Clinical, behavioral, and socio-economic determinants of self-perceived oral health

Background

Self-perceived oral health (SPOH) is a meaningful indicator of oral health, complementing clinical measures by capturing individuals’ subjective assessment. This study examined clinical, behavioral, general health, and socio-economic determinants of SPOH in the Belgian population.

Methods

National representative data were obtained from the OHDRES 2023–2024 cross-sectional survey, linking questionnaire data, standardized oral examinations, and administrative healthcare records. The analysis included 1,245 participants aged ≥15 years. SPOH was dichotomized (good vs poor) and analyzed using weighted logistic regression with multiple imputation for handling missing data. Adjusted models controlled for socio-demographic factors.

Results

Overall, 63.5% reported good SPOH. Poor SPOH was strongly associated with worse clinical status, including tooth loss (1–9 teeth vs ≥ 28: OR 0.26, 95% CI 0.17-0.39), caries experience (DMFT upper categories vs 0: OR 0.14-0.18; p < 0.001), and periodontal disease (DPSI>2 vs ≤ 2: OR 0.79, CI 0.66-0.93). Oral symptoms, such as toothache, bleeding gums, and other oral pain/inconveniences, were all strongly associated with SPOH (OR 0.29-0.49; p < 0.001). Poor general health perception, smoking, low toothbrushing frequency and irregular dental attendance were also linked to lower odds of good SPOH. Only perceived financial difficulties and region were significantly associated with SPOH; age, sex, and education were not. Dento-facial anomalies were associated with better SPOH (OR 1.35, CI 1.15-1.58).

Conclusions

SPOH is strongly associated with clinical oral health status, oral symptoms, behavioral factors, and general health perception, while socio-economic factors were partly evident. The strong associations with largely preventable conditions highlight the need for sustained investment in preventive strategies, including early detection and promotion of healthy behaviors to improve both objective and perceived oral health outcomes.

Key messages

• Self-perceived oral health is strongly associated with clinical oral health status, oral symptoms, behavioral factors, and general health perception.

• Strong associations with largely preventable conditions highlight the need for sustained investment in preventive strategies, including early detection and promotion of healthy behaviors.