic database at Bang Kwang Central Prison. Covariates included age, marital status, and duration of incarceration. Categorical variables were operationalized as follows: educational attainment (low: no formal education or 15,000 Baht), and frequency of family visits (rare: no history or <1 visit/month; regular: ≥1 visit/month). Questionnaires Structured questionnaires were administered to all participants to collect data on oral health behaviors, physical health status, mental health status, and oral health-related quality of life. Oral health behaviors: Questions included past dental visits, history of oral hygiene instructions, and self-reported smoking and alcohol consumption habits. Physical health status - Activities of Daily Living (ADL): Participants were asked if they required assistance with any of the five ADLs: bathing, eating, toileting, dressing, and transferring. Total scores ranged from 0 to 20, with lower scores indicating greater functional disability. Activities never performed were recorded as missing values and excluded from the calculation. Mental health status - Patient Health Questionnaire-9 (PHQ-9): Participants rated the frequency (0 = not at all, 3 = nearly every day) of nine problems experienced in the past two weeks, including anhedonia, depressed mood, sleep disturbances, fatigue, appetite changes, feelings of worthlessness, concentration difficulties, psychomotor changes, and suicidal ideation. Total scores ranged from 0 to 27, with higher scores indicating greater symptom severity [16]. OHRQoL - The 14-item Oral Health Impact Profile (OHIP-14) [17]: The OHIP-14 measures the frequency of impact (0 = never, 4 = very often) of orofacial and denture function on 14 items across seven dimensions (functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap) during the preceding 12 months. A summary score, ranging from 0 to 56, was calculated, with higher scores indicating poorer OHRQoL. Oral Examination Clinical oral evaluations were conducted in the morning; participants were instructed to refrain from oral hygiene and food intake for at least 2 hours prior to assessment. Procedures employed standard dental instrumentation, including a dental unit, mouth mirror, explorer, and Community Periodontal Index (CPI) probe. Two calibrated dentists performed the assessments. Intra-examiner reliability was substantial (Rater 1: ICC = 0.92; Rater 2: ICC = 0.94), with an inter-examiner reliability of 0.88. Data were recorded by a trained dental assistant on standardized forms. The following indices and parameters were assessed: The Simplified Oral Hygiene Index (OHI-S) was used to evaluate both debris and calculus components on pre-selected tooth surfaces, assessed by running a dental explorer along the surface. Scores for each component ranged from 0 to 3, which were summed to yield a total OHI-S score from 0 to 6 for each participant [18]. OHI-S scores were interpreted as good (0–1.2), fair (1.3–3.0), or poor (3.1–6.0) [19]. The DMFT (Decayed, Missing, Filled Teeth) index was recorded for all dried permanent tooth surfaces (crowns and roots). Specific codes were assigned: 0 = sound, 1 = caries, 2 = filled with caries, 3 = filled without caries, 4 = missing, 6 = fissure sealant, 7 = fixed dental prosthesis. The D component included teeth coded 1 or 2; the M component included teeth coded 4; and the F component included teeth coded 3. Other codes were excluded from DMFT calculation. Periodontal health was assessed using a WHO gingival probe (20g force). Indicators recorded included periodontal pocket depth and clinical attachment loss, scored according to established criteria. Information on prostheses, removable denture wearing history and denture type(s) was collected directly from participants. The total number of remaining natural teeth (0-32, including third molars) and the number of posterior occluding pairs (0-10, including those provided by dentures) were also counted. Data Analysis Raw data were initially tabulated in Microsoft Office Excel. Descriptive statistics were used to summarize demographic characteristics and clinical conditions; categorical variables were presented as frequencies and percentages, whereas continuous variables were reported as means and standard deviations (SDs) or medians and interquartile ranges (IQRs), depending on their distribution. Bivariate analyses, utilizing Chi-square tests, Mann-Whitney U tests, or independent t-tests as appropriate for data type and distribution, were conducted to assess associations between OHIP-14 scores and all other study variables. Subsequently, multivariate logistic regression was employed to identify significant independent factors associated with OHRQoL. Statistical analyses were performed using SPSS version 22, with a p -value < 0.05 considered statistically significant. Results Socio-demographic and Health Characteristics, OHRQoL, and Factors Associated with OHRQoL A total of 141 older male inmates, with a mean age of 69.26 ± 7.15 years, participated in the study. The majority of participants reported living alone (n = 71, 51.4%). Educational attainment was generally low: 57.6% (n = 80) had completed elementary school or less, and 65% (n = 91) reported low income. The average imprisonment duration was 9.08 years, with a maximum of 25 years, with most (n = 80, 58.4%) incarcerated for less than 10 years. A significant portion received infrequent family visits, less than once a month (n = 73, 51.8%). Regarding substance use, the majority were non-alcohol drinkers (n = 113, 81.9%), non-smokers (n = 71, 51.8%), and reported no history of drug abuse (n = 124, 89.2%). Concerning oral health behaviors, 79.9% (n = 106) of participants reported never having received oral hygiene instructions from dental professionals, and 57.9% (n = 73) reported never or rarely visiting a dentist. A substantial proportion of inmates exhibited no ADL problems (n = 77, 84.6%) and no depressive symptoms (n = 63, 45.0%). The mean OHIP-14 score for the study population was 6.44 ± 8.12, with a median of 3.0 (IQR: 0.0–9.0). Participants exhibiting depressive symptoms recorded the highest mean OHIP-14 scores. The mean Oral Health Impact Profile-14 (OHIP-14) score among participants was 6.44, and the median score was 3. Participants exhibiting depressive symptoms recorded the highest mean OHIP-14 scores. Bivariate analysis (Mann-Whitney U Test) revealed statistically significant associations between OHIP-14 scores and several categorical variables: educational level, imprisonment period, smoking status, history of oral hygiene instructions, history of dental visits, presence of ADL problems, and presence of depressive symptoms (all p < 0.05). Detailed demographic and health characteristics, as well as bivariate associations, are presented in Table 1 . Table 1 Demographic characteristics, ADL, and PHQ-9, and OHIP-14 scores according to categorical variables among Thai older male inmates in Bang Kwang Central Prison. Variable n (%) OHIP-14 Mean ± S.D. Median (IQR) p -value # Overall participants 141 (100%) 6.44 ± 8.333 3.00 (10) - Marital status (n = 138) Single/divorced/widowed 71 (51.4%) 6.24 ± 8.29 4.00 (9) 0.831 Married 67 (48.6%) 6.60 ± 8.59 3.00 (11) Education (n = 139) Low education (no formal education or < high school) 80 (57.6%) 5.03 ± 7.16 2.00 (8) 0.019 High education (≥ high school) 59 (42.4%) 8.44 ± 9.49 4.00 (14) Income (n = 140) Low income (≤ 15,000 Baht/month) 91 (65%) 6.33 ± 8.81 3.00 (9) 0.269 High income (> 15,000 Baht/month) 49 (35%) 6.78 ± 7.49 4.00 (10) Imprisonment Period (n = 141) < 10 years 80 (58.4%) 5.56 ± 8.15 2.00 (8) 0.024 ≥ 10 years 57 (41.6) 8.12 ± 8.54 5.00 (13) History of Family Visit (n = 141) Rare family visit (no history or < 1 visit/month). 73 (51.8%) 6.70 ± 9.06 3.00 (11) 0.662 Regular family visit (≥ 1 visit/month) 68 (48.2%) 6.16 ± 7.54 4.00 (9) Alcohol consumption (n = 138) Non-drinker 113 (81.9%) 6.10 ± 8.27 3.00 (9) 0.170 Alcohol drinker 25 (18.1%) 7.56 ± 8.64 5.00 (10) Smoking (n = 137) Non-smoker 71 (51.8%) 5.27 ± 8.08 0.00 (8) 0.006 Ex-smoker 66 (48.2%) 7.85 ± 8.66 5.00 (11) Drug Abuse (n = 139) No 124 (89.2%) 6.04 ± 8.15 3.00 (9) 0.067 Yes 15 (10.8%) 10.00 ± 9.78 7.00 (14) Oral hygiene instruction (n = 133) Never 106 (79.7%) 5.61 ± 8.10 2.00 (8) 0.020 Ever 27 (20.3%) 7.30 ± 7.45 6.00 (8) Last dental visit (n = 126) Never/Rare 73 (57.9%) 4.70 ± 7.63 1.00 (7) 0.002 Saw dentist 1–2 year(s) ago 53 (42.1%) 8.58 ± 8.99 6.00 (13) ADL (n = 91) No problem 77 (84.6%) 4.17 ± 7.41 0.00 (4) 0.005 With ADL problems 14 (15.4%) 9.79 ± 10.12 6.00 (14) PHQ-9 (n = 140) No problem 63 (45%) 1.49 ± 3.40 0.00 (2) < 0.001 With depressive symptoms 77 (55%) 10.34 ± 9.00 8.00 (12) # Differences between groups were analyzed using the Mann–Whitney U test. Bold numbers indicate statistically significant differences ( p -value ≤ 0.05). Percentages were calculated from valid data. Dentition Status The dentition status of participants is detailed in Tables 2 and 3 , which present the mean values of oral health parameters across various categorical variables. Specifically, the mean number of decayed teeth (D component) was 1.72 ± 2.85, the number of filled teeth without caries (F component) was 1.24 ± 2.53, and the number of missing teeth (M component) was 11.74 ± 9.67. Further analysis revealed significant associations between dentition components and participant characteristics. A higher number of filled teeth without caries (F) was significantly associated with higher educational attainment ( p < 0.001), higher income ( p = 0.013), more regular family visits ( p = 0.042), and a history of having received oral hygiene instructions ( p = 0.005). Conversely, a higher number of missing teeth (M) was significantly associated with lower educational attainment ( p = 0.021), a history of smoking ( p = 0.006), and a visit to a dentist in the past 1–2 years ( p < 0.001). These findings highlight differential impacts of socio-demographic factors and oral health behaviors on dental restorative status and tooth loss among the incarcerated elderly. Table 2 Dentition status according to categorical variables among Thai older male inmates in Bang Kwang Central Prison. Variables Decayed Filled with no caries Missing teeth M ± S.D. p- value* M ± S.D. p-value* M ± S.D. p -value # Overall participants 1.72 ± 2.85 1.24 ± 2.53 11.74 ± 9.67 Marital status Single/divorced/widowed 2.27 ± 3.52 0.062 1.22 ± 2.53 0.938 10.97 ± 8.10 0.155 Married 1.16 ± 1.90 1.25 ± 2.60 10.14 ± 8.61 Education Low education 1.97 ± 3.36 0.755 0.53 ± 1.61 < 0.001 11.59 ± 9.06 0.021 High education 1.31 ± 2.10 2.15 ± 3.23 9.44 ± 7.41 Income Low income 1.82 ± 3.21 0.926 1.01 ± 2.49 0.013 11.71 ± 8.91 0.053 High income 1.39 ± 2.06 1.71 ± 2.72 8.44 ± 6.89 Imprisonment Period < 10 years 1.78 ± 2.94 0.442 1.18 ± 2.46 0.898 11.20 ± 8.26 0.268 ≥ 10 years 1.21 ± 2.30 1.38 ± 2.91 10.38 ± 8.83 History of Family Visit Rare family visit 1.64 ± 3.07 0.970 0.59 ± 1.55 0.042 9.86 ± 7.26 0.190 Regular family visit 1.47 ± 2.29 2.00 ± 3.32 12.00 ± 9.54 Alcohol consumption Non-drinker 1.55 ± 2.81 0.710 1.12 ± 2.51 0.155 10.37 ± 7.88 0.801 Alcohol drinker 1.62 ± 2.31 1.86 ± 3.09 12.95 ± 10.46 Smoking Non-smoker 1.60 ± 3.02 0.920 0.98 ± 2.26 0.350 9.04 ± 7.56 0.006 Ex-smoker 1.52 ± 2.41 1.54 ± 2.95 12.69 ± 8.95 Drug Abuse No 1.48 ± 2.71 0.667 1.25 ± 2.64 0.370 10.78 ± 8.52 0.905 Yes 2.27 ± 2.80 1.36 ± 2.73 11.73 ± 8.22 Oral hygiene instruction Never 1.66 ± 2.95 0.517 0.92 ± 2.22 0.005 10.81 ± 8.63 0.797 Ever 1.18 ± 1.50 2.59 ± 3.59 11.14 ± 7.94 Last dental visit Never/Rare 1.90 ± 3.27 0.605 1.37 ± 2.73 0.862 9.03 ± 8.18 < 0.001 Saw a dentist 1–2 years ago 1.07 ± 1.52 1.11 ± 2.51 13.52 ± 8.22 # Differences between groups were analyzed using the Mann–Whitney U test. Bold numbers indicate statistically significant differences ( p -value ≤ 0.05). Percentages were calculated from valid data. Periodontal and Oral Hygiene Status Periodontal and oral hygiene status, as presented in Table 3 , revealed a mean OHI-S score of 3.38 ± 1.23, indicating generally poor oral hygiene. The mean periodontal pocket score was 0.77 ± 0.61, and the mean loss of attachment (LOA) score was 0.81 ± 0.59. Further analysis demonstrated that the history of smoking was significantly associated with poorer periodontal health, specifically manifesting as significantly higher mean pocket scores ( p = 0.032) and higher mean loss of attachment scores ( p = 0.015). Table 3 Oral hygiene and periodontal status according to categorical variables among Thai older male inmates in Bang Kwang Central Prison. Variables OHI-S Pocket scores LOA scores M ± S.D. p -value # M ± S.D. p -value # M ± S.D. p -value # Overall participants 3.38 ± 1.23 0.77 ± 0.61 0.81 ± 0.59 Marital status Single/divorced/widowed 3.47 ± 1.05 0.766 0.78 ± 0.62 0.962 0.78 ± 0.58 0.547 Married 3.34 ± 1.38 0.78 ± 0.61 0.85 ± 0.62 Education Low education 3.56 ± 1.22 0.060 0.78 ± 0.61 0.819 0.84 ± 0.63 0.695 High education 3.16 ± 1.23 0.76 ± 0.62 0.77 ± 0.56 Income Low income 3.43 ± 1.23 0.425 0.74 ± 0.61 0.332 0.86 ± 0.62 0.308 High income 3.27 ± 1.25 0.84 ± 0.62 0.71 ± 0.55 Imprisonment Period < 10 years 3.41 ± 1.25 0.480 0.79 ± 0.61 0.655 0.78 ± 0.58 0.371 ≥ 10 years 3.30 ± 1.18 0.75 ± 0.62 0.85 ± 0.60 History of Family Visit Rare family visit 3.54 ± 1.23 0.083 0.80 ± 0.63 0.685 0.78 ± 0.58 0.609 Regular family visit 3.19 ± 1.22 0.74 ± 0.59 0.84 ± 0.62 Alcohol consumption Non-drinker 3.41 ± 1.22 0.806 0.79 ± 0.60 0.374 0.83 ± 0.58 0.723 Alcohol drinker 3.35 ± 1.25 0.70 ± 0.67 0.79 ± 0.65 Smoking Non-smoker 3.27 ± 1.15 0.145 0.66 ± 0.54 0.032 0.70 ± 0.51 0.015 Ex-smoker 3.59 ± 1.25 0.92 ± 0.67 0.97 ± 0.64 Drug Abuse No 3.36 ± 1.18 0.572 0.75 ± 0.59 0.436 0.80 ± 0.59 0.227 Yes 3.60 ± 1.54 0.93 ± 0.75 0.98 ± 0.58 Oral hygiene instruction Never 3.45 ± 1.24 0.412 0.80 ± 0.61 0.665 0.81 ± 0.61 0.980 Ever 3.24 ± 1.33 0.75 ± 0.64 0.81 ± 0.60 Last dental visit Never/Rare 3.35 ± 1.28 0.797 0.73 ± 0.63 0.424 0.75 ± 0.58 0.051 Saw a dentist 1–2 years ago 3.44 ± 1.21 0.83 ± 0.65 0.94 ± 0.57 # Differences between groups were analyzed using the Mann–Whitney U test. Bold numbers indicate statistically significant differences ( p -value ≤ 0.05). Percentages were calculated from valid data. Clinical Factors and OHRQoL To further investigate the relationship between oral health status and OHRQoL, the OHIP-14 score was dichotomized into two groups based