Quality of Life and Oral Health among Older People in Southeast Asia: A Scoping Review

Quality of Life and Oral Health among Older People in Southeast Asia: A Scoping Review | 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 Systematic Review Quality of Life and Oral Health among Older People in Southeast Asia: A Scoping Review Wasinee Kiatadisorn This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6773219/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives to determine the relationship between oral health and quality of life with different assessments among older adults in Southeast countries and explore the facilitators and barriers to oral health accessibility. Materials and Methods Using the key terms "oral health," "quality of life," and "older people" in Southeast Asia. The online literature search was carried out from four electronic databases: CINAHL, Web of Science, Google Scholar, and the University of Southampton library services. Results The qualified articles were chosen, scrutinized, and summarized with critical quality assessment. As a result, from 1,061 search results, 24 original articles were selected from eight ASEAN nations—Brunei, Indonesia, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam. The Geriatric Oral Health Assessment Index (GOHAI) and Oral Impact on Daily Performance (OIDP) were the two oral health-related quality of life (OHrQoL) indices that were mostly used in these eligible publications. Based on the outcomes, they showed that oral health behaviors, socioeconomic status, dental health status (e.g., quality of prostheses, number of remaining functional teeth), and health perceptions were associated with the quality of life of older persons. Additionally, financial limitations, inadequate dental staff, treatment standards, and insufficient integration between oral and general health were the barriers to oral health accessibility. Conclusions Oral health-related quality-of-life assessments could be combined with general health assessments in both community dwellings and institutionalized older adults to solve oral health issues and increase well-being in later life. oral health-related quality of life older people oral healthcare accessibility Southeast Asia Figures Figure 1 Introduction “Association of Southeast Asian Nations” or “ASEAN” is a regional organization that includes disparate neighbors in Southeast Asia to address economic and human security issues (Council on Foreign Relations, 2022 ). 1 It was expected that all Southeast countries would reach a completely aged society by 2050, with a growing number of individuals over 65 (United Nations, 2022). 2 Consequently, there will be challenges, and it is important to establish strategies for economic, health, and security sustainability for aged society preparation. Maintaining oral health is essential because overall health and oral health are inextricably related, especially in older people. (Razak et al., 2014 ). 3 There are relationships between systemic disorders and oral diseases that may develop into more serious conditions when people become older (Meyerowitz, 1991 ). 4 Oral health dysfunction has a detrimental effect on the quality of life, and poor oral health affects people as individuals, families, communities, and societies 5,6 Oral health issues are a major public health burden in older populations( WHO,2022). Access to oral healthcare is unevenly distributed among older adults throughout Southeast Asia. 5 Following the WHO Action Plan for Oral Health (2022–2030), dental care services should be arranged by Universal Health Coverage for individuals, and oral health screenings should be combined in geriatric and noncommunicable disease (NCD) clinics. 5 Hence, strengthening the policy for oral health promotion is required to eliminate the gap in healthcare access that affects older people and vulnerable persons. Thus, understanding the differences and varieties in oral health services and the relationship between oral health outcomes and quality of life among older people in ASEAN countries will be the main points of this paper. There are various economic statuses and healthcare systems in ASEAN countries. Moreover, there was still a low rate of oral healthcare access among older people in Southeast Asia. (Chongsuvivatwong, et al., 2011 ). 7 Comparing the data on oral healthcare services and well-being in Southeast Asia should be explored to find the determinants for improving oral healthcare accessibility and raising equity among older adults. The primary objective of this research is to identify the oral health status and relative factors that are associated with older people's quality of life. Second, this paper also clarified the facilitators and barriers to access to oral health services among older adults in ASEAN countries. Method This scoping literature review was conducted in 2022 from 4 different digital databases which were Web of Science Core Collection, CINAHL Plus with Full Text (Cumulative Index of Nursing and Allied Health Literature), Google Scholar, and Library services of the University of Southampton. The main key terms were "Oral Health," "Quality of Life," and "Old* person*" in the "Southeast Asia” region setting. Inclusion : Articles that were published from 1990 onwards. Referring to the original parameter of Oral health-related quality of life: GOHAI (Geriatric Oral Health Index) was assessed and published in that year (Atchinson and Dolan, 1990) 8 . Studies related to dependent and independent older adults (aged more than 60), including dental and healthcare staff in healthcare services and nursing homes, were included. All articles must include references and proper citations. Exclusion The articles had no method shown in the papers. The researches were conducted with a sample size or population who did not hold Southeast Asian nationalities or live in their native countries not in ASEAN, such as Japanese older residents in care homes were excluded. 