Comparison of Oral Health Ratings by Dentists and Dentate Elders


  • This study is part of a larger project funded by the Office of Research and Demonstrations, US Health Care Financing Administration (HCFA), #95-C- 99165/9–01. The total (direct and indirect) costs of the six-year project, which ends April 30, 1994, are estimated to be $1,932,000. Total reimbursements for Medicare-waivered services were $404,300. HCFA is funding 100 percent of the total costs. Dr. Atchison was supported by the Bureau of Health Professions, Mid-Career Training Program in Geriatric Medicine and Dentistry. A Biomedical Research Support Grant provided through the UCLA School of Dentistry also supported this study. Disclaimer: Interpretations of the data are the authors' own and do not necessarily represent the official opinion of the Health Care Financing Administration.

Send correspondence and reprint requests to Dr. Atchison, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90024–1668. A paper was presented on July 2, 1992, at the International Association of Dental Research meeting, Glasgow, Scotland.


Previous studies suggest a discrepancy between the way dentists and patients measure oral health. The purpose of this study was to determine the relationship between a dentist's rating of an older dentate person's oral health and the patient self-rating using a single-item indicator, and to compare the clinical (i.e., number of teeth, caries, etc.) and subjective (problems with function, pain, etc.) factors that influence the rating. The study sample consisted of 776 older dentate people. Results showed that dentists judged subjects' oral health significantly more positively than the self-ratings. Approximately 30 percent of the elders rated their oral health identically to the dentist and half rated their oral health lower than the dentist. Bivariate comparisons showed that similar clinical and subjective variables were associated with the dentist and patient ratings. Multiple regression findings, however, highlighted differences in the factors that influenced the ratings. In addition, the proportion of variance accounted for by the clinical factors as opposed to the subjective factors was greater for the dentist rating (R2=.28 of.33) than the subject self-rating (R2=.18 of.43).