on the study's median score of 3: “Good OHRQoL” (OHIP-14 score < 3) and “Poor OHRQoL” (OHIP-14 score ≥ 3). Analysis revealed that participants with “filled with no caries” teeth were significantly associated with “Poor OHRQoL” ( p = 0.011). In contrast, the mean number of remaining natural teeth (20.26 ± 9.67) and the mean number of posterior occluding pairs (4.91 ± 3.33) did not show a statistically significant association with OHIP-14 scores ( p > 0.05). Regarding general health metrics, while the overall mean ADL score was 19.59 ± 2.04 and the mean PHQ-9 score was 2.21 ± 3.02, both were significantly associated with OHRQoL. Specifically, the “Poor OHRQoL” group exhibited a significantly lower mean ADL score (indicating greater disability) compared to the “Good OHRQoL” group ( p = 0.004). Conversely, the “Poor OHRQoL” group had a significantly higher mean PHQ-9 score (indicating greater depressive symptom severity) than the “Good OHRQoL” group (p < 0.001). Detailed findings are presented in Table 4 . Table 4 Association of Oral Health Status and Related Factors with OHIP-14 Scores Among Older Male Inmates in Bang Kwang Central Prison, Thailand. Variables Total cases Good OHRQoL Poor OHRQoL p -value Mean ± S.D. Median (IQR) Mean ± S.D. Median (IQR) Mean ± S.D. Median (IQR) Sound teeth 17.32 ± 9.378 19.50 (15) 18.87 ± 8.694 21.00 (16) 18.09 ± 8.345 20.00 (14) 0.531 a Decayed teeth 1.62 ± 2.80 0.00 (2) 2.03 ± 3.178 0.00 (3) 1.26 ± 2.385 0.50 (2) 0.624 a Filled teeth with caries 0.10 ± 0.494 0.00 (0) 0.08 ± 0.522 0.00 (0) 0.12 ± 0.474 0.00 (0) 0.318 a Filled teeth with no caries 1.24 ± 2.532 0.00 (1) 0.98 ± 2.545 0.00 (0) 1.44 ± 2.530 0.00 (2) 0.011 a Missing teeth 11.74 ± 9.673 9.00 (15) 9.79 ± 8.462 7.50 (10) 10.96 ± 8.290 9.00 (14) 0.840 a Sealant 0 0 0 0 0 0 - Fixed prostheses 0.18 ± 0.991 0.00 (0) 0.24 ± 1.314 0.00 (0) 0.13 ± 0.571 0.00 (0) 0.887 a OHI-S score 3.38 ± 1.229 3.33 (1.83) 3.40 ± 1.34 3.37 (2.03) 3.37 ± 1.14 3.25 (1.44) 0.118 b Debris score 1.65 ± 0.625 1.60 (1) 1.68 ± 0.67 1.67 (1.04) 1.62 ± 0.59 1.50 (0.81) 0.439 a Calculus score 1.73 ± 0.722 1.80 (0.97) 1.72 ± 0.77 1.67 (1.05) 1.74 ± 0.69 1.83 (0.88) 0.722 a Pocket score 0.77 ± 0.609 0.67 (1) 0.79 ± 0.62 0.67 (1.02) 0.75 ± 0.61 0.67 (1.06) 0.753 a Bleeding score 0.90 ± 0.199 1.00 (0.17) 0.90 ± 0.20 1 (0.17) 0.89 ± 0.21 1 (0.17) LOS score 0.81 ± 0.593 0.80 (0.84) 0.74 ± 0.61 0.67 (0.84) 0.87 ± 0.59 0.83 (0.75) 0.163 a Remaining teeth 20.26 ± 9.673 23.00 (15) 22.21 ± 8.46 24.50 (10) 21.04 ± 8.29 23.00 (14) 0.840 a Occluding pairs 4.91 ± 3.296 6.00 (6) 4.84 ± 3.34 5.50 (6) 4.69 ± 3.27 5.00 (6) 0.531 a ADL scores 19.59 ± 2.044 20.00 (0) 19.91 ± 0.342 20.00 (0) 19.03 ± 3.32 20.00 (1) 0.004 a PHQ9 scores 2.21 ± 3.017 1.00 (3) 0.51 ± 1.12 0.00 (0) 4.61 ± 3.94 3.00 (5) < 0.001 a a Difference tested using the Mann-Whitney U-Test, b using Independent T-Test. Bold numbers indicate statistically significant differences ( p -value ≤ 0.05). Multivariate Analysis of Factors Associated with OHRQoL A multivariate logistic regression model was conducted to identify independent factors associated with “Poor OHRQoL” (defined as OHIP-14 score ≥ 3). The analysis included variables identified as significant in bivariate tests, such as educational level, incarceration period, smoking status, history of oral hygiene instructions, dental visit history, ADL problems, and depressive symptoms. The multivariate model revealed that two factors remained significantly associated with “Poor OHRQoL”: prolonged incarceration (more than 10 years) and the presence of depressive symptoms. Specifically, participants incarcerated for over 10 years experienced 5.689 times higher odds of having “Poor OHRQoL” compared to those incarcerated for 10 years or less (Adjusted Odds Ratio [AOR] = 5.689; 95% Confidence Interval [CI]: 1.209–26.765; p = 0.028). Furthermore, participants exhibiting depressive symptoms had 9.997 times higher odds of experiencing 'Poor OHRQoL' compared to those without depressive symptoms (AOR = 9.997; 95% CI: 2.158–46.313; p < 0.001). The crude and adjusted odds ratios, along with their 95% confidence intervals, for all factors included in the model are presented in Table 5 . Table 5 Crude and Adjusted Odds Ratios (AOR) with 95% Confidence Intervals (CI) for Factors Associated with Poor OHRQoL Among Older Male Inmates. Variables Univariate logistic regression Multivariate logistic regression Crude OR (95% CI) p -value Adjusted OR (95% CI) p -value High education 2.229 (1.122–4.431) 0.022 2.636 (0.603–11.519) 0.198 > 10 years’ incarceration 2.319 (1.155–4.658) 0.018 5.689 (1.209–26.765) 0.028 Smoker 2.218 (1.120–4.394) 0.022 1.082 (0.256–4.570) 0.915 History of ora hygiene instructions 3.219 (1.294–8.010) 0.012 4.894 (0.639–37.460) 0.126 Recent dental visit 3.515 (1.671–7.392) < 0.001 2.320 (0.511–10.529) 0.275 ADL problems 5.521 (1.573–19.382) 0.008 4.968 (0.840-29.397) 0.077 Depressive symptoms 21.176 (8.717–51.447) < 0.001 9.997 (2.158–46.313) < 0.001 Bold numbers indicate statistically significant differences ( p -value ≤ 0.05). Discussion This cross-sectional study comprehensively investigated the oral health status and OHRQoL among older male inmates in Bang Kwang Central Prison, Thailand, and identified associated socio-demographic, behavioral, and clinical factors. While oral health disparities in incarcerated populations are well-documented, specific data on older prisoners, particularly in Thailand, remain scarce. Our findings provide crucial insights into this vulnerable group. The study population (n = 141, mean age 69.26 years) exhibited socio-economic characteristics consistent with broader incarcerated demographics, including low educational attainment and income [ 20 – 22 ]. Interestingly, higher education and income were associated with better restorative dental health (more fillings without caries and higher remaining teeth), highlighting socio-economic gradients even within this confined setting. Behavioral patterns revealed a significant proportion of participants reported living alone and experiencing infrequent family visits. While most were non-alcohol drinkers and non-drug users, a substantial almost half (48.2%) were current or former smokers. Importantly, smoking history was significantly linked to poorer periodontal health (higher pocket and attachment loss scores) and greater tooth loss, underscoring its detrimental and cumulative impact on oral health in this population. Regarding oral health practices, a concerning majority of inmates reported never having received professional oral hygiene instructions (79.7%) and infrequent dental visits (57.9%). These rates are notably lower than those reported in some other incarcerated populations, such as in Pakistan and Australia [ 20 , 23 ], suggesting potentially greater unmet needs in the Thai context. While receiving oral hygiene instructions was associated with more fillings (indicating prior restorative care), a counterintuitive finding was that recent dental visits were associated with a higher number of missing teeth and prosthetic needs. This likely indicates that inmates primarily seek dental care when symptomatic or facing significant functional impairments, such as discomfort or difficulty chewing due to tooth loss, thus leading to treatment for existing problems rather than preventive care Oral health status As anticipated, this study revealed a generally poor oral hygiene status among older Thai inmates, with a mean OHI-S score of 3.38. This is comparable to findings in incarcerated populations in India but higher than in Russia (OHI-S 2.77 for male inmates) [ 4 , 5 ], indicating regional variations in oral hygiene practices or provision of care [ 24 ]. Comparisons with the 9th Thailand National Oral Health Survey (2023) among age-matched general populations provide mixed insights. Our incarcerated cohort exhibited lower mean counts of decayed (D) and filled (F) teeth compared to older Thai non-inmates [ 25 ]. Similarly, mean periodontal pocket and loss of attachment (LOA) scores were lower than those reported for older Thai non-inmates [ 25 , 26 ]. However, the mean number of missing teeth (M component = 11.74), resulting in an average of 20.26 remaining natural teeth, was comparable to the national survey's findings for the 60–74 age group (19.6 teeth) but notably higher than for the 80–85 age group (11.7 teeth) [ 25 ]. Interestingly, this count of remaining teeth is also higher than that reported for older inmates (age ≥ 60) in Hong Kong (mean missing teeth = 20.28) [ 27 ], suggesting potentially better tooth retention among older Thai inmates compared to some other incarcerated populations. Despite this, a substantial proportion (34.3%) of inmates had fewer than 20 remaining teeth, and among these, 45.8% required prostheses, highlighting a significant unmet need for functional rehabilitation. Oral Health-Related Quality of Life (OHRQoL) The mean OHIP-14 score in this study was 6.44 (median 3). This indicates a comparatively lower negative impact on OHRQoL among older Thai inmates than among older male inmates in other international studies [ 11 , 28 ]. Intriguingly, our OHIP-14 scores were also comparable to those observed in older Thai non-inmates [ 12 , 29 ]. This convergence of OHRQoL scores between incarcerated and non-incarcerated older Thai populations warrants further exploration. A plausible explanation for these relatively low OHIP-14 scores, even amidst clinical oral health challenges, could stem from cultural factors. Older individuals in Thailand, irrespective of their incarcerated status, may exhibit lower expectations for their oral health, a greater propensity for adaptation to existing conditions, and a reduced drive to seek extensive dental care. This cultural inclination, coupled with socioeconomic factors such as low income, could lead to the normalization of poorer oral health outcomes and reduced reporting of oral health impacts, thereby resulting in lower OHIP-14 scores. Financial constraints may also pose a significant barrier to accessing dental treatment, further influencing self-perceived OHRQoL. Associated factors related to oral health status and OHRQoL This study identified several sociodemographic, behavioral, and health factors that influence oral health status and OHRQoL among older Thai inmates. Initially, bivariate analyses indicated that higher education, incarceration exceeding 10 years, smoking, history of oral hygiene instructions (OHI), recent dental visits, ADL problems, and depressive symptoms were associated with OHRQoL. However, after adjusting for potential confounders in the multivariate logistic regression model, only prolonged incarceration (more than 10 years) and the presence of depressive symptoms remained significant independent predictors of “Poor OHRQoL”. The strong association between depressive symptoms and “Poor OHRQoL” aligns with findings from studies in older populations, including incarcerated settings, where mental health significantly impacts perceived quality of life and oral health outcomes [ 11 , 30 ]. Similarly, functional limitations (ADL problems) were associated with OHRQoL in bivariate analysis, consistent with a Korean study linking ADL problems to both OHRQoL and depression [ 11 ]. However, the lack of an independent association in our multivariate model suggests that the impact of ADL might be mediated or confounded by other factors, potentially depressive symptoms themselves. Regarding clinical oral health parameters, Decayed teeth (D component) showed no significant association with OHRQoL or any other studied factors. This finding is consistent with prior research suggesting that decayed teeth may not always have a direct negative impact on OHRQoL, perhaps due to adaptation or lower expectations [ 7 ]. However, this contrasts with studies reporting an increase in decayed teeth among inmates with prolonged incarceration (> 3 years) [ 22 , 27 ]. The higher number of filled teeth (F component) was, as expected, significantly associated with higher education, higher income, more regular family visits, and a history of receiving OHI, indicating the role of socioeconomic status and preventive behaviors in accessing restorative care. In terms of periodontal status, as hypothesized, a history of smoking was significantly associated with poorer periodontal conditions (higher pocket and loss of attachment scores). Nevertheless, contrary to expectations, no significant association was found between periodontal conditions and OHRQoL in this cohort. This lack of a clear link between objective periodontal disease and subjective OHRQoL is not uncommon and aligns with systematic reviews indicating no consensus on this relationship in older populations [ 7 ], possibly due to adaptation or individuals prioritizing more acute symptoms. The number of remaining natural teeth and the number of posterior occluding pairs were not significantly associated with OHRQoL in our study. This finding contrasts sharply with a substantial body of evidence, including a systematic review in older people (13) and a specific study on older Thai individuals [ 31 ], which consistently demonstrate a positive association between a higher number of natural teeth/occluding pairs and better OHRQoL. It also contrasts with the results from another study where it was concluded that older adults with at least 27 teeth (p < 0.05), or at least eight occlusal pairs (p < 0.05) were more likely to have less chewing difficulty [ 32 ]. It also deviates from studies in older inmates linking fewer than 20 teeth and high DMFT scores to poor OHRQoL [ 7 ]. This discrepancy in our findings could again be attributed to the potential influence of cultural adaptation, lower expectations among older Thai inmates, or other unmeasured confounding factors within this unique population. Limitations of the study This study presents important insights, but its findings should be interpreted with certain limitations. First, the relatively small sample size (n = 141) of older inmates in Bang Kwang Central Prison limits the generalizability of our findings. This restricted participation was primarily due to logistical challenges, such as difficulties transporting inmates from their dormitories to the examination site, and to the physical health conditions of some older inmates that precluded their movement or