9 The process of analysis was adopted from the literature reviews of Astvaldsdottir and colleagues (2017) 10 and Hawker et al . (2002) 11 . After assessing all papers, the qualitative synthesis will be evaluated. The different dental health measurements that have been used in oral health research were grouped, for example, such as GOHAI (Geriatric Oral Health Index), OHIP (Oral Health Impact Profile), OHAT (Oral Health Assessment Tool), and OIDP (Oral Health Impact on Daily Performance) (Sischo and Broder, 2011 ). 12 Then, after synthesizing and categorizing all eligible papers, the assessments and key points would be analyzed and compared in each country in Southeast Asia. Results From 1,061 initial searches, the final search yielded 24 articles from 8 different countries: Brunei (1 article), Indonesia (2 articles), Malaysia (4 articles), Myanmar (2 articles), the Philippines (2 articles), Singapore (4 articles), Thailand (7 articles), and Vietnam (2 articles). However, no publications in Lao and Cambodia matched this research's inclusion criteria. Most research articles were published from 2011 to the present and conducted mainly with quantitative methods. According to the assessment criteria of Hawker et al. (2002), there were 17 good-quality articles, five fair-quality articles, and two very poor proceeding papers from the overall assessment (see the details in Table 1 ). As the first research objective, many measurements have determined the OHrQoL assessment in older adults, which included the Geriatric Oral Health Assessment Index (GOHAI), the Oral Health Impact Profile-14 (OHIP-14), Oral Impacts on Daily Performance (OIDP), and the 10-item Eating Assessment Tool (EAT-10). After analyzing 16 of 24 articles that mentioned oral health-related quality of life measurements and related determinants. The OHrQoL indices were selected depending on the research purposes and the different groups of participants such as long-term care older people, denture users, and community-dwelling older adults. Each index had unique methods for assessment individually in oral health function and patient satisfaction. The majority of published papers show the leading impacts of oral health problems caused the difficulty in eating, chewing, and verbal communication, and oral diseases could lead to undernutrition which was related to their general health and quality of life. (See in Table 1 .) Table 1 Comparison of OHrQoL assessment in different ASEAN nations and critical appraisal assessment OHrQoL Authors/ Year/ Country Mean Scores Key Results Quality Assessment * GOHAI Agustina et al. , 2022/ Indonesia 13 45.5 ± 9.52 Dry mouth condition and posterior occluding teeth had impacted on quality of life. 13 Fair Utami and Yulianti, 2021 / Indonesia 14 Not mention A higher prevalence of dental cavities significantly lowered quality of life 14 Very Poor Rosli et al., 2019 /Malaysia 15 53.3 ± 4.7 Poor oral health perception impacted unsatisfactory Body Mass Index (BMI) and OHrQoL. 15 Good Mohamad Fuad et al. ,2020/Malaysia 16 51.83 ± 7.98 Individual self-perception in oral and general health could be a good indicator to assess quality of life . 16 Good GOHAI Samnieng and Lekatana, 2016 / Thailand 17 49.94 Several teeth and denture wearing strongly affected quality of life. 17 Fair OHIP Kuppusamy et al./ Malaysia 18 No mention Lower-income older adults living in an urban area experienced the impact on QoL with physical and oral discomfort. Fair Patil and Seow, 2021 / Malaysia 19 14.55–19.55 Two types of implant-supported overdentures could improve older patients' OHrQoL with not significantly different outcomes. Fair Tun et al ,2018/Myanmar 20 18.7 ± 9.7 Tooth loss and increasing age affected poorer QoL. Good Htun and Peltzer., 2019/Myanmar 21 8.1 ± 0.58 Health risk factors, poor oral health status, and impaired general health related to poor OHrQol. Good OIDP Nair et al. , 2015/ Singapore 22 1.83 19% of residents reported oral problems in eating. Higher OIDP significantly came with poor health perception. Good Nair and Yee, 2016 / Singapore 23 5.08 Participants with higher OIDP scores had a lower willingness to pay for basic dental services, especially in tooth extraction. Good Somsak and Kaewplung,2014/Thailand 24 9.38 (Natural teeth ≥ 20) 16.89(Natural teeth ≤ 20) Tooth loss, types of dentures, and quality of dental prostheses (retention and stability) could be related to chewing and QoL in denture patients. Good OIDP Techapiroontong et al. , 2022/Thailand 25 No mention Unsatisfied removable denture wearers showed higher Poor OIDP scores. Good Limpuangthip et al. , 2019/ Thailand 26 