Oral Health Conditions, Functional Dependence, and Oral Health-Related Quality of Life in Institutionalized and Non-Institutionalized Older Adults

Global population aging requires healthcare strategies that address the needs of older adults. This cross-sectional study compared oral health conditions and functional dependence between institutionalized and non-institutionalized older adults and explored factors associated with Oral Health-Related Quality of Life (OHRQoL), measured using the Geriatric Oral Health Assessment Index (GOHAI). The sample comprised 113 older adults in Araraquara, Brazil (52 institutionalized and 61 non-institutionalized). Eligibility required preserved cognition and a Barthel Index score of 40–100; individuals with severe functional dependence, palliative care needs, major communication limitations, or cognitive impairment incompatible with the interview were excluded. Data included sociodemographic characteristics, Barthel Index, GOHAI, coronal caries experience (DMFT), Decayed and Filled Root Surfaces (DFS), number of teeth, and prosthetic needs. Institutionalized participants had a higher median age (81.0 vs. 76.0 years; p = 0.005), lower functional capacity (95.0 vs. 100.0; p < 0.001), fewer present teeth (1.5 vs. 18.0; p = 0.003), more missing teeth (30.5 vs. 14.0; p = 0.003), higher DMFT (32.0 vs. 26.0; p = 0.019), and greater need for an upper prosthesis (34.6% vs. 14.8%; p = 0.008). GOHAI did not differ significantly between groups. In an exploratory multiple linear regression model adjusted for age, functional capacity, care setting, DMFT, and prosthetic needs, higher DFS was associated with lower GOHAI (β = −0.735; 95% CI: −1.135 to −0.335; p < 0.001). Among eligible institutionalized older adults with preserved cognition and without severe functional dependence, clinical and functional indicators were poorer than among non-institutionalized participants, while perceived OHRQoL was similar between groups. These findings should not be generalized to more vulnerable long-term care residents who did not meet the eligibility criteria. The adjusted DFS association should be regarded as exploratory and require confirmation in larger longitudinal studies.