participation. Consequently, our study predominantly included more independent and ambulatory older inmates, potentially leading to an underrepresentation of those with greater physical frailty or health issues. Therefore, these results may not be fully generalizable to the entire older inmate population within Central Prison, nor to other correctional facilities in Thailand. Future studies should aim for larger, more diverse samples across multiple prisons to enhance external validity. Second, the scope of the oral examination was limited, focusing primarily on oral hygiene, caries, periodontal health, and prosthetic status. Other potentially significant oral conditions, such as tooth wear, soft tissue lesions, and salivary gland dysfunction (e.g., xerostomia), were not assessed. Excluding these conditions may have led to the overlooking of oral diseases that potentially affect OHRQoL, thereby limiting a comprehensive understanding of all oral health determinants. Future research should consider expanding the scope of oral examinations to include these factors. Additionally, further studies are warranted to explore oral health status and OHRQoL across different age groups and in various prison settings within Thailand. Such research could also investigate other demographic and historical factors, such as pre-incarceration domiciles or health conditions, to better understand their influence on the oral health trajectory of older inmates. Finally, there is an urgent need to explore effective strategies for implementing and improving oral health care services specifically tailored to meet the unique treatment needs of older incarcerated individuals. Conclusions This study reveals that older inmates in the Central Prison, Thailand, exhibit a significant burden of poor oral health conditions and fewer remaining teeth compared to their age-matched non-incarcerated counterparts. Interestingly, despite these clinical disparities, no significant difference in OHRQoL was observed between older inmates and older Thai adults in the general population, potentially reflecting adaptive coping mechanisms or lower expectations within this population. However, independent of other factors, prolonged incarceration and the presence of depressive symptoms were identified as critical determinants negatively impacting OHRQoL among these inmates. These findings underscore an urgent need to develop and implement targeted oral health interventions and enhanced care strategies in the Thai prison setting. Such initiatives should prioritize preventive measures to minimize tooth loss and address the specific oral health needs of older inmates, while also integrating mental health support to improve their overall well-being and oral health-related quality of life Declarations FUNDING This research is funded by Thailand Science Research and Innovation Fund Chulalongkorn University (HEA_FF_69_036_3200_003), Health Systems Research Institute (68-032, 68-059), and Faculty of Dentistry, Chulalongkorn University (DRF68_014). AUTHOR CONTRIBUTION TC collected and analyzed data, performed statistical analyses, and drafted the initial manuscript. PB, SC, SP, AM and KR collected and analyzed data. TP designed the study, analyzed data, and drafted the manuscript. All authors read and approved the final version of the manuscript. DATA AVAILABILITY STATEMENT All the data produced throughout this research are incorporated in this published research article and its supplementary information. COMPETING INTERESTS The authors declare no competing interests. ACKNOWLEDGEMENT We gratefully acknowledge the support of the Good Health Good Heart Project under the Royal Patronage of H.M. the King, Bang Kwang Central Prison, Siam Commercial Bank, and PTT Public Company Limited. References Manna S, Tripathy S, Sah RK, Padhi BK, Kaur S, Nowrouzi-Kia B, et al. The Burden of Non-Communicable Diseases (NCDs) among Prisoners in India: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2022;10(10). Williams BA, Lindquist K, Sudore RL, Strupp HM, Willmott DJ, Walter LC. Being old and doing time: functional impairment and adverse experiences of geriatric female prisoners. J Am Geriatr Soc. 2006;54(4):702-7. Loeb SJ, Abudagga A. Health-Related Research on Older Inmates: An Integrative Review. Res Nurs Health. 2006;29(6):556-65. Reddy V, Kondareddy CV, Siddanna S, Manjunath M. A Survey on Oral Health Status and Treatment Needs of Life-Imprisoned Inmates in Central Jails of Karnataka, India. Int Dent J. 2012;62(1):27-32. Kondratyev SA, Turkina AY, Franco A, Budina TV, Ovsienko AG. Prevalence of Oral Diseases and The Assessment of The Simplified Oral Hygiene, Decayed-Missing-Filling and Community Periodontal Indices among Inmates of the Russian Federation. Bioscience Journal 2019;35:666-73. Vainionpaa R, Peltokangas A, Leinonen J, Pesonen P, Laitala ML, Anttonen V. Oral Health and Oral Health-Related Habits of Finnish Prisoners. BDJ Open. 2017;3:17006. Rijt LJMvd, Stoop CC, Weijenberg RAF, Vries Rd, Feast AR, Sampson EL, et al. The Influence of Oral Health Factors on the Quality of Life in Older People: A Systematic Review. Gerontologist. 2020;60(5):378-94. Wongbanthit Y, Rojvachiranonda N, Chantarangsu S, Suwanwitid P, Kamolvisit W, Porntaveetus T. Craniosynostosis: orofacial and oral health perspectives with masticatory insights. BMC Oral Health. 2024;24(1):767. Heidari E, Dickinson C, Wilson R, Fiske J. Oral Health of Remand Prisoners in HMP Brixton, London. Br Dent J. 2007;202(2):E1. Kumar P, Kumar P, Tiwari A, Patel M, Gadkari SN, Sao D, et al. A Cross-Sectional Assessment of Effects of Imprisonment Period on the Oral Health Status of Inmates in Ghaziabad, Delhi National Capital Region, India. Cureus. 2022;14(7):e27511. Yoon HS, Kim KS, Jang JH. Factors Related to Oral-Health-Related Quality of Life in Adult Male Inmates: A Cross-Sectional Study. Healthcare (Basel). 2023;11(21). Ngoenwiwatkul Y, Chatrchaiwiwatana S, Chaiprakarn K. Dental Status and Its Impact on the Quality of Life of Elderly in Phon Sawan, Nakhon Phanom Province. Southeast Asian J Trop Med Public Health. 2014;45(1):236-43. Srisilapanan P, Korwanich N, Jienmaneechotchai S, Dalodom S, Veerachai N, Vejvitee W, et al. Estimate of Impact on the Oral Health-Related Quality of Life of Older Thai People by the Provision of Dentures through the Royal Project. Int J Dent. 2016;2016:1976013. Watthanasaen S, Janthapa A, Tanigo G, Panyaphou S, Inkla P. Associations between Oral Health Behaviors and Oral Health Related Quality of Life among Prisoners in KhonKaen Central Prison. Thai Dental Nurse Journal. 2017;28. Sareeratewin P, Sritat J, Kankhwao P. Oral Health Behaviors and Associated Factor with Oral Health-Related Quality of Life among Prisoners in Nonthaburi Prison. Thai Dental Nurse Journal. 2021;32. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a Brief Depression Severity Measure. J Gen Intern Med. 2001;16(9):606-13. Nammontri O. Validation of the Thai Version of the 14- Item Oral Health Impact Profile (Thai OHIP-14) amongst the General Thai Adult Population in a Community Setting. Journal of Health Research. 2017;31(6):481-6. Greene JC, Vermillion JR. The Simplified Oral Hygiene Index. J Am Dent Assoc. 1964;68:7-13. Baishya B, Satpathy A, Nayak R, Mohanty R. Oral Hygiene Status, Oral Hygiene Practices and Periodontal Health of Brick Kiln Workers of Odisha. J Indian Soc Periodontol. 2019;23(2):163-7. Haq ZU, Nawaz K, Alam S, Khattak FA, Ullah N, Ahmed, et al. Oral Health Behind the Bars: Oral Health Seeking Behavior among Jail Prisoners at Central Jail of Peshawar, Pakistan: a Cross-Sectional Study. BMC Oral Health. 2023;23(1):979. Soares M, Goncalves M, Rompante P, Salazar F, Monteiro L, Pacheco JJ, et al. Assessment of Oral Health Status in a Prison Population in Northern Portugal. J Clin Exp Dent. 2023;15(11):e912-e9. Nobile CG, Fortunato L, Pavia M, Angelillo IF. Oral Health Status of Male Prisoners in Italy. Int Dent J. 2007;57(1):27-35. Osborn M, Butler T, Barnard PD. Oral Health Status of Prison Inmates--New South Wales, Australia. Aust Dent J. 2003;48(1):34-8. Causes of Death Collaborators, GBD 2023. Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406(10513):1811-72. Office of Dental Health Policy Ministry of Public Health. The 9th Thai National Oral Health Survey, 2023 (in Thai): Bureau of Dental Health, Department of Health; 2024. Available from: https://dental.anamai.moph.go.th/web-upload/5x9c01a3d6e5539cf478715290ac946bee/202406/m_magazine/36716/4952/file_download/f983389ded6e5dccbfe6f3362a453364.pdf. Thongchotchat V, Sutthiboonyapan P, Porntaveetus T, Wiriyakijja P. Relationship between periodontal health-related knowledge, belief, and behaviors: a structural equation modeling approach. BMC Oral Health. 2025;25(1):1244. McGrath C. Oral Health Behind Bars: A Study of Oral Disease and Its Impact on the Life Quality of an Older Prison Population. Gerodontology. 2002;19(2):109-14. Iosif L, Preoteasa CT, Preoteasa E, Ispas A, Ilinca R, Murariu-Mǎgureanu C, et al. Oral Health Related Quality of Life and Prosthetic Status among Institutionalized Elderly from the Bucharest Area: A Pilot Study. Int J Environ Res Public Health. 2021;18(12). Khongsirisombat N, SK, PS, RA, NO, ST. Oral Health-related Quality of Life in Thai Older People with Metabolic Syndrome. Journal of the Dental Association of Thailand. 2021:14. ASEAN Mental Disorders Collaborators, GBD 2021. The epidemiology and burden of ten mental disorders in countries of the Association of Southeast Asian Nations (ASEAN), 1990-2021: findings from the Global Burden of Disease Study 2021. Lancet Public Health. 2025;10(6):e480-e91. Somsak K, Kaewplung O. The Effects of the Number of Natural Teeth and Posterior Occluding Pairs on the Oral Health-Related Quality of Life in Elderly Dental Patients. Gerodontology. 2016;33(1):52-60. Kaewkamnerdpong I, Harirugsakul P, Prasertsom P, Vejvithee W, Niyomsilp K, Gururatana O. Oral Status is Associated with Chewing Difficulty in Thai Older Adults: Data from a National Oral Health Survey. BMC Oral Health. 2023;23(1):35. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 06 May, 2026 Reviews received at journal 07 Feb, 2026 Reviewers agreed at journal 30 Jan, 2026 Reviewers agreed at journal 30 Jan, 2026 Reviews received at journal 27 Jan, 2026 Reviewers agreed at journal 25 Jan, 2026 Reviewers invited by journal 22 Jan, 2026 Editor assigned by journal 20 Jan, 2026 Submission checks completed at journal 20 Jan, 2026 First submitted to journal 19 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8636082","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":580131528,"identity":"8c461fd2-b741-427a-bd5b-9bcf7c4ee367","order_by":0,"name":"Thananya Chongcharoenkit","email":"","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":false,"prefix":"","firstName":"Thananya","middleName":"","lastName":"Chongcharoenkit","suffix":""},{"id":580131529,"identity":"08647e04-e4e9-428d-9af5-d4c965ec29a4","order_by":1,"name":"Patita Bhuridej","email":"","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":false,"prefix":"","firstName":"Patita","middleName":"","lastName":"Bhuridej","suffix":""},{"id":580131530,"identity":"abc7195b-1844-49d2-b452-ebad2610cd45","order_by":2,"name":"Soranun Chantarangsu","email":"","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":false,"prefix":"","firstName":"Soranun","middleName":"","lastName":"Chantarangsu","suffix":""},{"id":580131531,"identity":"41e32a5b-bfe4-4d63-8a3b-335c56e2a9fa","order_by":3,"name":"Avirut Truntipakorn","email":"","orcid":"","institution":"Bangkwang Central Prison, Ministry of Justice","correspondingAuthor":false,"prefix":"","firstName":"Avirut","middleName":"","lastName":"Truntipakorn","suffix":""},{"id":580131532,"identity":"91e1782c-a87f-45ce-8739-cdc7fd793673","order_by":4,"name":"Anand Marya","email":"","orcid":"","institution":"University of Puthisastra","correspondingAuthor":false,"prefix":"","firstName":"Anand","middleName":"","lastName":"Marya","suffix":""},{"id":580131534,"identity":"f3db1f76-4228-4f88-b7f7-f6be7165706d","order_by":5,"name":"Sikharate Prachanukoon","email":"","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":false,"prefix":"","firstName":"Sikharate","middleName":"","lastName":"Prachanukoon","suffix":""},{"id":580131546,"identity":"901f4a3b-144e-44ff-b911-762cbd81f2c2","order_by":6,"name":"Khanti Rattanapornsompong","email":"","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":false,"prefix":"","firstName":"Khanti","middleName":"","lastName":"Rattanapornsompong","suffix":""},{"id":580131555,"identity":"b7999790-caad-45d1-9616-2a0983a4f0ec","order_by":7,"name":"Thantrira Porntaveetus","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYDACCQTJ+ICxgUEGKn4Apw4eCbA0WAuzAVALD0Q8gaAWMGCTIEqLvXTzs8cf91jk8zfwHqv4ueMwD38D88MPjD/u4LZF5pi5wYFnEpYzDvCl3ew9c5hH4gCbsQRDwjM8DkswkzhwQMKA4QCP2W3GtsM8QGeaAR12GI+W9G9gLfJALcUgLfIH2L8R0JIDscUAqIUZpAXEwK/lRk6ZxBmgFsPDfMmSvW3pPIaHeYolEtJwa2Gfkb5NouJAnYHc8d6DH362WcvJHW/f+OGDDW4tCMDMA2MAcQIRGkBuJE7ZKBgFo2AUjDwAALvcUL1p3w3rAAAAAElFTkSuQmCC","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":true,"prefix":"","firstName":"Thantrira","middleName":"","lastName":"Porntaveetus","suffix":""}],"badges":[],"createdAt":"2026-01-19 08:27:48","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8636082/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8636082/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101397837,"identity":"c1c423d7-9090-43e8-8a6d-c99daf40db11","added_by":"auto","created_at":"2026-01-29 09:37:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1641902,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8636082/v1/7b07da33-d752-42af-a25b-b7f4a5abe1d3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Oral Health Burden and Determinants of Oral Health-Related Quality of Life Among Geriatric Incarcerated Individuals: A Cross-Sectional Analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIncarcerated populations globally endure substantial health disparities, primarily stemming from restrictive environmental determinants and impeded healthcare access within correctional settings [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This vulnerability is heightened among aging inmates, who demonstrate an elevated prevalence of chronic morbidity and functional impairment relative to age-matched community-dwelling peers [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Consequently, this demographic trajectory necessitates targeted interventions to address the complex clinical requirements of the aging prison cohort.