No mention Chewing with pain and discomfort in denture-wearing impacted quality of life. Good EAT-10 Chaleekrua et al., 2021 /Thailand 27 Not mentioned 11.4% of older participants had swallowing problems in food sticking and choking. Good Saleedaeng et al., 2023 /Thailand 28 1.1 ± 2.3 (Undernutrition) 0.3 ± 0.9 (Normal Nutrition) Older people with dysphagia were 4.8 times undernutrition than older adults without dysphagia. Good * Good- Method is appropriate and described clearly /Fair- Method appropriate, description could be better/Poor- Questionable whether the method is appropriate. The method is described inadequately. /Very poor- No mention of method, AND/OR Method inappropriate, AND/OR No details of data (Hawker et al., 2002) Following the second objective, the supportive factors of oral healthcare accessibility came from a national health system and strategic plans (Thean et al., 2007 ; Somsak and Kaewplung, 2016 ). 29,24 In Malaysia, the government integrated oral health screening into the National Health and Morbidity Survey for older populations (Mohamad Fuad et al., 2020 ). 16 Besides, Singapore also strengthened oral care plans with a seamless collaborative care team for an increasing number of older dependent patients (Tada et al., 2023 ). 30 However, financial issues were one of the common barriers to oral health services in older people in ASEAN nations. Additionally, there were not only poor perceptions and beliefs that limit dental visits (Nguyen et al., 2018; Htun and Peltzer, 2019 ) 21,31 , but transport barriers to nearby dental clinics also decreased regular dental visits as well (Nguyen et al. , 2018) 31 . In dependent older people, inadequate numbers of staff, and oral health knowledge of non-dental nursing staff in the care homes were also barriers to dental services provision. 29,31 In the Philippines, guidelines for oral care practices, assessments, and surveillance were still needed for institutionalized older people. 32 Discussion From the first research question, this part compared the relationship between oral health and quality of life to other studies. The reason for using these Oral Health-related Quality of Life indicators depended on the research’s objectives, precision, reliability, and validity of tools (da Mata et al. , 2018). 33 Similarly, this study showed the comparison of OHrQoL in different dependency levels of older adults in multiple settings with different purposes. In China, Wang et al. ( 2022 ) proved that there was a significant association between OHrQoL scores (GOHAI), and life satisfaction scores among older Chinese older migrants. 34 Notably, the means GOHAI scores in Chinese were 54.95, close to the average scores (45–59) of this dissertation in ASEAN countries (See Table 1 .). Comparing the OHrQoL assessment in India, Dhama et al. (2018) showed that the GOHAI and OIDP scores were influenced by oral motor activities such as eating and speaking. 35 Likewise, many studies in this literature review showed dental status problems related to chewing and eating function. Also, older people with a lower OHrQoL score showed more difficulties in deglutition and swallowing. From the second research question, in South Africa, Low SES groups of pensioners had less dental services access and presented poor oral health status with a high prevalence of dental caries, and periodontal disease (Molete et al., 2014 ). 36 The causes of barriers in oral care came from transport, out-of-pocket payment, living in remote areas, advancing ages, and inadequate social support. Similarly, in Southeast Asia, older adults avoided dental appointments because of individual factors such as financial difficulty, or living far from dental clinics 31 There are some limitations in this literature review. Some studies needed cohort or longitudinal studies to determine the clinical outcome and the implementation in older adults with different dependency levels (Patil and Seow, 2021 ). 19 Furthermore, there were specific sampling techniques, such as purposive and convenient sampling, in a few selected articles 20,31 ; it needs further studies with larger sample sizes to represent each country's population. Conclusion Two main OHrQoL indices applied in the eligible articles were from the Geriatric Oral Assessment Index (GOHAI) and Oral Health Impact on Daily Performance (OIDP). The purposes for the selected OHrQoL assessment related to the dimension of oral health patterns, type of dependency, area or setting, and other social factors. In the last decade, researchers were concerned more about swallowing or deglutition patterns in older participants with long-term care found both in Thailand and Singapore which share higher life expectancy compared to other nations. To explore oral healthcare access facilitators and barriers, ASEAN older people still needed financial support for dental treatment, availability of dental staff, transport to nearby dental services, and motivations to dental awareness among misbeliefs or poor oral health perceptions in older adults. Declarations Ethical Approval: Not applicable, as this study is a literature review and does not involve human or animal subjects. