Development of a Geriatric Oral Health Vulnerability Score (GOHVS) and Its Association with Functional Tooth Loss in Older Adults: A Cross-Sectional Study

Background Oral health is a critical component of healthy ageing, yet many older adults postpone dental visits until oral diseases reach an advanced stage. This study aimed to describe the oral health status, multimorbidity, and hygiene behaviours among first-time dental attendees aged 65 years and older. Furthermore, it sought to identify predictors of functional tooth loss, defined as having fewer than 20 teeth, and to develop a composite risk index - the Geriatric Oral Health Vulnerability Score (GOHVS) - to facilitate early identification of individuals at increased risk of oral health decline. Methods Records of 361 patients (mean age 69.9 ± 5.9 years; 61.8% female) presenting for their first dental visit at a university clinic were retrospectively analysed. Data on systemic conditions, hygiene practices and periodontal status were extracted. Multivariable Poisson regression with robust variance estimated adjusted prevalence ratios (aPR) for functional tooth loss. Model discrimination was assessed using receiver operating characteristic (ROC) analysis. Results Hypertension (58%) and diabetes (20%) were the most common comorbidities. Periodontitis affected 54% of participants, and 48% lacked a functional dentition. Toothbrushing < 2×/day (aPR = 1.41, p = 0.001), absence of interdental cleaning (aPR = 1.27, p = 0.019), irregular dental attendance (< 1×/year; aPR = 1.29, p = 0.006), smoking (aPR = 1.36, p = 0.010) and multimorbidity (≥ 2 chronic diseases; aPR = 1.33, p = 0.002) were independent predictors. The GOHVS, integrating these five factors, demonstrated acceptable discrimination for functional tooth loss (AUC = 0.76). Conclusions Poor oral hygiene behaviours and multimorbidity are key determinants of functional tooth loss in older adults. The GOHVS offers a simple, data-driven tool for identifying high-risk individuals and guiding preventive interventions in geriatric dentistry.