\u003c/p\u003e \u003cp\u003e Oral health is a fundamental determinant of overall well-being, but it remains disproportionately compromised within correctional facilities. Literature consistently indicates a high prevalence of oral pathology among incarcerated individuals, characterized by suboptimal oral hygiene, dental caries, advanced periodontal disease, and edentulism [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. These deficits precipitate substantial unmet treatment needs, particularly among older inmates burdened by multimorbidity.\u003c/p\u003e \u003cp\u003e Oral Health-Related Quality of Life (OHRQoL) is a multidimensional measure of the functional and psychological impact of oral conditions. Although the association between OHRQoL and clinical parameters is well-documented in the general population [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], the determinants of OHRQoL within prison populations, specifically among older adults, remain under-investigated. Variables such as incarceration duration, restricted healthcare access, and carceral lifestyle factors are hypothesized to significantly modulate OHRQoL in this vulnerable cohort [\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite global acknowledgement of these disparities, epidemiological data regarding older inmates in Thailand are limited. Prior Thai studies have examined general prison populations or community-dwelling older adults, thereby neglecting the intersection of aging and incarceration [\u003cspan additionalcitationids=\"CR13 CR14\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Consequently, this study addresses this gap by evaluating the oral health status and OHRQoL of older Thai inmates and by identifying correlates of these outcomes.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cem\u003eStudy Design and Setting\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study was conducted at Bang Kwang Central Prison, Nonthaburi, Thailand. Data were collected through structured questionnaires and comprehensive oral examinations performed by experienced dentists.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEthical Considerations and Informed Consent\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was approved by the Ethical Committee at the Faculty of Dentistry, Chulalongkorn University (HREC-DCU 2024-009). Official permission to conduct the study was also obtained from the Director of Bang Kwang Central Prison. Prior to participation, all potential participants received a detailed information sheet outlining the research objectives, procedures, and potential benefits. Written informed consent was obtained from each participant before any data collection commenced.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eParticipants and Sampling\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThai inmates aged 60 years and above, residing in Bang Kwang Central Prison during the period of June to December 2024, were eligible for inclusion. Exclusion criteria comprised individuals who declined, were unwilling, or were medically or cognitively unable to provide informed consent, complete questionnaires, or undergo an oral examination.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData Collection Procedures\u003c/em\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eSocio-demographic characteristics and relevant medical history were extracted from the electronic database at Bang Kwang Central Prison. Covariates included age, marital status, and duration of incarceration. Categorical variables were operationalized as follows: educational attainment (low: no formal education or \u0026lt; high school; high: ≥ high school), monthly income (low: ≤15,000 Baht; high: \u0026gt;15,000 Baht), and frequency of family visits (rare: no history or \u0026lt;1 visit/month; regular: ≥1 visit/month).\u003c/li\u003e\n \u003cli\u003eQuestionnaires\u003c/li\u003e\n \u003cli\u003eStructured questionnaires were administered to all participants to collect data on oral health behaviors, physical health status, mental health status, and oral health-related quality of life.\u003c/li\u003e\n \u003cli\u003eOral health behaviors: Questions included past dental visits, history of oral hygiene instructions, and self-reported smoking and alcohol consumption habits.\u003c/li\u003e\n \u003cli\u003ePhysical health status - Activities of Daily Living (ADL): Participants were asked if they required assistance with any of the five ADLs: bathing, eating, toileting, dressing, and transferring. Total scores ranged from 0 to 20, with lower scores indicating greater functional disability. Activities never performed were recorded as missing values and excluded from the calculation.\u003c/li\u003e\n \u003cli\u003eMental health status - Patient Health Questionnaire-9 (PHQ-9): Participants rated the frequency (0 = not at all, 3 = nearly every day) of nine problems experienced in the past two weeks, including anhedonia, depressed mood, sleep disturbances, fatigue, appetite changes, feelings of worthlessness, concentration difficulties, psychomotor changes, and suicidal ideation. Total scores ranged from 0 to 27, with higher scores indicating greater symptom severity [16].\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eOHRQoL - The 14-item Oral Health Impact Profile (OHIP-14) [17]: The OHIP-14 measures the frequency of impact (0 = never, 4 = very often) of orofacial and denture function on 14 items across seven dimensions (functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap) during the preceding 12 months. A summary score, ranging from 0 to 56, was calculated, with higher scores indicating poorer OHRQoL.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cem\u003eOral Examination\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eClinical oral evaluations were conducted in the morning; participants were instructed to refrain from oral hygiene and food intake for at least 2 hours prior to assessment. Procedures employed standard dental instrumentation, including a dental unit, mouth mirror, explorer, and Community Periodontal Index (CPI) probe. Two calibrated dentists performed the assessments. Intra-examiner reliability was substantial (Rater 1: ICC = 0.92; Rater 2: ICC = 0.94), with an inter-examiner reliability of 0.88. Data were recorded by a trained dental assistant on standardized forms. The following indices and parameters were assessed:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eThe Simplified Oral Hygiene Index (OHI-S) was used to evaluate both debris and calculus components on pre-selected tooth surfaces, assessed by running a dental explorer along the surface. Scores for each component ranged from 0 to 3, which were summed to yield a total OHI-S score from 0 to 6 for each participant [18]. OHI-S scores were interpreted as good (0–1.2), fair (1.3–3.0), or poor (3.1–6.0) [19].\u003c/li\u003e\n \u003cli\u003eThe DMFT (Decayed, Missing, Filled Teeth) index was recorded for all dried permanent tooth surfaces (crowns and roots). Specific codes were assigned: 0 = sound, 1 = caries, 2 = filled with caries, 3 = filled without caries, 4 = missing, 6 = fissure sealant, 7 = fixed dental prosthesis. The D component included teeth coded 1 or 2; the M component included teeth coded 4; and the F component included teeth coded 3. Other codes were excluded from DMFT calculation.\u003c/li\u003e\n \u003cli\u003ePeriodontal health was assessed using a WHO gingival probe (20g force). Indicators recorded included periodontal pocket depth and clinical attachment loss, scored according to established criteria.\u003c/li\u003e\n \u003cli\u003eInformation on prostheses, removable denture wearing history and denture type(s) was collected directly from participants. The total number of remaining natural teeth (0-32, including third molars) and the number of posterior occluding pairs (0-10, including those provided by dentures) were also counted.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cem\u003eData Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eRaw data were initially tabulated in Microsoft Office Excel. Descriptive statistics were used to summarize demographic characteristics and clinical conditions; categorical variables were presented as frequencies and percentages, whereas continuous variables were reported as means and standard deviations (SDs) or medians and interquartile ranges (IQRs), depending on their distribution. Bivariate analyses, utilizing Chi-square tests, Mann-Whitney U tests, or independent t-tests as appropriate for data type and distribution, were conducted to assess associations between OHIP-14 scores and all other study variables. Subsequently, multivariate logistic regression was employed to identify significant independent factors associated with OHRQoL. Statistical analyses were performed using SPSS version 22, with a \u003cem\u003ep\u003c/em\u003e-value \u0026lt; 0.05 considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic and Health Characteristics, OHRQoL, and Factors Associated with OHRQoL\u003c/h2\u003e \u003cp\u003eA total of 141 older male inmates, with a mean age of 69.26\u0026thinsp;\u0026plusmn;\u0026thinsp;7.15 years, participated in the study. The majority of participants reported living alone (n\u0026thinsp;=\u0026thinsp;71, 51.4%). Educational attainment was generally low: 57.6% (n\u0026thinsp;=\u0026thinsp;80) had completed elementary school or less, and 65% (n\u0026thinsp;=\u0026thinsp;91) reported low income. The average imprisonment duration was 9.08 years, with a maximum of 25 years, with most (n\u0026thinsp;=\u0026thinsp;80, 58.4%) incarcerated for less than 10 years. A significant portion received infrequent family visits, less than once a month (n\u0026thinsp;=\u0026thinsp;73, 51.8%). Regarding substance use, the majority were non-alcohol drinkers (n\u0026thinsp;=\u0026thinsp;113, 81.9%), non-smokers (n\u0026thinsp;=\u0026thinsp;71, 51.8%), and reported no history of drug abuse (n\u0026thinsp;=\u0026thinsp;124, 89.2%).\u003c/p\u003e \u003cp\u003e Concerning oral health behaviors, 79.9% (n\u0026thinsp;=\u0026thinsp;106) of participants reported never having received oral hygiene instructions from dental professionals, and 57.9% (n\u0026thinsp;=\u0026thinsp;73) reported never or rarely visiting a dentist. A substantial proportion of inmates exhibited no ADL problems (n\u0026thinsp;=\u0026thinsp;77, 84.6%) and no depressive symptoms (n\u0026thinsp;=\u0026thinsp;63, 45.0%). The mean OHIP-14 score for the study population was 6.44\u0026thinsp;\u0026plusmn;\u0026thinsp;8.12, with a median of 3.0 (IQR: 0.0\u0026ndash;9.0). Participants exhibiting depressive symptoms recorded the highest mean OHIP-14 scores. The mean Oral Health Impact Profile-14 (OHIP-14) score among participants was 6.44, and the median score was 3. Participants exhibiting depressive symptoms recorded the highest mean OHIP-14 scores.\u003c/p\u003e \u003cp\u003eBivariate analysis (Mann-Whitney U Test) revealed statistically significant associations between OHIP-14 scores and several categorical variables: educational level, imprisonment period, smoking status, history of oral hygiene instructions, history of dental visits, presence of ADL problems, and presence of depressive symptoms (all \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Detailed demographic and health characteristics, as well as bivariate associations, are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics, ADL, and PHQ-9, and OHIP-14 scores according to categorical variables among Thai older male inmates in Bang Kwang Central Prison.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eOHIP-14\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall participants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e141 (100%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.44\u0026thinsp;\u0026plusmn;\u0026thinsp;8.333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status (n\u0026thinsp;=\u0026thinsp;138)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle/divorced/widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71 (51.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.24\u0026thinsp;\u0026plusmn;\u0026thinsp;8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.00 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.831\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67 (48.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.60\u0026thinsp;\u0026plusmn;\u0026thinsp;8.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00 (11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation (n\u0026thinsp;=\u0026thinsp;139)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow education (no formal education or \u0026lt;\u0026thinsp;high school)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (57.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.03\u0026thinsp;\u0026plusmn;\u0026thinsp;7.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.00 (8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh education (\u0026ge;\u0026thinsp;high school)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59 (42.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e8.44\u0026thinsp;\u0026plusmn;\u0026thinsp;9.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.00 (14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome (n\u0026thinsp;=\u0026thinsp;140)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow income (\u0026le;\u0026thinsp;15,000 Baht/month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91 (65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.33\u0026thinsp;\u0026plusmn;\u0026thinsp;8.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.269\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh income (\u0026gt;\u0026thinsp;15,000 Baht/month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.78\u0026thinsp;\u0026plusmn;\u0026thinsp;7.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.00 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eImprisonment Period (n\u0026thinsp;=\u0026thinsp;141)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (58.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.56\u0026thinsp;\u0026plusmn;\u0026thinsp;8.