Title:
Happiness, subjective and objective oral health status, and oral health behaviors among Korean elders.

Abstract:
This study aims to comprehensively assess the association of subjective and objective oral health status and oral health behaviors with happiness, under consideration of demographic, socioeconomic, and general health-related factors. This study also aims to test whether subjective oral health outcomes are better predictors of happiness compared with objective oral health outcomes.
The data were collected from 479 community-dwelling elders aged 65 years or over selected by a cluster sampling method. A questionnaire and an oral examination were implemented. A multiple regression method was conducted to assess associations with happiness index (HI).
The mean age of the elders was 74.6 years. Mean (standard deviation, SD) HI, EuroQol-visual analog scale (EQ-VAS) and 14-item oral health impact profile (OHIP-14) index were 5.7 (SD 2.3), 59.8 (SD 21.1), and 16.3 (SD 13.1). In the final model, a significant association with HI of the OHIP-14 index (P = 0.091) among all the participants and significant associations of oral symptoms (P = 0.038), wearing a removable denture (P = 0.039), and of the oral health behavior of daily toothbrushing (P = 0.007) among poorer oral health QoL group were confirmed under consideration of other related factors. While correlations of HI to subjective measures of health, EQ-VAS and OHIP-14 score were moderate to weak, those to objective measures of health were only weak or insignificant.
Oral impacts which might persistently affect one's daily life need to be considered in designing and delivering public services aimed to promote people's happiness. With oral health impacts and behaviors accounting for 10% of happiness among elders, public and community services for the elderly that support oral health and daily toothbrushing for the dentate are critical for the well-being of our elders.