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Author Contribution I conceptualized the study with all process in the literature review and drafted the manuscript.. critically revised the manuscript. Acknowledgments The author expresses gratitude to>>>>>>>>>>>>>>>>>>>>>, and the supporting staff at the University of >>>>>>>>>>>>>>>>>>>>>>>for their guidance and thoughtful assistance during the study period. A part of this study was conducted in an MSc Dissertation within the Department of Gerontology, University of >>>>>>>>>>>>>>>>> References Agustina, D., Hanindriyo, L., Chrismawaty, B. E., & Naritasari, F. (2023). Oral conditions as risk factors for low oral health-related quality of life among the elderly population in Yogyakarta, Indonesia. *European Journal of Dentistry , 17* (2), 504–510. Ástvaldsdóttir, Á., Boström, A., Davidson, T., & Gabre, P. (2018). Oral health and dental care of older persons—A systematic map of systematic reviews. *Gerodontology 35* , (4), 290–304. https://doi.org/10.1111/ger.12368 Chaleekrua, S., Janpol, K., & Wattanapan, P. (2021). Swallowing problems among community-dwelling elderly in Northeastern Thailand. *Journal of Primary Care & Community Health, 12*, 21501327211019596. https://doi.org/10.1177/21501327211019596 Chongsuvivatwong, V., Phua, K. H., Yap, M. T., Pocock, N. S., Hashim, J. H., Chhem, R. (2011). 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The dental awareness of nursing home staff in Singapore – A pilot study. Gerodontology , 24 (1), 58–63. Tun, K., Aung, P., Oo, M., & Ko, K. (2018). Oral health-related quality of life and a number of remaining teeth among elderly in Tha-bar-wa center, Thanlyin Township, Yangon, Myanmar. Journal of International Oral Health , 10 (6), 293. Wang, J., Zhao, J., Tian, T., Jiang, X., Li, H., Pang, M., & Kong, F. (2022). The effects of oral health and social support on health-related quality of life of migrant older with children in Weifang, China. Bmc Public Health , 22 (1), 1505. https://doi.org/10.1186/s12889-022-13843-0 World Health Organization (2022). Action plan for oral health in Southeast Asia 2022–2030. https://www.who.int/publications-detail-redirect/9789290210061 World population prospects 2022 Summary of results | population division. https://www.un.org/development/desa/pd/content/World-Population-Prospects-2022 Additional Declarations No competing interests reported. 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(Razak et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). \u003csup\u003e3\u003c/sup\u003e There are relationships between systemic disorders and oral diseases that may develop into more serious conditions when people become older (Meyerowitz, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e1991\u003c/span\u003e).\u003csup\u003e4\u003c/sup\u003e Oral health dysfunction has a detrimental effect on the quality of life, and poor oral health affects people as individuals, families, communities, and societies \u003csup\u003e5,6\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eOral health issues are a major public health burden in older populations( WHO,2022). Access to oral healthcare is unevenly distributed among older adults throughout Southeast Asia. \u003csup\u003e5\u003c/sup\u003e Following the WHO Action Plan for Oral Health (2022\u0026ndash;2030), dental care services should be arranged by Universal Health Coverage for individuals, and oral health screenings should be combined in geriatric and noncommunicable disease (NCD) clinics.\u003csup\u003e5\u003c/sup\u003e Hence, strengthening the policy for oral health promotion is required to eliminate the gap in healthcare access that affects older people and vulnerable persons.\u003c/p\u003e\u003cp\u003eThus, understanding the differences and varieties in oral health services and the relationship between oral health outcomes and quality of life among older people in ASEAN countries will be the main points of this paper. There are various economic statuses and healthcare systems in ASEAN countries. Moreover, there was still a low rate of oral healthcare access among older people in Southeast Asia. (Chongsuvivatwong, et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003csup\u003e7\u003c/sup\u003e Comparing the data on oral healthcare services and well-being in Southeast Asia should be explored to find the determinants for improving oral healthcare accessibility and raising equity among older adults. The primary objective of this research is to identify the oral health status and relative factors that are associated with older people's quality of life. Second, this paper also clarified the facilitators and barriers to access to oral health services among older adults in ASEAN countries.\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003eThis scoping literature review was conducted in 2022 from 4 different digital databases which were Web of Science Core Collection, CINAHL Plus with Full Text (Cumulative Index of Nursing and Allied Health Literature), Google Scholar, and Library services of the University of Southampton. The main key terms were \"Oral Health,\" \"Quality of Life,\" and \"Old* person*\" in the \"Southeast Asia\u0026rdquo; region setting.