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.00 (8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.024\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57 (41.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e8.12\u0026thinsp;\u0026plusmn;\u0026thinsp;8.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.00 (13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHistory of Family Visit (n\u0026thinsp;=\u0026thinsp;141)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRare family visit (no history or \u0026lt;\u0026thinsp;1 visit/month).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73 (51.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.70\u0026thinsp;\u0026plusmn;\u0026thinsp;9.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00 (11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.662\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular family visit (\u0026ge;\u0026thinsp;1 visit/month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68 (48.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.16\u0026thinsp;\u0026plusmn;\u0026thinsp;7.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.00 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlcohol consumption (n\u0026thinsp;=\u0026thinsp;138)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-drinker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113 (81.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.10\u0026thinsp;\u0026plusmn;\u0026thinsp;8.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.170\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol drinker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (18.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e7.56\u0026thinsp;\u0026plusmn;\u0026thinsp;8.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.00 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking (n\u0026thinsp;=\u0026thinsp;137)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71 (51.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.27\u0026thinsp;\u0026plusmn;\u0026thinsp;8.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.00 (8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEx-smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66 (48.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e7.85\u0026thinsp;\u0026plusmn;\u0026thinsp;8.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.00 (11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDrug Abuse (n\u0026thinsp;=\u0026thinsp;139)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e124 (89.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.04\u0026thinsp;\u0026plusmn;\u0026thinsp;8.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (10.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e10.00\u0026thinsp;\u0026plusmn;\u0026thinsp;9.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.00 (14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral hygiene instruction (n\u0026thinsp;=\u0026thinsp;133)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e106 (79.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.61\u0026thinsp;\u0026plusmn;\u0026thinsp;8.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.00 (8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (20.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e7.30\u0026thinsp;\u0026plusmn;\u0026thinsp;7.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.00 (8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLast dental visit (n\u0026thinsp;=\u0026thinsp;126)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever/Rare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73 (57.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e4.70\u0026thinsp;\u0026plusmn;\u0026thinsp;7.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.00 (7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSaw dentist 1\u0026ndash;2 year(s) ago\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (42.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e8.58\u0026thinsp;\u0026plusmn;\u0026thinsp;8.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.00 (13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eADL (n\u0026thinsp;=\u0026thinsp;91)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77 (84.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e4.17\u0026thinsp;\u0026plusmn;\u0026thinsp;7.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.00 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWith ADL problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (15.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e9.79\u0026thinsp;\u0026plusmn;\u0026thinsp;10.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.00 (14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePHQ-9 (n\u0026thinsp;=\u0026thinsp;140)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63 (45%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.49\u0026thinsp;\u0026plusmn;\u0026thinsp;3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.00 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWith depressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77 (55%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e10.34\u0026thinsp;\u0026plusmn;\u0026thinsp;9.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.00 (12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e#\u003c/sup\u003eDifferences between groups were analyzed using the Mann\u0026ndash;Whitney U test. Bold numbers indicate statistically significant differences (\u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026le;\u0026thinsp;0.05). Percentages were calculated from valid data.\u003c/p\u003e \u003c/div\u003e"},{"header":"Dentition Status","content":"\u003cp\u003eThe dentition status of participants is detailed in Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, which present the mean values of oral health parameters across various categorical variables. Specifically, the mean number of decayed teeth (D component) was 1.72\u0026thinsp;\u0026plusmn;\u0026thinsp;2.85, the number of filled teeth without caries (F component) was 1.24\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53, and the number of missing teeth (M component) was 11.74\u0026thinsp;\u0026plusmn;\u0026thinsp;9.67. Further analysis revealed significant associations between dentition components and participant characteristics. A higher number of filled teeth without caries (F) was significantly associated with higher educational attainment (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), higher income (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.013), more regular family visits (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.042), and a history of having received oral hygiene instructions (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005). Conversely, a higher number of missing teeth (M) was significantly associated with lower educational attainment (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.021), a history of smoking (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.006), and a visit to a dentist in the past 1\u0026ndash;2 years (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). These findings highlight differential impacts of socio-demographic factors and oral health behaviors on dental restorative status and tooth loss among the incarcerated elderly.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDentition status according to categorical variables among Thai older male inmates in Bang Kwang Central Prison.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eDecayed\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eFilled with no caries\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eMissing teeth\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep-\u003c/em\u003evalue*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall participants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.72\u0026thinsp;\u0026plusmn;\u0026thinsp;2.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.24\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e11.74\u0026thinsp;\u0026plusmn;\u0026thinsp;9.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle/divorced/widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.27\u0026thinsp;\u0026plusmn;\u0026thinsp;3.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.22\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e10.97\u0026thinsp;\u0026plusmn;\u0026thinsp;8.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.16\u0026thinsp;\u0026plusmn;\u0026thinsp;1.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.25\u0026thinsp;\u0026plusmn;\u0026thinsp;2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e10.14\u0026thinsp;\u0026plusmn;\u0026thinsp;8.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.97\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.755\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.53\u0026thinsp;\u0026plusmn;\u0026thinsp;1.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e11.59\u0026thinsp;\u0026plusmn;\u0026thinsp;9.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.021\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.31\u0026thinsp;\u0026plusmn;\u0026thinsp;2.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e2.15\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e9.44\u0026thinsp;\u0026plusmn;\u0026thinsp;7.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.926\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.013\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e11.71\u0026thinsp;\u0026plusmn;\u0026thinsp;8.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.39\u0026thinsp;\u0026plusmn;\u0026thinsp;2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.71\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e8.44\u0026thinsp;\u0026plusmn;\u0026thinsp;6.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eImprisonment Period\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.442\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.18\u0026thinsp;\u0026plusmn;\u0026thinsp;2.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.898\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e11.20\u0026thinsp;\u0026plusmn;\u0026thinsp;8.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.268\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.21\u0026thinsp;\u0026plusmn;\u0026thinsp;2.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.38\u0026thinsp;\u0026plusmn;\u0026thinsp;2.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e10.38\u0026thinsp;\u0026plusmn;\u0026thinsp;8.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHistory of Family Visit\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRare family visit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.64\u0026thinsp;\u0026plusmn;\u0026thinsp;3.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.970\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.042\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e9.86\u0026thinsp;\u0026plusmn;\u0026thinsp;7.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular family visit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e2.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e12.00\u0026thinsp;\u0026plusmn;\u0026thinsp;9.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlcohol consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-drinker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.55\u0026thinsp;\u0026plusmn;\u0026thinsp;2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.710\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e10.37\u0026thinsp;\u0026plusmn;\u0026thinsp;7.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.801\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol drinker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.62\u0026thinsp;\u0026plusmn;\u0026thinsp;2.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.86\u0026thinsp;\u0026plusmn;\u0026thinsp;3.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e12.95\u0026thinsp;\u0026plusmn;\u0026thinsp;10.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.920\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e9.04\u0026thinsp;\u0026plusmn;\u0026thinsp;7.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEx-smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.52\u0026thinsp;\u0026plusmn;\u0026thinsp;2.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.54\u0026thinsp;\u0026plusmn;\u0026thinsp;2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e12.69\u0026thinsp;\u0026plusmn;\u0026thinsp;8.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDrug Abuse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.25\u0026thinsp;\u0026plusmn;\u0026thinsp;2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.370\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e10.78\u0026thinsp;\u0026plusmn;\u0026thinsp;8.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.905\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.27\u0026thinsp;\u0026plusmn;\u0026thinsp;2.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.36\u0026thinsp;\u0026plusmn;\u0026thinsp;2.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e11.73\u0026thinsp;\u0026plusmn;\u0026thinsp;8.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral hygiene instruction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.66\u0026thinsp;\u0026plusmn;\u0026thinsp;2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.517\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.92\u0026thinsp;\u0026plusmn;\u0026thinsp;2.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e10.81\u0026thinsp;\u0026plusmn;\u0026thinsp;8.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.797\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.18\u0026thinsp;\u0026plusmn;\u0026thinsp;1.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e2.59\u0026thinsp;\u0026plusmn;\u0026thinsp;3.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e11.14\u0026thinsp;\u0026plusmn;\u0026thinsp;7.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLast dental visit\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever/Rare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.90\u0026thinsp;\u0026plusmn;\u0026thinsp;3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.605\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.862\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e9.03\u0026thinsp;\u0026plusmn;\u0026thinsp;8.