Structural Equation Modeling Of Caries And Related Factors In Elderly

Caries is prevalent among the elderly and influenced by complicated factors. This study explored pathways linking socioeconomic status (SES), oral health knowledge-attitude-practice, self-rated oral health, dental visits, and dental caries status in seniors. Cross-sectional data was collected from 1,304 65-74-olds in Northeast China including oral examinations and questionnaires. We used structural equation modeling with maximum likelihood estimation and 1000 bias-corrected bootstrap iterations to analyze associations. SES directly enhanced oral health knowledge (β = 0.294, SE = 0.248, BC 95% CI [0.186, 0.325], p < 0.001) and brushing frequency (β = 0.378, SE = 0.139, BC 95% CI [0.127, 0.193], p < 0.001), while exhibiting a protective direct effect on DMFT (β = -0.133, SE = 1.530, BC 95% CI [-4.604, -3.010], p = 0.003). Self-rated oral health reduced brushing frequency (β = -0.127, SE = 0.045, BC 95% CI [-0.204, -0.138], p < 0.001) but increased DMFT (β = 0.192, SE = 0.493, BC 95% CI [1.356, 2.291], p < 0.001). Dental visit behavior mediated between SES and DMFT (indirect effect: β = -0.152, SE = 0.788, BC 95% CI [-1.009, -0.634], p < 0.001). Dental visit, SES, and self-rated oral health directly influence dental caries. The latter two are also instrumental in behavioral pathways. Overconfidence in oral health may worsen hygiene practices, underscoring the need for enhanced oral cognition. Targeted policies addressing SES disparities and KAP could reduce caries burden in elderly populations.