\u003c/p\u003e\u003cp\u003e\u003cem\u003eInclusion\u003c/em\u003e: Articles that were published from 1990 onwards. Referring to the original parameter of Oral health-related quality of life: GOHAI (Geriatric Oral Health Index) was assessed and published in that year (Atchinson and Dolan, 1990) \u003csup\u003e8\u003c/sup\u003e. Studies related to dependent and independent older adults (aged more than 60), including dental and healthcare staff in healthcare services and nursing homes, were included. All articles must include references and proper citations.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eExclusion\u003c/strong\u003e\u003cp\u003eThe articles had no method shown in the papers. The researches were conducted with a sample size or population who did not hold Southeast Asian nationalities or live in their native countries not in ASEAN, such as Japanese older residents in care homes were excluded. \u003csup\u003e9\u003c/sup\u003e\u003c/p\u003e\u003c/p\u003e\u003cp\u003eThe process of analysis was adopted from the literature reviews of Astvaldsdottir and colleagues (2017) \u003csup\u003e10\u003c/sup\u003e and Hawker \u003cem\u003eet al\u003c/em\u003e. (2002)\u003csup\u003e11\u003c/sup\u003e. After assessing all papers, the qualitative synthesis will be evaluated. The different dental health measurements that have been used in oral health research were grouped, for example, such as GOHAI (Geriatric Oral Health Index), OHIP (Oral Health Impact Profile), OHAT (Oral Health Assessment Tool), and OIDP (Oral Health Impact on Daily Performance) (Sischo and Broder, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003csup\u003e12\u003c/sup\u003e Then, after synthesizing and categorizing all eligible papers, the assessments and key points would be analyzed and compared in each country in Southeast Asia.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eFrom 1,061 initial searches, the final search yielded 24 articles from 8 different countries: Brunei (1 article), Indonesia (2 articles), Malaysia (4 articles), Myanmar (2 articles), the Philippines (2 articles), Singapore (4 articles), Thailand (7 articles), and Vietnam (2 articles). However, no publications in Lao and Cambodia matched this research's inclusion criteria. Most research articles were published from 2011 to the present and conducted mainly with quantitative methods. According to the assessment criteria of Hawker \u003cem\u003eet al.\u003c/em\u003e (2002), there were 17 good-quality articles, five fair-quality articles, and two very poor proceeding papers from the overall assessment (see the details in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAs the first research objective, many measurements have determined the OHrQoL assessment in older adults, which included the Geriatric Oral Health Assessment Index (GOHAI), the Oral Health Impact Profile-14 (OHIP-14), Oral Impacts on Daily Performance (OIDP), and the 10-item Eating Assessment Tool (EAT-10). After analyzing 16 of 24 articles that mentioned oral health-related quality of life measurements and related determinants. The OHrQoL indices were selected depending on the research purposes and the different groups of participants such as long-term care older people, denture users, and community-dwelling older adults. Each index had unique methods for assessment individually in oral health function and patient satisfaction. The majority of published papers show the leading impacts of oral health problems caused the difficulty in eating, chewing, and verbal communication, and oral diseases could lead to undernutrition which was related to their general health and quality of life. (See 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\u003eComparison of OHrQoL assessment in different ASEAN nations and critical appraisal assessment\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\"\u003e\u003cp\u003eOHrQoL\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAuthors/ Year/ Country\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean Scores\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eKey Results\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eQuality Assessment *\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGOHAI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAgustina \u003cem\u003eet al.\u003c/em\u003e, 2022/ Indonesia \u003csup\u003e13\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45.5\u0026thinsp;\u0026plusmn;\u0026thinsp;9.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDry mouth condition and posterior occluding teeth had impacted on quality of life. \u003csup\u003e13\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFair\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUtami and Yulianti, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2021\u003c/span\u003e/ Indonesia \u003csup\u003e14\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot mention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eA higher prevalence of dental cavities significantly lowered quality of life \u003csup\u003e14\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eVery Poor\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRosli et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003e/Malaysia\u003csup\u003e15\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePoor oral health perception impacted unsatisfactory Body Mass Index (BMI) and OHrQoL. \u003csup\u003e15\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMohamad Fuad \u003cem\u003eet al.