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSaw a dentist 1\u0026ndash;2 years ago\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.07\u0026thinsp;\u0026plusmn;\u0026thinsp;1.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e13.52\u0026thinsp;\u0026plusmn;\u0026thinsp;8.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e#\u003c/sup\u003eDifferences between groups were analyzed using the Mann\u0026ndash;Whitney U test. Bold numbers indicate statistically significant differences (\u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026le;\u0026thinsp;0.05). Percentages were calculated from valid data.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePeriodontal and Oral Hygiene Status\u003c/h2\u003e \u003cp\u003ePeriodontal and oral hygiene status, as presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, revealed a mean OHI-S score of 3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23, indicating generally poor oral hygiene. The mean periodontal pocket score was 0.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61, and the mean loss of attachment (LOA) score was 0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59. Further analysis demonstrated that the history of smoking was significantly associated with poorer periodontal health, specifically manifesting as significantly higher mean pocket scores (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.032) and higher mean loss of attachment scores (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.015).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eOral hygiene and periodontal status according to categorical variables among Thai older male inmates in Bang Kwang Central Prison.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eOHI-S\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003ePocket scores\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eLOA scores\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall participants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle/divorced/widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.47\u0026thinsp;\u0026plusmn;\u0026thinsp;1.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.766\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.962\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.547\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.56\u0026thinsp;\u0026plusmn;\u0026thinsp;1.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.695\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.16\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.74\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.332\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.308\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.27\u0026thinsp;\u0026plusmn;\u0026thinsp;1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eImprisonment Period\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.41\u0026thinsp;\u0026plusmn;\u0026thinsp;1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.371\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHistory of Family Visit\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRare family visit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.54\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.685\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.609\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular family visit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.19\u0026thinsp;\u0026plusmn;\u0026thinsp;1.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.74\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlcohol consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-drinker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.41\u0026thinsp;\u0026plusmn;\u0026thinsp;1.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.806\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.374\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.723\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol drinker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.27\u0026thinsp;\u0026plusmn;\u0026thinsp;1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.66\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.032\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.015\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEx-smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.97\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDrug Abuse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.572\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.436\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.227\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.60\u0026thinsp;\u0026plusmn;\u0026thinsp;1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.93\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.98\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOral hygiene instruction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.45\u0026thinsp;\u0026plusmn;\u0026thinsp;1.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.665\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.980\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLast dental visit\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever/Rare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.797\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.424\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSaw a dentist 1\u0026ndash;2 years ago\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.44\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e#\u003c/sup\u003eDifferences between groups were analyzed using the Mann\u0026ndash;Whitney U test. Bold numbers indicate statistically significant differences (\u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026le;\u0026thinsp;0.05). Percentages were calculated from valid data.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eClinical Factors and OHRQoL\u003c/h2\u003e \u003cp\u003eTo further investigate the relationship between oral health status and OHRQoL, the OHIP-14 score was dichotomized into two groups based on the study's median score of 3: \u0026ldquo;Good OHRQoL\u0026rdquo; (OHIP-14 score\u0026thinsp;\u0026lt;\u0026thinsp;3) and \u0026ldquo;Poor OHRQoL\u0026rdquo; (OHIP-14 score\u0026thinsp;\u0026ge;\u0026thinsp;3). Analysis revealed that participants with \u0026ldquo;filled with no caries\u0026rdquo; teeth were significantly associated with \u0026ldquo;Poor OHRQoL\u0026rdquo; (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.011). In contrast, the mean number of remaining natural teeth (20.26\u0026thinsp;\u0026plusmn;\u0026thinsp;9.67) and the mean number of posterior occluding pairs (4.91\u0026thinsp;\u0026plusmn;\u0026thinsp;3.33) did not show a statistically significant association with OHIP-14 scores (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eRegarding general health metrics, while the overall mean ADL score was 19.59\u0026thinsp;\u0026plusmn;\u0026thinsp;2.04 and the mean PHQ-9 score was 2.21\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02, both were significantly associated with OHRQoL. Specifically, the \u0026ldquo;Poor OHRQoL\u0026rdquo; group exhibited a significantly lower mean ADL score (indicating greater disability) compared to the \u0026ldquo;Good OHRQoL\u0026rdquo; group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004). Conversely, the \u0026ldquo;Poor OHRQoL\u0026rdquo; group had a significantly higher mean PHQ-9 score (indicating greater depressive symptom severity) than the \u0026ldquo;Good OHRQoL\u0026rdquo; group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Detailed findings are presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation of Oral Health Status and Related Factors with OHIP-14 Scores Among Older Male Inmates in Bang Kwang Central Prison, Thailand.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eTotal cases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eGood OHRQoL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003ePoor OHRQoL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSound teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17.32\u0026thinsp;\u0026plusmn;\u0026thinsp;9.378\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.50 (15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.87\u0026thinsp;\u0026plusmn;\u0026thinsp;8.694\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.00 (16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.09\u0026thinsp;\u0026plusmn;\u0026thinsp;8.345\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.00 (14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.531\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDecayed teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.62\u0026thinsp;\u0026plusmn;\u0026thinsp;2.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.00 (3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.26\u0026thinsp;\u0026plusmn;\u0026thinsp;2.385\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.50 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.624\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFilled teeth with caries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.08\u0026thinsp;\u0026plusmn;\u0026thinsp;0.522\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.474\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.318\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFilled teeth with no caries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.24\u0026thinsp;\u0026plusmn;\u0026thinsp;2.532\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.545\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.44\u0026thinsp;\u0026plusmn;\u0026thinsp;2.530\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.00 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.74\u0026thinsp;\u0026plusmn;\u0026thinsp;9.673\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.00 (15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.79\u0026thinsp;\u0026plusmn;\u0026thinsp;8.462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.50 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.96\u0026thinsp;\u0026plusmn;\u0026thinsp;8.290\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9.00 (14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.840\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSealant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFixed prostheses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.991\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.314\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.571\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.887\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOHI-S score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.33 (1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.40\u0026thinsp;\u0026plusmn;\u0026thinsp;1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.37 (2.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.37\u0026thinsp;\u0026plusmn;\u0026thinsp;1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.25 (1.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.118\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDebris score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.65\u0026thinsp;\u0026plusmn;\u0026thinsp;0.625\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.60 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.67 (1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.50 (0.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.439\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalculus score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.722\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.80 (0.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.67 (1.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.74\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.83 (0.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.722\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePocket score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.609\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.67 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.67 (1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.67 (1.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.753\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBleeding score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00 (0.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (0.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.89\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (0.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLOS score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.593\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.80 (0.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.74\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.67 (0.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.83 (0.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.163\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRemaining teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.26\u0026thinsp;\u0026plusmn;\u0026thinsp;9.673\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.00 (15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.21\u0026thinsp;\u0026plusmn;\u0026thinsp;8.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.50 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.04\u0026thinsp;\u0026plusmn;\u0026thinsp;8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00 (14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.840\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccluding pairs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.91\u0026thinsp;\u0026plusmn;\u0026thinsp;3.296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.00 (6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.84\u0026thinsp;\u0026plusmn;\u0026thinsp;3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.50 (6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.69\u0026thinsp;\u0026plusmn;\u0026thinsp;3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.00 (6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.531\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADL scores\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.59\u0026thinsp;\u0026plusmn;\u0026thinsp;2.