# Multilevel analyses of oral health conditions among older adults in the All of Us Research Program

> **NIH NIH R03** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $128,191

## Abstract

Abstract
The U.S. population is rapidly aging. Americans are living longer, with more chronic conditions, and retaining
more teeth. Because of the relationships between oral and systemic conditions, there is a need for dental care
to become better integrated with primary care. Oral health inequalities in access to dental care are prevalent
among older adults. Routine dental care is not included in Medicare and large state-level variations exist in
dental Medicaid benefits. The oral health of older adults in the US is understudied due to few national large-
scale studies with longitudinal components that include medical dental, individual and community level data.
With this supplement, secondary data analysis from the national NIH All of US (AoU) Research Project will
expand information about adults age 51+ available from the longitudinal, nationally representative US Health
and Retirement Study (HRS) currently being analyzed (NIDCR R03 DE030161-02). Our R03 goals are to
study longitudinal changes in the oral health of older adults in relationship to changes in cognition, retirement,
medical, contextual, psychosocial, behavioral and dental utilization data. Both HRS and AoU datasets provide
information to link oral health status to medical conditions, demographics, lifestyle, psychosocial factors, and
overall health. The HRS and AoU both include self-report survey data. Additionally, the AoU includes clinically-
determined information from participants' electronic health records (EHR) obtained in healthcare settings. AoU
seeks to enroll diverse, traditionally under-represented groups. The AoU Controlled Tier level data includes 3-
digit ZIP code that provides access to geographical contextual information to explore social determinants of
health using multilevel analyses. Poor oral health, partial tooth loss, and edentulism among older adults
negatively affect their quality of life and functional status. An AoU analytical Controlled Tier dataset will be
constructed with 3 groups having different oral conditions based on EHR data for comparison: 1) completely
edentulous, 2) partially edentulous, and 3) evidence of being dentate (e.g., dental caries, periodontitis). The
specific aims are: AIM 1a) Tabulate the means (SD) and frequency distribution of socio-demographic factors
in Controlled Tier AoU data and medical, cognition, and social/lifestyle risk indicators from survey and EHR
data associated with these 3 dental status groups (above). Aim 1b) Develop multivariable models using these
3 dental status groups and dental utilization to determine their influence on self-rated health, cognition, and
other medical conditions (e.g., diabetes, cardiovascular disease, stroke). Aim 1c) Develop multilevel models
including contextual variables using zip code data to represent geographic regions where participants reside to
examine individual and area variations in outcomes. AIM 2: Compare AoU findings with 2018 HRS data and
assess population differences in se...

## Key facts

- **NIH application ID:** 10658463
- **Project number:** 3R03DE030161-02S1
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Jane A Weintraub
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $128,191
- **Award type:** 3
- **Project period:** 2022-08-15 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10658463

## Citation

> US National Institutes of Health, RePORTER application 10658463, Multilevel analyses of oral health conditions among older adults in the All of Us Research Program (3R03DE030161-02S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10658463. Licensed CC0.

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