\u003c/em\u003e,2020/Malaysia \u003csup\u003e16\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.83\u0026thinsp;\u0026plusmn;\u0026thinsp;7.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndividual self-perception in oral and general health could be a good indicator to assess quality of life .\u003csup\u003e16\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGOHAI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSamnieng and Lekatana, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2016\u003c/span\u003e/ Thailand \u003csup\u003e17\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSeveral teeth and denture wearing strongly affected quality of life. \u003csup\u003e17\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFair\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOHIP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKuppusamy \u003cem\u003eet al./\u003c/em\u003e Malaysia \u003csup\u003e18\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo mention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLower-income older adults living in an urban area experienced the impact on QoL with physical and oral discomfort.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFair\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePatil and Seow, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e/ Malaysia \u003csup\u003e19\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.55\u0026ndash;19.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTwo types of implant-supported overdentures could improve older patients' OHrQoL with not significantly different outcomes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFair\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTun \u003cem\u003eet al\u003c/em\u003e,2018/Myanmar\u003csup\u003e20\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.7\u0026thinsp;\u0026plusmn;\u0026thinsp;9.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTooth loss and increasing age affected poorer QoL.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHtun and Peltzer., 2019/Myanmar \u003csup\u003e21\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHealth risk factors, poor oral health status, and impaired general health related to poor OHrQol.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOIDP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNair \u003cem\u003eet al.\u003c/em\u003e, 2015/ Singapore \u003csup\u003e22\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19% of residents reported oral problems in eating. Higher OIDP significantly came with poor health perception.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNair and Yee, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2016\u003c/span\u003e/ Singapore\u003csup\u003e23\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eParticipants with higher OIDP scores had a lower willingness to pay for basic dental services, especially in tooth extraction.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSomsak and Kaewplung,2014/Thailand\u003csup\u003e24\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9.38 (Natural teeth\u0026thinsp;\u0026ge;\u0026thinsp;20)\u003c/p\u003e\u003cp\u003e16.89(Natural teeth\u0026thinsp;\u0026le;\u0026thinsp;20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTooth loss, types of dentures, and quality of dental prostheses (retention and stability) could be related to chewing and QoL in denture patients.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOIDP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTechapiroontong\u0026nbsp;\u003cem\u003eet\u0026nbsp;al.\u003c/em\u003e, 2022/Thailand \u003csup\u003e25\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo mention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUnsatisfied removable denture wearers showed higher Poor OIDP scores.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLimpuangthip \u003cem\u003eet al.\u003c/em\u003e, 2019/ Thailand \u003csup\u003e26\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo mention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eChewing with pain and discomfort in denture-wearing impacted quality of life.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEAT-10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChaleekrua et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e /Thailand \u003csup\u003e27\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot mentioned\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.4% of older participants had swallowing problems in food sticking and choking.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSaleedaeng et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2023\u003c/span\u003e/Thailand \u003csup\u003e28\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3 (Undernutrition)\u003c/p\u003e\u003cp\u003e0.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9 (Normal Nutrition)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOlder people with dysphagia were 4.8 times undernutrition than older adults without dysphagia.