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.91\u0026thinsp;\u0026plusmn;\u0026thinsp;0.342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.00 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePHQ9 scores\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.21\u0026thinsp;\u0026plusmn;\u0026thinsp;3.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00 (3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.51\u0026thinsp;\u0026plusmn;\u0026thinsp;1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.00 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.61\u0026thinsp;\u0026plusmn;\u0026thinsp;3.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.00 (5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e Difference tested using the Mann-Whitney U-Test, \u003csup\u003eb\u003c/sup\u003e using Independent T-Test. Bold numbers indicate statistically significant differences (\u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026le;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eMultivariate Analysis of Factors Associated with OHRQoL\u003c/h2\u003e \u003cp\u003eA multivariate logistic regression model was conducted to identify independent factors associated with \u0026ldquo;Poor OHRQoL\u0026rdquo; (defined as OHIP-14 score\u0026thinsp;\u0026ge;\u0026thinsp;3). The analysis included variables identified as significant in bivariate tests, such as educational level, incarceration period, smoking status, history of oral hygiene instructions, dental visit history, ADL problems, and depressive symptoms. The multivariate model revealed that two factors remained significantly associated with \u0026ldquo;Poor OHRQoL\u0026rdquo;: prolonged incarceration (more than 10 years) and the presence of depressive symptoms. Specifically, participants incarcerated for over 10 years experienced 5.689 times higher odds of having \u0026ldquo;Poor OHRQoL\u0026rdquo; compared to those incarcerated for 10 years or less (Adjusted Odds Ratio [AOR]\u0026thinsp;=\u0026thinsp;5.689; 95% Confidence Interval [CI]: 1.209\u0026ndash;26.765; p\u0026thinsp;=\u0026thinsp;0.028). Furthermore, participants exhibiting depressive symptoms had 9.997 times higher odds of experiencing 'Poor OHRQoL' compared to those without depressive symptoms (AOR\u0026thinsp;=\u0026thinsp;9.997; 95% CI: 2.158\u0026ndash;46.313; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The crude and adjusted odds ratios, along with their 95% confidence intervals, for all factors included in the model are presented in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eCrude and Adjusted Odds Ratios (AOR) with 95% Confidence Intervals (CI) for Factors Associated with Poor OHRQoL Among Older Male Inmates.\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eUnivariate logistic regression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMultivariate logistic regression\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCrude OR\u003c/p\u003e \u003cp\u003e(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdjusted OR\u003c/p\u003e \u003cp\u003e(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.229 (1.122\u0026ndash;4.431)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.636 (0.603\u0026ndash;11.519)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.198\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 years\u0026rsquo; incarceration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.319 (1.155\u0026ndash;4.658)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.689 (1.209\u0026ndash;26.765)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.218 (1.120\u0026ndash;4.394)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.082 (0.256\u0026ndash;4.570)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.915\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of ora hygiene instructions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.219 (1.294\u0026ndash;8.010)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.894 (0.639\u0026ndash;37.460)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.126\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecent dental visit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.515 (1.671\u0026ndash;7.392)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.320 (0.511\u0026ndash;10.529)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.275\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADL problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.521 (1.573\u0026ndash;19.382)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.968 (0.840-29.397)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.077\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.176 (8.717\u0026ndash;51.447)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.997 (2.158\u0026ndash;46.313)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBold numbers indicate statistically significant differences (\u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026le;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003e This cross-sectional study comprehensively investigated the oral health status and OHRQoL among older male inmates in Bang Kwang Central Prison, Thailand, and identified associated socio-demographic, behavioral, and clinical factors. While oral health disparities in incarcerated populations are well-documented, specific data on older prisoners, particularly in Thailand, remain scarce. Our findings provide crucial insights into this vulnerable group.\u003c/p\u003e \u003cp\u003eThe study population (n\u0026thinsp;=\u0026thinsp;141, mean age 69.26 years) exhibited socio-economic characteristics consistent with broader incarcerated demographics, including low educational attainment and income [\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Interestingly, higher education and income were associated with better restorative dental health (more fillings without caries and higher remaining teeth), highlighting socio-economic gradients even within this confined setting. Behavioral patterns revealed a significant proportion of participants reported living alone and experiencing infrequent family visits. While most were non-alcohol drinkers and non-drug users, a substantial almost half (48.2%) were current or former smokers. Importantly, smoking history was significantly linked to poorer periodontal health (higher pocket and attachment loss scores) and greater tooth loss, underscoring its detrimental and cumulative impact on oral health in this population.\u003c/p\u003e \u003cp\u003e Regarding oral health practices, a concerning majority of inmates reported never having received professional oral hygiene instructions (79.7%) and infrequent dental visits (57.9%). These rates are notably lower than those reported in some other incarcerated populations, such as in Pakistan and Australia [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], suggesting potentially greater unmet needs in the Thai context. While receiving oral hygiene instructions was associated with more fillings (indicating prior restorative care), a counterintuitive finding was that recent dental visits were associated with a higher number of missing teeth and prosthetic needs. This likely indicates that inmates primarily seek dental care when symptomatic or facing significant functional impairments, such as discomfort or difficulty chewing due to tooth loss, thus leading to treatment for existing problems rather than preventive care\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eOral health status\u003c/h2\u003e \u003cp\u003e As anticipated, this study revealed a generally poor oral hygiene status among older Thai inmates, with a mean OHI-S score of 3.38. This is comparable to findings in incarcerated populations in India but higher than in Russia (OHI-S 2.77 for male inmates) [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], indicating regional variations in oral hygiene practices or provision of care [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Comparisons with the 9th Thailand National Oral Health Survey (2023) among age-matched general populations provide mixed insights. Our incarcerated cohort exhibited lower mean counts of decayed (D) and filled (F) teeth compared to older Thai non-inmates [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Similarly, mean periodontal pocket and loss of attachment (LOA) scores were lower than those reported for older Thai non-inmates [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. However, the mean number of missing teeth (M component\u0026thinsp;=\u0026thinsp;11.74), resulting in an average of 20.26 remaining natural teeth, was comparable to the national survey's findings for the 60\u0026ndash;74 age group (19.6 teeth) but notably higher than for the 80\u0026ndash;85 age group (11.7 teeth) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Interestingly, this count of remaining teeth is also higher than that reported for older inmates (age\u0026thinsp;\u0026ge;\u0026thinsp;60) in Hong Kong (mean missing teeth\u0026thinsp;=\u0026thinsp;20.28) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], suggesting potentially better tooth retention among older Thai inmates compared to some other incarcerated populations. Despite this, a substantial proportion (34.3%) of inmates had fewer than 20 remaining teeth, and among these, 45.8% required prostheses, highlighting a significant unmet need for functional rehabilitation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eOral Health-Related Quality of Life (OHRQoL)\u003c/h2\u003e \u003cp\u003eThe mean OHIP-14 score in this study was 6.44 (median 3). This indicates a comparatively lower negative impact on OHRQoL among older Thai inmates than among older male inmates in other international studies [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Intriguingly, our OHIP-14 scores were also comparable to those observed in older Thai non-inmates [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. This convergence of OHRQoL scores between incarcerated and non-incarcerated older Thai populations warrants further exploration. A plausible explanation for these relatively low OHIP-14 scores, even amidst clinical oral health challenges, could stem from cultural factors. Older individuals in Thailand, irrespective of their incarcerated status, may exhibit lower expectations for their oral health, a greater propensity for adaptation to existing conditions, and a reduced drive to seek extensive dental care. This cultural inclination, coupled with socioeconomic factors such as low income, could lead to the normalization of poorer oral health outcomes and reduced reporting of oral health impacts, thereby resulting in lower OHIP-14 scores. Financial constraints may also pose a significant barrier to accessing dental treatment, further influencing self-perceived OHRQoL.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eAssociated factors related to oral health status and OHRQoL\u003c/h2\u003e \u003cp\u003e This study identified several sociodemographic, behavioral, and health factors that influence oral health status and OHRQoL among older Thai inmates. Initially, bivariate analyses indicated that higher education, incarceration exceeding 10 years, smoking, history of oral hygiene instructions (OHI), recent dental visits, ADL problems, and depressive symptoms were associated with OHRQoL. However, after adjusting for potential confounders in the multivariate logistic regression model, only prolonged incarceration (more than 10 years) and the presence of depressive symptoms remained significant independent predictors of \u0026ldquo;Poor OHRQoL\u0026rdquo;.\u003c/p\u003e \u003cp\u003eThe strong association between depressive symptoms and \u0026ldquo;Poor OHRQoL\u0026rdquo; aligns with findings from studies in older populations, including incarcerated settings, where mental health significantly impacts perceived quality of life and oral health outcomes [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Similarly, functional limitations (ADL problems) were associated with OHRQoL in bivariate analysis, consistent with a Korean study linking ADL problems to both OHRQoL and depression [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. However, the lack of an independent association in our multivariate model suggests that the impact of ADL might be mediated or confounded by other factors, potentially depressive symptoms themselves.\u003c/p\u003e \u003cp\u003eRegarding clinical oral health parameters, Decayed teeth (D component) showed no significant association with OHRQoL or any other studied factors. This finding is consistent with prior research suggesting that decayed teeth may not always have a direct negative impact on OHRQoL, perhaps due to adaptation or lower expectations [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. However, this contrasts with studies reporting an increase in decayed teeth among inmates with prolonged incarceration (\u0026gt;\u0026thinsp;3 years) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The higher number of filled teeth (F component) was, as expected, significantly associated with higher education, higher income, more regular family visits, and a history of receiving OHI, indicating the role of socioeconomic status and preventive behaviors in accessing restorative care.\u003c/p\u003e \u003cp\u003eIn terms of periodontal status, as hypothesized, a history of smoking was significantly associated with poorer periodontal conditions (higher pocket and loss of attachment scores). Nevertheless, contrary to expectations, no significant association was found between periodontal conditions and OHRQoL in this cohort. This lack of a clear link between objective periodontal disease and subjective OHRQoL is not uncommon and aligns with systematic reviews indicating no consensus on this relationship in older populations [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], possibly due to adaptation or individuals prioritizing more acute symptoms.