Oral health impacts and socioeconomic inequalities in disability and quality of life: A population-based study

To examine whether oral health impacts function as a pathway linking socioeconomic position to functional disability and multidimensional quality of life in a nationally representative Chilean sample, we conducted a cross-sectional population-based analysis using complex survey methods and mediation modelling. Data were obtained from a national population-based household survey in Chile and included 16,590 non-institutionalized individuals aged 15 years and older, representing approximately 16.2 million individuals in the Chilean population after application of survey weights. Main outcome measures were oral health-related quality of life (OHIP-7), self-reported functional disability, and WHOQOL-BREF physical, psychological, social, and environmental domains. Pronounced socioeconomic gradients were observed in oral health impacts. Individuals in the highest education and income strata had significantly lower odds of high oral health impact (OR = 0.39 and 0.33, respectively, p < .001). High oral health impact was strongly associated with functional disability (OR = 3.85, p < .001) and with lower scores across all WHOQOL-BREF domains (physical B = −10.58, psychological B = −7.19, social B = −8.52, environmental B = −7.04, all p < .001). Inclusion of OHIP attenuated associations between socioeconomic indicators and disability. Monte Carlo simulations indicated statistically significant indirect effects of education and income on disability and quality-of-life domains through oral health impact. Oral health impacts are socially patterned and closely linked to functional disability and multidimensional quality of life. Findings are consistent with the interpretation that oral conditions may contribute to broader socioeconomic gradients in functioning and well-being, supporting the integration of oral health within primary care and health equity strategies.