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003e*\u003c/b\u003eGood- Method is appropriate and described clearly /Fair- Method appropriate, description could be better/Poor- Questionable whether the method is appropriate. The method is described inadequately. /Very poor- No mention of method, AND/OR Method inappropriate, AND/OR No details of data (Hawker et al., 2002)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFollowing the second objective, the supportive factors of oral healthcare accessibility came from a national health system and strategic plans (Thean et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Somsak and Kaewplung, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). \u003csup\u003e29,24\u003c/sup\u003e In Malaysia, the government integrated oral health screening into the National Health and Morbidity Survey for older populations (Mohamad Fuad et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003csup\u003e16\u003c/sup\u003e Besides, Singapore also strengthened oral care plans with a seamless collaborative care team for an increasing number of older dependent patients (Tada et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). \u003csup\u003e30\u003c/sup\u003e However, financial issues were one of the common barriers to oral health services in older people in ASEAN nations. Additionally, there were not only poor perceptions and beliefs that limit dental visits (Nguyen et al., 2018; Htun and Peltzer, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) \u003csup\u003e21,31\u003c/sup\u003e, but transport barriers to nearby dental clinics also decreased regular dental visits as well (Nguyen \u003cem\u003eet al.\u003c/em\u003e, 2018)\u003csup\u003e31\u003c/sup\u003e. In dependent older people, inadequate numbers of staff, and oral health knowledge of non-dental nursing staff in the care homes were also barriers to dental services provision.\u003csup\u003e29,31\u003c/sup\u003e In the Philippines, guidelines for oral care practices, assessments, and surveillance were still needed for institutionalized older people.\u003csup\u003e32\u003c/sup\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eFrom the first research question, this part compared the relationship between oral health and quality of life to other studies. The reason for using these Oral Health-related Quality of Life indicators depended on the research\u0026rsquo;s objectives, precision, reliability, and validity of tools (da Mata \u003cem\u003eet al.\u003c/em\u003e, 2018). \u003csup\u003e33\u003c/sup\u003e Similarly, this study showed the comparison of OHrQoL in different dependency levels of older adults in multiple settings with different purposes. In China, Wang et al. (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) proved that there was a significant association between OHrQoL scores (GOHAI), and life satisfaction scores among older Chinese older migrants.\u003csup\u003e34\u003c/sup\u003e Notably, the means GOHAI scores in Chinese were 54.95, close to the average scores (45\u0026ndash;59) of this dissertation in ASEAN countries (See Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.).\u003c/p\u003e\u003cp\u003eComparing the OHrQoL assessment in India, Dhama \u003cem\u003eet al.\u003c/em\u003e (2018) showed that the GOHAI and OIDP scores were influenced by oral motor activities such as eating and speaking.\u003csup\u003e35\u003c/sup\u003e Likewise, many studies in this literature review showed dental status problems related to chewing and eating function. Also, older people with a lower OHrQoL score showed more difficulties in deglutition and swallowing.\u003c/p\u003e\u003cp\u003eFrom the second research question, in South Africa, Low SES groups of pensioners had less dental services access and presented poor oral health status with a high prevalence of dental caries, and periodontal disease (Molete et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003csup\u003e36\u003c/sup\u003e The causes of barriers in oral care came from transport, out-of-pocket payment, living in remote areas, advancing ages, and inadequate social support. Similarly, in Southeast Asia, older adults avoided dental appointments because of individual factors such as financial difficulty, or living far from dental clinics\u003csup\u003e31\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThere are some limitations in this literature review. Some studies needed cohort or longitudinal studies to determine the clinical outcome and the implementation in older adults with different dependency levels (Patil and Seow, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003csup\u003e19\u003c/sup\u003e Furthermore, there were specific sampling techniques, such as purposive and convenient sampling, in a few selected articles\u003csup\u003e20,31\u003c/sup\u003e; it needs further studies with larger sample sizes to represent each country's population.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eTwo main OHrQoL indices applied in the eligible articles were from the Geriatric Oral Assessment Index (GOHAI) and Oral Health Impact on Daily Performance (OIDP). The purposes for the selected OHrQoL assessment related to the dimension of oral health patterns, type of dependency, area or setting, and other social factors. In the last decade, researchers were concerned more about swallowing or deglutition patterns in older participants with long-term care found both in Thailand and Singapore which share higher life expectancy compared to other nations.