\u003c/p\u003e \u003cp\u003eThe number of remaining natural teeth and the number of posterior occluding pairs were not significantly associated with OHRQoL in our study. This finding contrasts sharply with a substantial body of evidence, including a systematic review in older people (13) and a specific study on older Thai individuals [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], which consistently demonstrate a positive association between a higher number of natural teeth/occluding pairs and better OHRQoL. It also contrasts with the results from another study where it was concluded that older adults with at least 27 teeth (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), or at least eight occlusal pairs (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) were more likely to have less chewing difficulty [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. It also deviates from studies in older inmates linking fewer than 20 teeth and high DMFT scores to poor OHRQoL [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. This discrepancy in our findings could again be attributed to the potential influence of cultural adaptation, lower expectations among older Thai inmates, or other unmeasured confounding factors within this unique population.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of the study\u003c/h2\u003e \u003cp\u003eThis study presents important insights, but its findings should be interpreted with certain limitations. First, the relatively small sample size (n\u0026thinsp;=\u0026thinsp;141) of older inmates in Bang Kwang Central Prison limits the generalizability of our findings. This restricted participation was primarily due to logistical challenges, such as difficulties transporting inmates from their dormitories to the examination site, and to the physical health conditions of some older inmates that precluded their movement or participation. Consequently, our study predominantly included more independent and ambulatory older inmates, potentially leading to an underrepresentation of those with greater physical frailty or health issues. Therefore, these results may not be fully generalizable to the entire older inmate population within Central Prison, nor to other correctional facilities in Thailand. Future studies should aim for larger, more diverse samples across multiple prisons to enhance external validity.\u003c/p\u003e \u003cp\u003e Second, the scope of the oral examination was limited, focusing primarily on oral hygiene, caries, periodontal health, and prosthetic status. Other potentially significant oral conditions, such as tooth wear, soft tissue lesions, and salivary gland dysfunction (e.g., xerostomia), were not assessed. Excluding these conditions may have led to the overlooking of oral diseases that potentially affect OHRQoL, thereby limiting a comprehensive understanding of all oral health determinants.\u003c/p\u003e \u003cp\u003eFuture research should consider expanding the scope of oral examinations to include these factors. Additionally, further studies are warranted to explore oral health status and OHRQoL across different age groups and in various prison settings within Thailand. Such research could also investigate other demographic and historical factors, such as pre-incarceration domiciles or health conditions, to better understand their influence on the oral health trajectory of older inmates. Finally, there is an urgent need to explore effective strategies for implementing and improving oral health care services specifically tailored to meet the unique treatment needs of older incarcerated individuals.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003e This study reveals that older inmates in the Central Prison, Thailand, exhibit a significant burden of poor oral health conditions and fewer remaining teeth compared to their age-matched non-incarcerated counterparts. Interestingly, despite these clinical disparities, no significant difference in OHRQoL was observed between older inmates and older Thai adults in the general population, potentially reflecting adaptive coping mechanisms or lower expectations within this population. However, independent of other factors, prolonged incarceration and the presence of depressive symptoms were identified as critical determinants negatively impacting OHRQoL among these inmates. These findings underscore an urgent need to develop and implement targeted oral health interventions and enhanced care strategies in the Thai prison setting. Such initiatives should prioritize preventive measures to minimize tooth loss and address the specific oral health needs of older inmates, while also integrating mental health support to improve their overall well-being and oral health-related quality of life\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFUNDING\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis research is funded by Thailand Science Research and Innovation Fund Chulalongkorn University (HEA_FF_69_036_3200_003), Health Systems Research Institute (68-032, 68-059), and Faculty of Dentistry, Chulalongkorn University (DRF68_014).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAUTHOR CONTRIBUTION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTC collected and analyzed data, performed statistical analyses, and drafted the initial manuscript. PB, SC, SP, AM and KR collected and analyzed data. TP designed the study, analyzed data, and drafted the manuscript. All authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDATA AVAILABILITY STATEMENT\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the data produced throughout this research are incorporated in this published research article and its supplementary information.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCOMPETING INTERESTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eACKNOWLEDGEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully acknowledge the support of the Good Health Good Heart Project under the Royal Patronage of H.M. the King, Bang Kwang Central Prison, Siam Commercial Bank, and PTT Public Company Limited.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eManna S, Tripathy S, Sah RK, Padhi BK, Kaur S, Nowrouzi-Kia B, et al. 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Validation of the Thai Version of the 14- Item Oral Health Impact Profile (Thai OHIP-14) amongst the General Thai Adult Population in a Community Setting. Journal of Health Research. 2017;31(6):481-6.\u003c/li\u003e\n\u003cli\u003eGreene JC, Vermillion JR. The Simplified Oral Hygiene Index. J Am Dent Assoc. 1964;68:7-13.\u003c/li\u003e\n\u003cli\u003eBaishya B, Satpathy A, Nayak R, Mohanty R. Oral Hygiene Status, Oral Hygiene Practices and Periodontal Health of Brick Kiln Workers of Odisha. J Indian Soc Periodontol. 2019;23(2):163-7.\u003c/li\u003e\n\u003cli\u003eHaq ZU, Nawaz K, Alam S, Khattak FA, Ullah N, Ahmed, et al. Oral Health Behind the Bars: Oral Health Seeking Behavior among Jail Prisoners at Central Jail of Peshawar, Pakistan: a Cross-Sectional Study. BMC Oral Health. 2023;23(1):979.\u003c/li\u003e\n\u003cli\u003eSoares M, Goncalves M, Rompante P, Salazar F, Monteiro L, Pacheco JJ, et al. Assessment of Oral Health Status in a Prison Population in Northern Portugal. J Clin Exp Dent. 2023;15(11):e912-e9.\u003c/li\u003e\n\u003cli\u003eNobile CG, Fortunato L, Pavia M, Angelillo IF. Oral Health Status of Male Prisoners in Italy. Int Dent J. 2007;57(1):27-35.\u003c/li\u003e\n\u003cli\u003eOsborn M, Butler T, Barnard PD. Oral Health Status of Prison Inmates--New South Wales, Australia. Aust Dent J. 2003;48(1):34-8.\u003c/li\u003e\n\u003cli\u003eCauses of Death Collaborators, GBD 2023. Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406(10513):1811-72.\u003c/li\u003e\n\u003cli\u003eOffice of Dental Health Policy Ministry of Public Health. The 9th Thai National Oral Health Survey, 2023 (in Thai): Bureau of Dental Health, Department of Health; 2024. Available from: https://dental.anamai.moph.go.th/web-upload/5x9c01a3d6e5539cf478715290ac946bee/202406/m_magazine/36716/4952/file_download/f983389ded6e5dccbfe6f3362a453364.pdf.\u003c/li\u003e\n\u003cli\u003eThongchotchat V, Sutthiboonyapan P, Porntaveetus T, Wiriyakijja P. Relationship between periodontal health-related knowledge, belief, and behaviors: a structural equation modeling approach. BMC Oral Health. 2025;25(1):1244.\u003c/li\u003e\n\u003cli\u003eMcGrath C. Oral Health Behind Bars: A Study of Oral Disease and Its Impact on the Life Quality of an Older Prison Population. Gerodontology. 2002;19(2):109-14.\u003c/li\u003e\n\u003cli\u003eIosif L, Preoteasa CT, Preoteasa E, Ispas A, Ilinca R, Murariu-Mǎgureanu C, et al. Oral Health Related Quality of Life and Prosthetic Status among Institutionalized Elderly from the Bucharest Area: A Pilot Study. Int J Environ Res Public Health. 2021;18(12).\u003c/li\u003e\n\u003cli\u003eKhongsirisombat N, SK, PS, RA, NO, ST. Oral Health-related Quality of Life in Thai Older People with Metabolic Syndrome. Journal of the Dental Association of Thailand. 2021:14.\u003c/li\u003e\n\u003cli\u003eASEAN Mental Disorders Collaborators, GBD 2021. The epidemiology and burden of ten mental disorders in countries of the Association of Southeast Asian Nations (ASEAN), 1990-2021: findings from the Global Burden of Disease Study 2021. Lancet Public Health. 2025;10(6):e480-e91.\u003c/li\u003e\n\u003cli\u003eSomsak K, Kaewplung O. The Effects of the Number of Natural Teeth and Posterior Occluding Pairs on the Oral Health-Related Quality of Life in Elderly Dental Patients. Gerodontology. 2016;33(1):52-60.\u003c/li\u003e\n\u003cli\u003eKaewkamnerdpong I, Harirugsakul P, Prasertsom P, Vejvithee W, Niyomsilp K, Gururatana O. Oral Status is Associated with Chewing Difficulty in Thai Older Adults: Data from a National Oral Health Survey. BMC Oral Health. 2023;23(1):35.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"clinical-oral-investigations","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"cloi","sideBox":"Learn more about [Clinical Oral Investigations](http://link.springer.com/journal/784)","snPcode":"784","submissionUrl":"https://submission.nature.com/new-submission/784/3","title":"Clinical Oral Investigations","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Dentition, Oral health, Healthcare access, Incarceration, Older inmates, Prison","lastPublishedDoi":"10.21203/rs.3.rs-8636082/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8636082/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003e This study aimed to comprehensively assess the oral health status and oral health-related quality of life (OHRQoL) among older Thai prisoners and to identify key determinants influencing these outcomes, particularly within the context of long-term incarceration. Ultimately, we sought to inform targeted interventions to improve the holistic well-being of this vulnerable population.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted among 141 older prisoners (aged\u0026thinsp;\u0026ge;\u0026thinsp;60 years) at Bang Kwang Central Prison, Thailand. Data included socio-demographics, physical health, and validated mental health indicators. Clinical oral examinations were conducted to assess oral hygiene, dental caries, periodontal status, and prosthetic needs. Bivariate analyses and multivariate logistic regression identified factors associated with OHRQoL.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe cohort (mean age: 69.26 years) exhibited severe oral health burdens, including poor oral hygiene (mean Oral Hygiene Index: 3.38), high caries prevalence (mean decayed teeth: 1.72), and limited occluding pairs (mean: 4.91). Multivariate analysis revealed that long-term incarceration (\u0026ge;\u0026thinsp;10 years; Adjusted Odds Ratio (AOR)\u0026thinsp;=\u0026thinsp;2.58, p\u0026thinsp;=\u0026thinsp;0.028) and depressive symptoms (AOR\u0026thinsp;=\u0026thinsp;4.12, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significant, independent predictors of lower OHRQoL.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOlder incarcerated individuals in Thailand face pervasive poor oral health and diminished OHRQoL. Long-term incarceration and depressive symptoms are critical, modifiable determinants.\u003c/p\u003e\u003ch2\u003eClinical Relevance:\u003c/h2\u003e \u003cp\u003eThese findings underscore an urgent need for integrated oral health services and mental health support within correctional facilities, prioritizing this vulnerable geriatric population to mitigate health disparities and improve their overall quality of life during and after incarceration.\u003c/p\u003e","manuscriptTitle":"Oral Health Burden and Determinants of Oral Health-Related Quality of Life Among Geriatric Incarcerated Individuals: A Cross-Sectional Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-27 17:51:54","doi":"10.21203/rs.3.rs-8636082/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-06T12:10:56+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-07T13:24:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"205286813023364426157194377312543235836","date":"2026-01-30T14:36:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"237773511032891581595106012081506381169","date":"2026-01-30T12:50:21+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-27T12:02:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"27071619110482446375242777202963997183","date":"2026-01-25T17:53:04+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-22T11:25:08+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-20T11:10:30+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-20T11:07:14+00:00","index":"","fulltext":""},{"type":"submitted","content":"Clinical Oral Investigations","date":"2026-01-19T07:06:22+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"clinical-oral-investigations","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"cloi","sideBox":"Learn more about [Clinical Oral Investigations](http://link.springer.com/journal/784)","snPcode":"784","submissionUrl":"https://submission.nature.com/new-submission/784/3","title":"Clinical Oral Investigations","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"f35bae3c-6ccb-4909-930e-2b6a27bd53b2","owner":[],"postedDate":"January 27th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-06T12:10:56+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-06T12:26:42+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-27 17:51:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8636082","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8636082","identity":"rs-8636082","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}