\u003c/p\u003e\u003cp\u003eTo explore oral healthcare access facilitators and barriers, ASEAN older people still needed financial support for dental treatment, availability of dental staff, transport to nearby dental services, and motivations to dental awareness among misbeliefs or poor oral health perceptions in older adults.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable, as this study is a literature review and does not involve human or animal subjects.\u003c/p\u003e\n\u003ch2\u003eFunding:\u003c/h2\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eI conceptualized the study with all process in the literature review and drafted the manuscript.. critically revised the manuscript.\u003c/p\u003e\n\u003ch2\u003eAcknowledgments\u003c/h2\u003e\n\u003cp\u003eThe author expresses gratitude to\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;, and the supporting staff at the University of \u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;for their guidance and thoughtful assistance during the study period. A part of this study was conducted in an MSc Dissertation within the Department of Gerontology, University of \u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u0026gt;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAgustina, D., Hanindriyo, L., Chrismawaty, B. E., \u0026amp; Naritasari, F. (2023). Oral conditions as risk factors for low oral health-related quality of life among the elderly population in Yogyakarta, Indonesia. \u003cem\u003e*European Journal of Dentistry\u003c/em\u003e, \u003cem\u003e17*\u003c/em\u003e(2), 504\u0026ndash;510.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e\u0026Aacute;stvaldsd\u0026oacute;ttir, \u0026Aacute;., Bostr\u0026ouml;m, A., Davidson, T., \u0026amp; Gabre, P. (2018). 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Action plan for oral health in Southeast Asia 2022\u0026ndash;2030. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/publications-detail-redirect/9789290210061\u003c/span\u003e\u003cspan address=\"https://www.who.int/publications-detail-redirect/9789290210061\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld population prospects 2022 Summary of results | population division. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.un.org/development/desa/pd/content/World-Population-Prospects-2022\u003c/span\u003e\u003cspan address=\"https://www.un.org/development/desa/pd/content/World-Population-Prospects-2022\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"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":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"oral health-related quality of life, older people, oral healthcare accessibility, Southeast Asia","lastPublishedDoi":"10.21203/rs.3.rs-6773219/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6773219/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjectives\u003c/h2\u003e\u003cp\u003eto determine the relationship between oral health and quality of life with different assessments among older adults in Southeast countries and explore the facilitators and barriers to oral health accessibility.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e\u003cp\u003eUsing the key terms \"oral health,\" \"quality of life,\" and \"older people\" in Southeast Asia. The online literature search was carried out from four electronic databases: CINAHL, Web of Science, Google Scholar, and the University of Southampton library services.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe qualified articles were chosen, scrutinized, and summarized with critical quality assessment. As a result, from 1,061 search results, 24 original articles were selected from eight ASEAN nations\u0026mdash;Brunei, Indonesia, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam. The Geriatric Oral Health Assessment Index (GOHAI) and Oral Impact on Daily Performance (OIDP) were the two oral health-related quality of life (OHrQoL) indices that were mostly used in these eligible publications. Based on the outcomes, they showed that oral health behaviors, socioeconomic status, dental health status (e.g., quality of prostheses, number of remaining functional teeth), and health perceptions were associated with the quality of life of older persons. Additionally, financial limitations, inadequate dental staff, treatment standards, and insufficient integration between oral and general health were the barriers to oral health accessibility.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eOral health-related quality-of-life assessments could be combined with general health assessments in both community dwellings and institutionalized older adults to solve oral health issues and increase well-being in later life.\u003c/p\u003e","manuscriptTitle":" Quality of Life and Oral Health among Older People in Southeast Asia: A Scoping Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-08 12:35:12","doi":"10.21203/rs.3.rs-6773219/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"28351beb-6531-4e7f-8ab1-2f7c241cfa4a","owner":[],"postedDate":"July 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-08T12:35:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-08 12:35:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6773219","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6773219","identity":"rs-6773219","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}